Atlas of Complicated Abdominal Emergencies : Tips on by Ti Thiow Kong, Davide Lomanto

By Ti Thiow Kong, Davide Lomanto

This booklet is novel in that it's a unmarried quantity supplying precious useful advice within the functionality of the large diversity of techniques utilized by gastroenterologists, interventional radiologists and surgeons within the present administration of advanced belly emergencies and anxious accidents. Emphasis is put on useful counsel that may be life-saving.

The participants are skilled employees participants from the nationwide collage medical institution, Singapore. via a step by step narrative and an abundance of scientific illustrations, the individuals impart to the reader how most sensible to accomplish and conquer problems encountered within the administration of complex belly emergencies. studying is more desirable by way of movies of strategies recorded reside, within the DVD-ROM that accompanies the book.

Readership: Surgeons less than education and specialists in surgical procedure; gastroenterologists, and radiologists.

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Extra resources for Atlas of Complicated Abdominal Emergencies : Tips on Laparoscopic and Open Surgery, Therapeutic Endoscopy and Interventional Radiology (with DVD-ROM)

Sample text

Esomeprazole), and there is no current evidence to favour the use of one drug over the other. Proton pump inhibitors (such as omeprazole) are given as an infusion. The loading dose of 80 mg of PPI is administered first, followed by an infusion of 8 mg/ hour of PPI. 5 Starting PPI infusion before endoscopy has been shown to downstage the high-risk stigmata seen at endoscopy and result in faster resolution of bleeding. 10 Lesions which are Forrest IIb and above should continue with PPI infusion, while lesions which are Forrest IIc and below can be treated with oral PPI therapy.

One advantage of airway protection is that it facilitates repositioning of the patient when the source of bleeding is submerged under or obscured by blood. Positioning the patient’s body 45 degrees head 3/4/2014 2:15:14 PM b1397 Atlas of Complicated Abdominal Emergencies 34 Atlas of Complicated Abdominal Emergencies up, rotating to supine or right lateral may sometimes improve visibility by pooling blood and clots away, revealing the source of the bleeding. These manoeuvers, with the exception of positioning the patient’s head up, should be performed only after intubation.

Cold snare removal of the adherent clot. These lesions (graded Forrest IIc and below) can be treated solely with medical therapy. Once the bleeding source is identified, haemostasis is applied through one or more of the following methods as described below. Epinephrine injection Epinephrine injection is a useful method to induce haemostasis for both arterial and venous bleeding. However, the effects and duration of action of epinephrine are temporary. A meta-analysis of randomised controlled trials has indicated that when epinephrine injection therapy is combined with a second modality of haemostatic therapy (see below), the re-bleeding, emergency surgery and mortality rates are reduced.

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