Features of small bowel obstruction include the central position of gas-filled and distended loops of bowel.
The white lines passing across the full width of the bowel are 'valvulae conniventes' - these are only found in the small bowel.
Small bowel obstruction (SBO) accounts for 80% of all mechanical intestinal obstruction, the remaining 20% results from a large bowel obstruction.
It has a mortality rate of ~5%.
The valvulae conniventes, also known as Kerckring folds/valves, plicae circulares or just small bowel folds, are the mucosal folds of the small intestine
starting from the second part of the duodenum, they are large and thick at the jejunum and considerably decrease in size distally in the ileum to disappear entirely in the distal ileal bowel loops.
They result in a classical appearance on abdominal radiographs, barium studies and CT scans.
What is the diagnosis in this 52-year-old man with epigastric pain?
CT of the abdomen revealed dilated small-bowel loops and a "target sign," findings characteristic of intussusception, without evidence of a lead point.
Jejunojejunal intussusception caused by an adenocarcinoma was confirmed at laparotomy
All these antihypertensive drugs are safe in pregnancy, except which?
Labetalol
Ramipril
Nifedipine
Methyldopa
Ramipril is an ACE inhibitor –
👉 ACE inhibitors are teratogenic drugs which can cause damage to the developing fetus.
Antihypertensive drugs safe in pregnancy include nifedipine, methyldopa, labetalol, and hydralazine.
It is well accepted that angiotensin-converting enzyme (ACE) inhibitors are contraindicated during the second and third trimesters of pregnancy because of increased risk of fetal renal damage.
First-trimester use, however, has not been linked to adverse fetal outcomes.
Case: 23 years old female is admitted to ICU with anxiety, depression, and suicidal ideation.
Family reported recent symptoms of tic.
What is this?
Answer:
Psychology service was consulted, and they diagnosed patient with "TikTok tics."
Interestingly, there was an increase in reporting of functional tics during COVID-Pandemic.
The probable cause is mental health issues while in isolation.
A particular form is called "TikTok tics."
Most young females between the ages of 15 and 25 have been reported to have acute, complex vocal and motor tics involving large-amplitude arm movements.