Abstract:
INTRODUCTION:Accurate recognition of omental infarction has resulted in increasing supporters of non-operative approach. In order to assess the efficacy and safety of conservative management, we surveyed the cases of omental infarction treated at a single institution. MATERIAL AND METHODS:Primary omental infarction treated between 2004 and 2011 were reviewed. Cases recognized by imaging studies were submitted to conservative treatment that consisted of intravenous analgesics and antibiotics. Demographics, clinical presentation, laboratory findings, imaging diagnosis and outcome were analyzed. RESULTS:There were 9 cases of omental infarction. Eight patients (4 males; median age, 8.5 years) presented at initial course of disease; all had right-sided abdominal pain and a normal or lightly increased leukocyte count. Six cases, diagnosed by CT scan after US suspicion in four, were managed conservatively, recovered uneventfully, and were discharged after a median hospital stay of 3 days. Two patients were only recognized at surgery. An additional case presented with intestinal obstruction due to an internal hernia and was successfully resolved by laparoscopy. DISCUSSION:Imaging techniques were diagnostic of omental infarction in the majority of cases, enabling a conservative approach to be adopted. Non-operative management was successful with no complications in all patients presenting at the initial course of disease. One patient presented with a harmful complication that required operative treatment. CONCLUSION:In the absence of a standard approach for omental infarction, conservative management is an effective noninvasive alternative but it claims for active surveillance. :Introdução: A melhoria da acuidade diagnóstica do enfarte do omento resultou num incremento da atitude conservadora no seu tratamento. Com o objectivo de avaliar a eficácia e segurança da abordagem não-operatória, analisámos os casos de enfarte do omento tratados num hospital terciário. Material e Métodos: Incluímos os casos de enfarte do omento primários tratados entre 2004 e 2011. Os enfartes do omento diagnosticados por imagiologia foram submetidos a tratamento conservador que constou de analgésicos e antibioterapia intravenosa. Avaliámos os dados demográficos, apresentação clínica, dados laboratoriais, imagiologia e resultado. Resultados: Ocorreram nove casos de enfarte do omento. Oito pacientes (4 rapazes), com uma idade mediana de 8,5 anos, apresentaram- se na fase inicial da doença por dor abdominal à direita; a contagem leucocitária era normal ou ligeiramente elevada. Seis casos, diagnosticados por TC após ecografia suspeita de enfarte do omento em quatro, foram trados conservadoramente sem complicações, tendo alta ao terceiro dia (mediana). Dois doentes foram apenas diagnosticados durante a intervenção cirúrgica por suposta apendicite. O nono caso apresentou-se com uma obstrução intestinal devida a hérnia interna que foi resolvida por laparoscopia. Discussão: A imagiologia foi diagnóstica na maioria dos casos de enfarte do omento, permitindo a adoção de uma abordagem conservadora. O tratamento não-operatório foi eficaz e sem complicações em todos os doentes que se apresentaram na fase inicial da doença. Um doente apresentou-se com uma complicação grave que requereu intervenção cirúrgica. Conclusão: Na ausência de um tratamento consensual para o enfarte do omento, a abordagem não-operatória é uma alternativa não invasiva e eficaz, mas requer uma vigilância clínica ativa.
journal_name
Acta Med Portjournal_title
Acta medica portuguesaauthors
Estevão-Costa J,Alvarenga AS,Fragoso AC,Garcia M,Campos Mdoi
10.20344/amp.4996subject
Has Abstractpub_date
2014-07-01 00:00:00pages
433-6issue
4eissn
0870-399Xissn
1646-0758journal_volume
27pub_type
杂志文章abstract:OBJECTIVES:This study was undertaken to assess the value of Cockroft-Gault Formula (FCG) in the patients of an Internal Medicine ward. METHODS:FCG was compared with creatinine clearance (DC) adjusted for corporal area. Serum creatinine was measured after 24 h urine collection and 8 h fast. By the subtraction of FCG fr...
journal_title:Acta medica portuguesa
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更新日期:1998-08-01 00:00:00
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journal_title:Acta medica portuguesa
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journal_title:Acta medica portuguesa
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abstract::The authors present the experience of 63 clinical cases of microsurgical reconstruction of the head and neck. These reconstructions were accomplished by different microvascular free flaps which were selected according to the type, size and location of the defects. Fasciocutaneous, osteofasciocutaneous, adipofascial, m...
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更新日期:1998-10-01 00:00:00
abstract::In this article we reviewed some examples of our experience in clinical applications of functional MRI (fMRI) in the motor and verbal fluency tasks evaluation. Seventeen patients with supratentorial cerebral pathology (5 arteriovenous malformations--AVMs, 2 meningiomas, 1 tuberculoma, 1 cortical tuberoma, 1 DNET, 2 ce...
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journal_title:Acta medica portuguesa
pub_type: 杂志文章,评审
doi:
更新日期:1994-02-01 00:00:00
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journal_title:Acta medica portuguesa
pub_type: 临床试验,杂志文章
doi:
更新日期:2002-09-01 00:00:00
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journal_title:Acta medica portuguesa
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doi:10.20344/amp.6517
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更新日期:2003-11-01 00:00:00
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更新日期:2011-07-01 00:00:00
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