The CBD showed an overall trend towards a slight, but significant, dilatation after cholecystectomy. The common bile duct dilates significantly 3 months after cholecystectomy. Familiarity with these patterns prevents ultrasound misdiagnosis when examining patients within 6 months of cholecystectomy.
The aim of this study was to validate City of Hope Quality of Life-Ostomy Questionnaire (CoH-QoL-OQ) for assessing the quality of life (QoL) of ostomy patients in the Republic of Croatia. The CoH-QoL-OQ is widely used, but has not been translated or validated so it can be used in the Republic of Croatia. This cross-sectional study encompassed 302 surgery patients with colostomy, ileostomy, or urostomy (182 (60.3%) male and 120 (39.7%) female), whose average age is 59 (M = 59.3, SD = 15.8). The CoH-QoL-OQ was translated into Croatian language using accepted guidelines for translation. Patients were recruited in a telephone conversation, followed by mail containing the CoH-QoL–OQ delivered to the home addresses of the patients who agreed to participate. The collected data were analyzed to verify psychometric properties of the questionnaire on the Croatian sample. All subscales showed high level of internal consistency (Cronbach α = 0.73–0.89). The test-retest reliability indicated a very satisfactory temporal stability (r = 0.99). The Confirmatory Factor Analysis (CFA), showed that the originally established model was not adequate for the data (χ2 = 4237.88, p < 0.01, CFI = 0.540, NNFI = 0.481, RMSEA = 0.113). However, after modification that excluded problematic items, the data showed a better fit with the theoretical model (except for the LR chi-square test that remained statistically significant: χ2 = 1144.28, p < 0.01, CFI = 0.869, NNFI = 0.855 RMSEA = 0.077). We conclude that the CoH-QoL-OQ is a valid, reliable, and reducible instrument for measuring the health-related quality of life (HRQoL) among Croatian patients with ostomy in clinical research and clinical practice.
Our preliminary data demonstrate that ultrasound-guided PDT as regards to complications is at least equally safe as ST; at the same time, it is much quicker method, probably with less late infections of the stoma, which could be an important advantage in patients with ACSF.
We report a case of a 20-year-old male with isolated complete duodenal transection at two duodenal segments after blunt abdominal trauma. On admission, the patient underwent physical examination, laboratory analysis, abdominal ultrasound and plain abdominal x-ray. Physical examination revealed diffuse and rebound tenderness and extreme rigidity of the abdomen, guarding and decreased bowel sounds. Standard surgical techniques were used (median laparotomy, primary anastomosis, nasojejunal three-luminal tube for feeding and gastric decompression). At exploration, we found complete transection of the duodenum just below the pylorus and between the second and third part of the duodenum. We performed primary anastomosis of both transections with interrupted sutures in two layers. Prior to discharge magnetic resonance imaging (MRI) was performed. Early diagnosis of duodenal rupture is important. When dealing with trauma patients with pain greater than local findings, the mechanism of injury should always be taken into account.
There are only a few cases found in literature regarding air embolism in endoscopic procedures, especially in connection to endoscopic retrograde cholangiopancreatography (ERCP). We are presenting a case of a 56-year-old female patient who suffered from non-Hodgkin lymphoma located in her right groin. She was also diagnosed with choledocholithiasis and underwent ERCP to remove the gallstones. Immediately after the procedure she went into sudden cardiac arrest and subsequently died, despite all of our efforts. We reviewed literature in order to identify possible causes of death because fatal outcome following an uneventful and successful procedure was not expected. It is important to bear in mind all possible complications of ERCP. Our focus during the literature search was on air embolism.
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