The American journal of the medical sciences
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Obturator hernia is relatively rare and is a diagnostic challenge in the emergency department because the hernia mass is usually concealed beneath the pectineus muscle. We report the case of a 91-year-old emaciated woman with an incarcerated obturator hernia. The hernia was discovered early in the emergency department by computed tomography and was reduced by emergency laparotomy. ⋯ One of the clinical clues in our patient was small-bowel obstruction of unknown origin, diagnosed by computed tomography. We emphasize that emergency physicians should keep a high index of clinical suspicion for obturator hernia when encountering small-bowel obstruction in emaciated elderly women. Although we cannot shorten the time from onset of symptoms to hospital admission, we can make rapid evaluation and surgical intervention to reduce the morbidity and mortality of obturator hernia.
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Comparative Study
Hypoalbuminemia and lymphocytopenia in patients with decompensated biventricular failure.
In patients hospitalized with decompensated biventricular failure having hypoalbuminemia and lymphocytopenia without underlying hepatic or renal disease, we addressed the presence of a protein-losing enteropathy (PLE). ⋯ Enteral losses of albumin and lymphocytes account for the reversible hypoalbuminemia and lymphocytopenia found in patients hospitalized with CHF having splanchnic congestion.
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Buckwheat is an important crop in China and is also known as an important potent allergen in the population. Here, we report a series of 7 Chinese patients with buckwheat allergy, which has never been reported previously in China. Mean age was 20 years at diagnosis. ⋯ Anaphylaxis might be characterized by severe symptoms. Buckwheat pillow is an important source of exposure to buckwheat in China and other Asian countries. Therefore, public education with effective avoidance measures should be an integral part of the management strategy.