O@'s Hy all all a @ books.google.co.sm/bosks' BR) oo ‘Aadtomy rary witerevtew pagesy <> o- feat to for a 20year oldman prerent to the emergency department complaining of ane andlowerback prin fr the previous 3h ld mam present with «2-day story jdomen and ha potent has vomited tr stbdomen, he hash (PL ivesricanions 1 What is the likely ding 2 What are the dtfn fr this condition?O@'Re Sil all 1) — @ books. google.co.sm/books BBS co ncctomymray — wnteren mee <)>] | Oe feat to for a 20year oldman prerent to the emergency department complaining of ane andlowerback prin fr the previous 3h ANSWER 2 coe Gnd eartation ici [EB ite rontalasgnores of cit appendices psa, Ambien shoul be iv ihe diagnose cea ad to avoid systemic ticity, The appendix cambe removed ral 2 the sme of the operation, the small bowe!| should be ce aMO@'he 1 GZ) 20:12 1) — @ books. google.co.sm/books Ce ed moss <>) feat to for a 20year oldman prerent to the emergency department complaining of ane andlowerback prin fr the previous 3h History ‘You are asked 8 review 4 72-year-dl mi on thé orthopaedic ward. He had & hemlartheo. wen well initially but has now developed platy of his ight hip 6 days earlier, He was Significant abdominal distension, He has not opcned his howls or passed Rtas forthe past 4 days Ls previous medical history inclades treatment fora trast sma of the blader and an appendicactomy, He i also known to havea hiatus hernia, He gave op smoking 6 months ay call cari Examination Tis blood pressure i 114/88 mit dd puke rates 98min. The abdomen i significantly ds tendod with mild generalized tenderness The abdomen stesonant to persuston and sounds ate heutd,Thereace no hernias sed dial rectal examination reveal an empty estur. 5 ?mmol BjmoV Fin x acl i portormec! Sis shown in Figure 3 Questions ‘What isthe diagnosis? + Arethere any patients a particular tak of developing this condition? + Whatisthe significance of the right inc foes pn inthis setting? ‘What does conservative treatment consist oft Figure 3.1 Plain xray the sodoman eO8'Ase a ut “all atl @ books.google.co.sm/bosks' Paes < ighour then a water Pscud pie [kev Points RE ceO@'Re Sal all a @ books.google.co.sm/bosks' BRB TS 00 Aeatomymrary —_wnteretw more <>) OD in forthe previous 36h, He Examination Inspection of the anus reveals & 3m x {uctusnt. TheO@'Re ‘Salall a @ books.google.co.sm/bosks' BBS co ncctomymray — wnteren vee <)>) oD in the eyploghindal us lning reached through the crypts of Morgans Which penetrate dhrongh the internal sphincter iio the interaphincteri space. Once the nce tion pases into the incrsphineteri pace ean spread eal int the adjacent petrctl spa jon Gh ancrectal abecweseO@'Re Sal all a feat tof fora 20year oldman precent tthe emergency department complaining of ane andlowerbeckp @ books.google.co.sm/bosks' 20 nsatomymerery —_wmtereview peor <> bled. There no relevant family half the year in California What isthe most likely di What treatment would yo ‘Why isitimportantto oxamine the abdomen aid chest and assoss nourology in such What are ti ik fctore ft this condition? What factors in the history of such patients would make you concerned?O@'Re Salal a @ books.google.co.sm/bosks' BSB] (oo) Accwmymm | | vmerenme mer) (ao until proven otherwise. A of 13mm and fall kiO@'he Sul GD 20:15 a @ books.google.co.sm/bosks' Ce ed pons <>) Be oN eM eras ANB History [A4-year-ld ae peesents tothe emergency department with 44-day history of abdominal distension, central colicky abdomine] pai, vomiting and constipation. On further qustion: fg he 39% he has passed a small amount of latus yesterday but none today. Fe ha previous right-sided hemicolectomy 2 years ago for colon eateinoma, He lives with his wife sd as no known allergies. Exem| igloo prewar emperatar are normal The pleural Pin ly. The He has obvious abdominal distension, but the abdomen is only mildly tender con nese and the rectum is etpty amnisation. TH benwel sounds ere ypernctive Bd high pitched, Chest exarsoation redaced ai entry bibasaly (P[invesriaarions R29) 1oex 435% 37 mmol &2immolt 25-67 mmol Tuma 44-80 pmol Que +) What fh diagnosis? + What features om the s-ry point towards the diggnosist + How should the patint be man aged initially? + What are the e this condition? aO8'Ase a i “All all @ books.google.co.sm/bosks' pagers <> 2 patito nally well with a Aisin [EW fetciegy ofomar-bowelctriretonO@'Re Sala a @ books.google.co.sm/bosks' BRB TS 00 Aeatomymrary —_wnteretw more <)>) oD ade to the pese faeces © What s the immediate management? ditfere auO@'Re Sala a @ books.google.co.sm/bosks' BSB] (oo) Accwmymm | | vmerenme =p] LL ANSWER 7 ‘The immediate management (obtain intravenous acess with two large-bors cannulae in the snterior cubital f Id be taken fora renal function and for at e nc units. lnteavenous ta pt. the patent isbest mon scomesstable with 7 and transfee to a high ‘unit (DU) mayb with conservative management, IF the Hleeding continues, an formed to asc the large refilled, patient may requtae§ dubeacal co KEY POINTO@'Re Sala a @ books.google.co.sm/bosks' BRB TS 00 Aeatomymrary —_wnteretw rosy <>) De the rg tion, He bas also 0 family history of bowel cane alcohol per week Exar Fe s apyrenial with normal blood there i some tendernessin the right ge thers iain ewaliog, whe ‘+ What s the likely diag 2 Whatare the anatomical boundaries?O@'Re Sala a @ books.google.co.sm/bosks' BSB] (oo) Accwmymm | | vmerenme =>) 2. feat tof fora 20year oldman precent tthe emergency department complaining of ane andlowerbeckp ANSWER 8 the twberce cand medial heen, This can by either an open we reduction ofthe hernia and placement of a mesh voO@'Re ‘ul all a @ books.google.co.sm/bosks' eddenunwversityecication © —Avdtomymerery—_wterevtew pagers <> o- eal of for a28yenr oldman presents othe emergency epariment complaining of anal wid lwer beck psf CUx een See ency department complaining severity ove i 26 wed woke hee from be simple aralgesia has snow om day 12 of {Hove should the patienebe man i you proceedO@'Re Salal 1) — @ books. google.co.sm/books BSB] (oo) Accwmymm | | vmerenme mr) ao feat to for a 20year oldman prerent to the emergency department complaining of ane andlowerback prin fr the previous 3h ANSWER 9 vic inflammatory disease end acite eppendisis lic! er diferen sin mimicking appendicitis | xevrowr ‘Aull gynaecological Nstory should be teken in fomale patientsO8'Ase a @ books.google.co.sm/bosks' © —Avdtomymerery—_wterevtew pagers <> 2 feat to for a 20year oldman prerent to the emergency department complaining of ane andlowerback prin fr the previous 3h to the amengency deparcment with a 24- history Wo the right Hie fossa and 2 diagnosis of ac Found to be normal and the a Figure 10-1 Operative pictur ofthe small bowe tics f this anomaly? with this intraoperative Siding?OAS “lal 1) — @ books. google.co.sm/books ot From the leocaseal ¥ nic or gastric cor, sd it m entation may «Inflammation ad perforation Sf 1 diverticulum pres sind pertoniss, mimicking ac & | xevrowr ' Padants should be made aware i on aeymptomatic Meckas dierticuhir te foun tH tine Bb suroen 1 t0 228 are not shown n ths previ