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Thomas Geeraerts - One of the best experts on this subject based on the ideXlab platform.
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diagnostic performance of abdominal point of care ultrasound performed by an emergency physician in acute Right Iliac Fossa pain
Critical Ultrasound Journal, 2018Co-Authors: Jeaneudes Bourcier, Emeric Gallard, Jeanphilippe Redonnet, Magali Majourau, Dominique Deshaie, Jeanmarie Bourgeois, Didier Garnier, Thomas GeeraertsAbstract:Right Iliac Fossa abdominal pain is a common reason for emergency ward admissions, its etiology is difficult to diagnose. It can be facilitated by an imaging examination, such as a Computerized Tomography scan which exposes the patient to ionizing radiation and implies delays. A bedside ultrasound performed by emergency physicians could avoid these issues. The aim of our study was to assess the performance of ultrasound carried out at the patient’s bedside by an emergency physician compared with a clinical-laboratory examination for the diagnosis of a surgical pathology in Right Iliac Fossa pain. This is a single-center prospective cohort study conducted in an Emergency Department receiving 19,000 patients per year. All patients presenting pain in the Right Iliac Fossa were included by four (out of ten) emergency physicians certified in an ultrasound examination. A full grid pattern scan ultrasound of the abdominal cavity with analysis of the Right Iliac Fossa was performed. The primary outcome was to compare the diagnosis performance of bedside ultrasound and clinical-laboratory examination to detect a surgical pathology. Two emergency physicians who did not participate in the study made the final diagnosis (i.e., surgical or non-surgical pathology) by reviewing the entire medical chart of each patient. From January 2011 to July 2013, 158 patients with a median age of 17 [13–32] years were analyzed. The diagnosed cases were: appendicitis (53), non-specific abdominal pain (48), lymphadenitis (22), ileitis (11), complicated ovarian cysts (7), neoplasias (5), inflammatory or infectious colitis (5), inguinal herniations (3), bowel obstructions (2), and salpingitis (2). The accuracy of ultrasound diagnoses was 0.89 (95% CI 0.84–0.94) versus 0.70 (95% CI 0.57–0.82) for diagnoses based on clinical-laboratory examination only (p < 0.001). Bedsides, ultrasound allows an accurate diagnosis of a surgical pathology in 89% of cases, which is more efficient than the clinical-laboratory examination.
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Diagnostic performance of abdominal point of care ultrasound performed by an emergency physician in acute Right Iliac Fossa pain
Critical ultrasound journal, 2018Co-Authors: Jeaneudes Bourcier, Emeric Gallard, Jeanphilippe Redonnet, Magali Majourau, Dominique Deshaie, Jeanmarie Bourgeois, Didier Garnier, Thomas GeeraertsAbstract:Right Iliac Fossa abdominal pain is a common reason for emergency ward admissions, its etiology is difficult to diagnose. It can be facilitated by an imaging examination, such as a Computerized Tomography scan which exposes the patient to ionizing radiation and implies delays. A bedside ultrasound performed by emergency physicians could avoid these issues. The aim of our study was to assess the performance of ultrasound carried out at the patient’s bedside by an emergency physician compared with a clinical-laboratory examination for the diagnosis of a surgical pathology in Right Iliac Fossa pain. This is a single-center prospective cohort study conducted in an Emergency Department receiving 19,000 patients per year. All patients presenting pain in the Right Iliac Fossa were included by four (out of ten) emergency physicians certified in an ultrasound examination. A full grid pattern scan ultrasound of the abdominal cavity with analysis of the Right Iliac Fossa was performed. The primary outcome was to compare the diagnosis performance of bedside ultrasound and clinical-laboratory examination to detect a surgical pathology. Two emergency physicians who did not participate in the study made the final diagnosis (i.e., surgical or non-surgical pathology) by reviewing the entire medical chart of each patient. From January 2011 to July 2013, 158 patients with a median age of 17 [13–32] years were analyzed. The diagnosed cases were: appendicitis (53), non-specific abdominal pain (48), lymphadenitis (22), ileitis (11), complicated ovarian cysts (7), neoplasias (5), inflammatory or infectious colitis (5), inguinal herniations (3), bowel obstructions (2), and salpingitis (2). The accuracy of ultrasound diagnoses was 0.89 (95% CI 0.84–0.94) versus 0.70 (95% CI 0.57–0.82) for diagnoses based on clinical-laboratory examination only (p
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Diagnostic performance of abdominal point of care ultrasound performed by an emergency physician in acute Right Iliac Fossa pain
SpringerOpen, 2018Co-Authors: Jeaneudes Bourcier, Emeric Gallard, Jeanphilippe Redonnet, Magali Majourau, Dominique Deshaie, Jeanmarie Bourgeois, Didier Garnier, Thomas GeeraertsAbstract:Abstract Background Right Iliac Fossa abdominal pain is a common reason for emergency ward admissions, its etiology is difficult to diagnose. It can be facilitated by an imaging examination, such as a Computerized Tomography scan which exposes the patient to ionizing radiation and implies delays. A bedside ultrasound performed by emergency physicians could avoid these issues. The aim of our study was to assess the performance of ultrasound carried out at the patient’s bedside by an emergency physician compared with a clinical-laboratory examination for the diagnosis of a surgical pathology in Right Iliac Fossa pain. Methods This is a single-center prospective cohort study conducted in an Emergency Department receiving 19,000 patients per year. All patients presenting pain in the Right Iliac Fossa were included by four (out of ten) emergency physicians certified in an ultrasound examination. A full grid pattern scan ultrasound of the abdominal cavity with analysis of the Right Iliac Fossa was performed. The primary outcome was to compare the diagnosis performance of bedside ultrasound and clinical-laboratory examination to detect a surgical pathology. Two emergency physicians who did not participate in the study made the final diagnosis (i.e., surgical or non-surgical pathology) by reviewing the entire medical chart of each patient. Results From January 2011 to July 2013, 158 patients with a median age of 17 [13–32] years were analyzed. The diagnosed cases were: appendicitis (53), non-specific abdominal pain (48), lymphadenitis (22), ileitis (11), complicated ovarian cysts (7), neoplasias (5), inflammatory or infectious colitis (5), inguinal herniations (3), bowel obstructions (2), and salpingitis (2). The accuracy of ultrasound diagnoses was 0.89 (95% CI 0.84–0.94) versus 0.70 (95% CI 0.57–0.82) for diagnoses based on clinical-laboratory examination only (p
Y Y Ng - One of the best experts on this subject based on the ideXlab platform.
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alvarado score an admission criterion in patients with Right Iliac Fossa pain
Surgeon-journal of The Royal Colleges of Surgeons of Edinburgh and Ireland, 2003Co-Authors: M Y P Chan, M T Chiu, Y Y NgAbstract:Appendicitis is an important differential diagnosis in patients with Right Iliac Fossa pain. The diagnosis in patients with equivocal signs can be difficult. Many patients with suspected appendicitis are admitted for observation. We studied the Alvarado scores of 175 patients who presented to the emergency department with Right Iliac Fossa pain and found that patients with scores of 4 or less did not have appendicitis. We also present an algorithm incorporating the Alvarado score for patients with suspected appendicitis
Yves Panis - One of the best experts on this subject based on the ideXlab platform.
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laparoscopic subtotal colectomy with double end ileosigmoidostomy in Right Iliac Fossa facilitates second stage surgery in patients with inflammatory bowel disease
Surgical Endoscopy and Other Interventional Techniques, 2020Co-Authors: D Mege, Léon Maggiori, Alice Frontali, Gianluca Pellino, S Adegbola, Janindra Warusavitarne, Yves PanisAbstract:Background There is no consensus about the most appropriate management of rectal stump in laparoscopic subtotal colectomy (STC) performed for inflammatory bowel disease (IBD). The objective is to report our experience of laparoscopic STC with double-end ileosigmoidostomy in the Right Iliac Fossa for IBD. Methods All patients undergoing laparoscopic STC and double-end ileosigmoidostomy in the Right Iliac Fossa for IBD in 2 European expert centres were included. Results From 1999 to 2017, laparoscopic STC and double-end ileosigmoidostomy in Right Iliac Fossa was performed in 213 consecutive patients, including 74 patients in an emergency setting (35%). Conversion to laparotomy was necessary in 9 patients (4%). One patient died postoperatively (0.5%). Postoperative morbidity occurred in 53 patients (25%) after STC, and was major in 18 patients (8%). A second stage was performed in 199 patients (94%), with a mean delay of 4.7 ± 6 months (range 1.4-77). The second stage was an ileorectal anastomosis (n = 50/199; 25%), performed by an elective open incision in the Right Iliac Fossa in 68% of cases; an ileal pouch-anal anastomosis (IPAA) (n = 139; 70%) successfully performed by laparoscopy in 96% of cases; or an abdominoperineal excision with end ileostomy (n = 10; 5%) successfully performed by laparoscopy in 8 cases. After this second stage, postoperative morbidity occurred in 53 patients (27%), and was major in 15 patients (8%). After a mean follow-up of 3.7 ± 3 years (range 0.1-15), stoma rate (end ileostomy and diverting stoma not closed) was 17%, and small bowel obstruction and incisional hernia occurred in 10 (5%) and 25 (12%) patients, respectively. Conclusions Laparoscopic STC and double-end ileosigmoidostomy in Right Iliac Fossa is safe, feasible, and facilitates the second stage for intestinal continuity by either elective incision or laparoscopy in 100% of ileorectal anastomoses and by laparoscopy in 96% of IPAA.
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Laparoscopic subtotal colectomy for acute or severe colitis with double-end ileo-sigmoidostomy in Right Iliac Fossa.
Surgical laparoscopy endoscopy & percutaneous techniques, 2010Co-Authors: Léon Maggiori, Frédéric Bretagnol, Arnaud Alves, Yves PanisAbstract:The aim of this study was to report an original technique of laparoscopic subtotal colectomy (STC) for acute colitis complicating inflammatory bowel disease where both ileostomy and sigmoidostomy are located in the Right Iliac Fossa. Thirty-five consecutive laparoscopic STC cases with ileo-sigmoidostomy in Right Iliac Fossa were retrospectively reviewed. There was no mortality. No patient was reoperated until stoma closure. Bowel continuity was restored by either ileorectal anastomosis (n=14) or secondary proctectomy with ileal-pouch-anal anastomosis (IPAA; n=21). Elective approach was performed in 11 of 14 ileorectal anastomoses (79%) and through iterative laparoscopy in 21 of 21 IPAA (100%). Laparoscopic STC with ileo-sigmoidostomy in Right Iliac Fossa avoid a secondary wound incision for sigmoidostomy, and offers the possibility of an elective approach for ileorectal anastomosis as in 79% of the patients. It allowed, in all cases, a totally laparoscopic approach for the second step of IPAA.
Jeaneudes Bourcier - One of the best experts on this subject based on the ideXlab platform.
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diagnostic performance of abdominal point of care ultrasound performed by an emergency physician in acute Right Iliac Fossa pain
Critical Ultrasound Journal, 2018Co-Authors: Jeaneudes Bourcier, Emeric Gallard, Jeanphilippe Redonnet, Magali Majourau, Dominique Deshaie, Jeanmarie Bourgeois, Didier Garnier, Thomas GeeraertsAbstract:Right Iliac Fossa abdominal pain is a common reason for emergency ward admissions, its etiology is difficult to diagnose. It can be facilitated by an imaging examination, such as a Computerized Tomography scan which exposes the patient to ionizing radiation and implies delays. A bedside ultrasound performed by emergency physicians could avoid these issues. The aim of our study was to assess the performance of ultrasound carried out at the patient’s bedside by an emergency physician compared with a clinical-laboratory examination for the diagnosis of a surgical pathology in Right Iliac Fossa pain. This is a single-center prospective cohort study conducted in an Emergency Department receiving 19,000 patients per year. All patients presenting pain in the Right Iliac Fossa were included by four (out of ten) emergency physicians certified in an ultrasound examination. A full grid pattern scan ultrasound of the abdominal cavity with analysis of the Right Iliac Fossa was performed. The primary outcome was to compare the diagnosis performance of bedside ultrasound and clinical-laboratory examination to detect a surgical pathology. Two emergency physicians who did not participate in the study made the final diagnosis (i.e., surgical or non-surgical pathology) by reviewing the entire medical chart of each patient. From January 2011 to July 2013, 158 patients with a median age of 17 [13–32] years were analyzed. The diagnosed cases were: appendicitis (53), non-specific abdominal pain (48), lymphadenitis (22), ileitis (11), complicated ovarian cysts (7), neoplasias (5), inflammatory or infectious colitis (5), inguinal herniations (3), bowel obstructions (2), and salpingitis (2). The accuracy of ultrasound diagnoses was 0.89 (95% CI 0.84–0.94) versus 0.70 (95% CI 0.57–0.82) for diagnoses based on clinical-laboratory examination only (p < 0.001). Bedsides, ultrasound allows an accurate diagnosis of a surgical pathology in 89% of cases, which is more efficient than the clinical-laboratory examination.
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Diagnostic performance of abdominal point of care ultrasound performed by an emergency physician in acute Right Iliac Fossa pain
Critical ultrasound journal, 2018Co-Authors: Jeaneudes Bourcier, Emeric Gallard, Jeanphilippe Redonnet, Magali Majourau, Dominique Deshaie, Jeanmarie Bourgeois, Didier Garnier, Thomas GeeraertsAbstract:Right Iliac Fossa abdominal pain is a common reason for emergency ward admissions, its etiology is difficult to diagnose. It can be facilitated by an imaging examination, such as a Computerized Tomography scan which exposes the patient to ionizing radiation and implies delays. A bedside ultrasound performed by emergency physicians could avoid these issues. The aim of our study was to assess the performance of ultrasound carried out at the patient’s bedside by an emergency physician compared with a clinical-laboratory examination for the diagnosis of a surgical pathology in Right Iliac Fossa pain. This is a single-center prospective cohort study conducted in an Emergency Department receiving 19,000 patients per year. All patients presenting pain in the Right Iliac Fossa were included by four (out of ten) emergency physicians certified in an ultrasound examination. A full grid pattern scan ultrasound of the abdominal cavity with analysis of the Right Iliac Fossa was performed. The primary outcome was to compare the diagnosis performance of bedside ultrasound and clinical-laboratory examination to detect a surgical pathology. Two emergency physicians who did not participate in the study made the final diagnosis (i.e., surgical or non-surgical pathology) by reviewing the entire medical chart of each patient. From January 2011 to July 2013, 158 patients with a median age of 17 [13–32] years were analyzed. The diagnosed cases were: appendicitis (53), non-specific abdominal pain (48), lymphadenitis (22), ileitis (11), complicated ovarian cysts (7), neoplasias (5), inflammatory or infectious colitis (5), inguinal herniations (3), bowel obstructions (2), and salpingitis (2). The accuracy of ultrasound diagnoses was 0.89 (95% CI 0.84–0.94) versus 0.70 (95% CI 0.57–0.82) for diagnoses based on clinical-laboratory examination only (p
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Diagnostic performance of abdominal point of care ultrasound performed by an emergency physician in acute Right Iliac Fossa pain
SpringerOpen, 2018Co-Authors: Jeaneudes Bourcier, Emeric Gallard, Jeanphilippe Redonnet, Magali Majourau, Dominique Deshaie, Jeanmarie Bourgeois, Didier Garnier, Thomas GeeraertsAbstract:Abstract Background Right Iliac Fossa abdominal pain is a common reason for emergency ward admissions, its etiology is difficult to diagnose. It can be facilitated by an imaging examination, such as a Computerized Tomography scan which exposes the patient to ionizing radiation and implies delays. A bedside ultrasound performed by emergency physicians could avoid these issues. The aim of our study was to assess the performance of ultrasound carried out at the patient’s bedside by an emergency physician compared with a clinical-laboratory examination for the diagnosis of a surgical pathology in Right Iliac Fossa pain. Methods This is a single-center prospective cohort study conducted in an Emergency Department receiving 19,000 patients per year. All patients presenting pain in the Right Iliac Fossa were included by four (out of ten) emergency physicians certified in an ultrasound examination. A full grid pattern scan ultrasound of the abdominal cavity with analysis of the Right Iliac Fossa was performed. The primary outcome was to compare the diagnosis performance of bedside ultrasound and clinical-laboratory examination to detect a surgical pathology. Two emergency physicians who did not participate in the study made the final diagnosis (i.e., surgical or non-surgical pathology) by reviewing the entire medical chart of each patient. Results From January 2011 to July 2013, 158 patients with a median age of 17 [13–32] years were analyzed. The diagnosed cases were: appendicitis (53), non-specific abdominal pain (48), lymphadenitis (22), ileitis (11), complicated ovarian cysts (7), neoplasias (5), inflammatory or infectious colitis (5), inguinal herniations (3), bowel obstructions (2), and salpingitis (2). The accuracy of ultrasound diagnoses was 0.89 (95% CI 0.84–0.94) versus 0.70 (95% CI 0.57–0.82) for diagnoses based on clinical-laboratory examination only (p
Amer Hayat K Han - One of the best experts on this subject based on the ideXlab platform.
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ILEAL LYMPHOMA: PITFALLS OF PALPABLE MASS IN THE Right Iliac Fossa
Journal of Pharmaceutical & Scientific Innovation, 2014Co-Authors: Andee Dzulkarnaen Zakaria, Syed Adeel Hassan, Siti Aishah Zailani, Syed Azhar, Syed Azhar Syed Sulaiman, Amer Hayat K HanAbstract:In the gastrointestinal organ , the ileum is more frequently affected as compared to duodenum and jejunum. Studies showed that Non - Hodgkin Lymphoma of the ileum accounts for some 3 % of extra nodal onset lymphoma and 20 % of gastrointestinal lymphoma. Symptoms that commonly presence in Non Hodgkin lymphoma patients is fever, abdominal pain and weight loss. The Right Iliac Fossa is predisposed to high tenderness because of anatomical and func tional reasons. Differential diagnosis of palpable mass in lower Right abdominal quadrant can sometimes be di fficult. Surgery represents the elective treatment for primary forms, followed by chemotherapy and radiotherapy. Patients with ileal lymphoma usually underwent emergency intestinal resection. This is a case of post - operative surgery and medications given t o this patient specifically to treat his complications after surgery.
