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Related Concept Videos

Esophageal Varices-II: Clinical Features and Management01:28

Esophageal Varices-II: Clinical Features and Management

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Esophageal varices often manifest as gastrointestinal bleeding episodes, presenting symptoms like hematemesis (vomiting of blood), hematochezia (passing fresh blood via the rectum), and melena (black, tarry stools). Other signs can include weight loss, anorexia, abdominal discomfort, jaundice, pruritus, altered mental status, and muscle cramps.
In the initial assessment, a thorough review of the patient's medical history is vital to identify risk factors such as liver disease, alcohol...
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Esophageal Varices-I: Introduction01:24

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Esophageal varices are dilated, tortuous veins which are found mainly in the submucosa of the lower esophagus but which may also appear higher up or extend into the stomach. They develop due to increased pressure in the portal venous system, often as a result of liver cirrhosis. This condition scars and damages the liver, impeding normal blood flow through the portal vein. To compensate, blood seeks alternative pathways, forming fragile new vessels (varices) in the esophagus and stomach. These...
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Nursing management begins with a thorough assessment of the patient's health history. Key factors include trauma to veins, peripherally inserted central catheters, varicose veins, recent pregnancy or childbirth, surgery, bacteremia, prolonged bed rest, atrial fibrillation, COPD, heart failure, cancer, coagulation disorders, myocardial infarction, spinal cord injury, stroke, prolonged travel, recent bone fractures, and dehydration. Review medication intake, particularly oral contraceptives,...
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Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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Inflammatory Bowel Disease I: Ulcerative Colitis01:27

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Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
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Related Experiment Video

Updated: Jan 19, 2026

Application of Laparoscopic Partial Splenectomy with Total Blood Flow Occlusion in Benign Splenic Lesions
02:09

Application of Laparoscopic Partial Splenectomy with Total Blood Flow Occlusion in Benign Splenic Lesions

Published on: December 20, 2024

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Risks and Realities of Delayed Splenic Bleeding.

Ian M Kratzke, Paula D Strassle, Sharon E Schiro

    The American Surgeon
    |September 28, 2019
    PubMed
    Summary

    Delayed splenic bleeding (DSB) after blunt splenic injury is not well understood. Older patients have higher odds of DSB, and angioembolization is not always a definitive treatment.

    Area of Science:

    • Trauma Surgery
    • Surgical Complications
    • Emergency Medicine

    Background:

    • Delayed splenic bleeding (DSB) is an infrequent but serious complication following blunt splenic injury.
    • While splenectomy has been the traditional treatment, angioembolization is increasingly used as an adjunct therapy.

    Purpose of the Study:

    • To investigate the incidence, mortality, and risk factors associated with delayed splenic bleeding in North Carolina.
    • To analyze outcomes of patients with blunt splenic injury managed nonoperatively versus those undergoing immediate splenectomy.

    Main Methods:

    • Retrospective analysis of the North Carolina Trauma Registry (1688 patients).
    • Patients stratified into immediate splenectomy and nonoperative management cohorts.
    • Delayed splenic bleeding defined as splenectomy >24 hours post-presentation; ICD-9/ICD-10 codes used for stratification.

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    Bloodless Laparoscopic Partial Splenectomy Assisted by Bipolar Radiofrequency Excision Hemostatic Device
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    Laparoscopic Splenectomy with Pericardial Devascularization for Hypersplenism and Esophageal Variceal Hemorrhage Due to Portal Hypertension
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    Bloodless Laparoscopic Partial Splenectomy Assisted by Bipolar Radiofrequency Excision Hemostatic Device
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    Main Results:

    • 2% of patients (32/1688) experienced delayed splenectomy.
    • Older age (≥30 years) was a significant risk factor for DSB (OR 4.30; P=0.04).
    • 4% of patients treated with nonoperative management and angioembolization ultimately required splenectomy.

    Conclusions:

    • Risk factors for delayed splenic bleeding remain largely unidentified.
    • Angioembolization can be an effective adjunct but does not eliminate the need for splenectomy in all cases.
    • Further research is needed to elucidate DSB etiology and optimize management strategies.