Giant dus

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Shaikhani.

Giant DUs

Formation Santé & Médecine

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The stomach J-shaped. It has two surfaces (the anterior & posterior), two curvatures (the greater & lesser), two orifices (the cardia & pylorus). It has fundus, body and pyloric antrum. Blood supply The left gastric artery Right gastric artery Right gastro-epiploic artery Left gastro-epiploic artery Short gastric arteries Stomach cancer begins when cancer cells form in the inner lining of your stomach. These cells can grow into a tumor. Also called gastric cancer, the disease usually grows slowly over many years. It could be: malignant or benign primary or secondary

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Appendicle abscess Siedah Telesford MD Dr. Griffith Team History CC: H.M. age 42 M p/w vomiting and diarrhea for 3 days. HPI: Pt p/w vomiting and diarrhea for 3 days. Pt was diagnosed with gastroenteritis at Arima General after 1 day of vomiting and diarrhea. Pt admitted to diffuse abdominal pain x 2 weeks. Initially 5/10, took antiemetics and panadol had some relief for 1 day. 1 day later, abdominal pain got progressively worse, 8/10, diffuse, took panadol but no relief 42 yo M came to the ED with vomiting and diarrhea x3days. 2 week h/o diffuse abd pain. Diagnosed as gastro 2 days before admission. Pt had pain relief with antiemetics and panadol initially. Physical 2 History Exacerbated by movement and cough Vomiting (3/7) 2 episodes/day of food bilious, nonbloody Anorexia Diarrhea Subjective Fever Tenesmus – he described wanting to pass stool but unable to Denies urinary symptoms No trauma PMHx: Denies Medications: Denies PSx: Denies Allergies: NKDA ROS- Noncontributory Tenesmus 3 Physical Exam General appearance: Young male in mild painful distress V/s: P- 96 O2- 98 T- 36.4 RR- 24 BP- 131/67 Abdomen: +BS, Nondistended, firm Tenderness in lower abd; ++RLQ , +rebound, +guarding +Rovsing sign, -Obturator sign,+iliopsoas sign, -DRE Respiratory: CTAB CVS: RRR, S1/S2 heard. Labs and ED course WBC- 16.9 Hb- 12 Plt- 290 RFT, LFT, amylase, lipase, UA- WNL CXR and AXR-WNL ED course: Pt received 4mg Buscopan 50mg Gravol 50mg zantac 1L IVF NS Imaging Appendix measuring 1.6cm 4.5mm appendicolith within its tip Small amount of free fluid in RIF Fat stranding around appendix 5.1cm x 4.2cm collection with enhancing walls at tip of appendix Fat stranding around the sigmoid colon Working diagnosis: Appendicitis with appendicular abscess Procedure General anesthesia. Open lap and appendectomy. 24 French was left. 7 Post op POD # 1 V/S: WNL Intake: 2L RL/24 hrs Urine output: 600 ml/24 hrs J-vac: 100 ml WBC 14.82 - Abd: +BS, distended, tenderness at incision site. Post op WBC: 14.8—>13.7—>12.6 Remained NPO, IVF, pain meds Antibiotic tx with Flagyl and Zinacef for 8 days and removal of the drain on POD #7 Management of appendicitis with abscess or mass Management of appendicitis presenting with abscess In acute appendicitis patients, the proportion of cases associated with an abscess or a tumor in the periappendix has been reported to be approximately 2% to 7%. 3 approaches: Emergency surgery Early conservative treatments followed by elective surgery Conservative treatments and follow-up observation only If surgery is performed under the condition that inflammation due to appendicitis has spread to adjacent areas, the inflammation may have spread over a wide area. In addition, because of edema and the vulnerability of the adjacent small intestine and large intestine, secondary fistulas, etc., may have developed. In our case, there was inflammation of the sigmoid and rectum. For.

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We present a patient at the age of 45, who visited a doctor because of pain in the stomach, nausea, and vomiting and weight loss of more than 20 kg. Clinical, biochemical, endoscopic, pathohistological, radiological and imaging studies (US and CT) have been performed. The radiological examination was performed using a monocontrast and double-contrast technique. The US examination was performed with a 3.75 MHz convex probe, using a standard overview technique. CT was made after oral administration of 700 ml of water, i.v. application of a non-ionic contrast agent of 90 ml in bolus, in hypotonia achieved by i.v. glucagon application, with a scanning width of 10 mm.

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Poster to be presented at Stochastic Numerics and Statistical Learning: Theory and Applications Workshop 2024, Kaust, Saudi Arabia, https://cemse.kaust.edu.sa/stochnum/events/event/snsl-workshop-2024. In this work we have considered a setting that mimics the Henry problem \cite{Simpson2003,Simpson04_Henry}, modeling seawater intrusion into a 2D coastal aquifer. The pure water recharge from the ``land side'' resists the salinisation of the aquifer due to the influx of saline water through the ``sea side'', thereby achieving some equilibrium in the salt concentration. In our setting, following \cite{GRILLO2010}, we consider a fracture on the sea side that significantly increases the permeability of the porous medium. The flow and transport essentially depend on the geological parameters of the porous medium, including the fracture. We investigated the effects of various uncertainties on saltwater intrusion. We assumed uncertainties in the fracture width, the porosity of the bulk medium, its permeability and the pure water recharge from the land side. The porosity and permeability were modeled by random fields, the recharge by a random but periodic intensity and the thickness by a random variable. We calculated the mean and variance of the salt mass fraction, which is also uncertain. The main question we investigated in this work was how well the MLMC method can be used to compute statistics of different QoIs. We found that the answer depends on the choice of the QoI. First, not every QoI requires a hierarchy of meshes and MLMC. Second, MLMC requires stable convergence rates for $\EXP{g_{\ell} - g_{\ell-1}}$ and $\Var{g_{\ell} - g_{\ell-1}}$. These rates should be independent of $\ell$. If these convergence rates vary for different $\ell$, then it will be hard to estimate $L$ and $m_{\ell}$, and MLMC will either not work or be suboptimal. We were not able to get stable convergence rates for all levels $\ell=1,\ldots,5$ when the QoI was an integral as in \eqref{eq:integral_box}. We found that for $\ell=1,\ldots 4$ and $\ell=5$ the rate $\alpha$ was different. Further investigation is needed to find the reason for this. Another difficulty is the dependence on time, i.e. the number of levels $L$ and the number of sums $m_{\ell}$ depend on $t$. At the beginning the variability is small, then it increases, and after the process of mixing salt and fresh water has stopped, the variance decreases again. The number of random samples required at each level was estimated by calculating the decay of the variances and the computational cost for each level. These estimates depend on the minimisation function in the MLMC algorithm. To achieve the efficiency of the MLMC approach presented in this work, it is essential that the complexity of the numerical solution of each random realisation is proportional to the number of grid vertices on the grid levels.

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Giant dus

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Giant dus

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