Kaohsiung J Med Sci
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Kaohsiung J Med Sci · Jan 2009
Case ReportsGastric subserosal hematoma developing from focal pancreatitis: a case report.
Pancreatitis complicated by gastric wall hemorrhagic is rarely reported. The imaging findings of focal pancreatitis with gastric wall hemorrhage can mimic a disease entity of gastric origin. We report a case of gastric subserosal hematoma developing in a patient with focal pancreatitis. ⋯ Computed tomography of the abdomen revealed focal pancreatitis that had eroded the gastric wall resulting in subserosal hemorrhage. The radiologist informed the surgeon of the possibility of focal pancreatitis complicated by gastric hemorrhage. The gastric subserosal hematoma was treated with percutaneous drainage and the patient recovered uneventfully.
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Kaohsiung J Med Sci · Jan 2009
Children presenting at the emergency department with right lower quadrant pain.
Right lower quadrant (RLQ) pain is a common complaint in children presenting at emergency departments. This study analyzed the etiologies of RLQ pain, and compared the clinical presentations, laboratory test results and imaging findings in patients with appendicitis with those in other groups of patients. We also investigated if active observation resulted in delayed diagnosis, to the detriment of patients. ⋯ There were significant differences in the incidences of fever (p = 0.004) and rebound tenderness (p = 0.019), and in white cell counts (p < 0.001), neutrophil percentages (p < 0.001), and C-reactive protein levels (p < 0.001) between patients with appendicitis and patients with other causes of RLQ pain. Clinical signs and symptoms, laboratory tests, and imaging studies can be used to differentiate between the causes of RLQ pain. Patients without the classical features of appendicitis or peritonitis can be safely managed by active observation and repeated physical examinations.
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Kaohsiung J Med Sci · Jan 2009
Effects of the Emergency Trauma Training Course on the confidence of final-year medical students dealing with trauma patients.
Trauma is an important issue that has been neglected in the training of medical students. This study evaluated the effects of the Emergency Trauma Training Course (ETTC), after completion of standard medical training, on seventh-year medical students. The ETTC was designed in Taiwan by the Taiwan Society of Emergency Medicine to train physicians and registered nurses who care for trauma patients in the emergency department (ED). ⋯ This indicates that the ETTC could increase the confidence of participants. This is the first evaluation of the implementation of the ETTC for final-year medical students in Taiwan. Based on our results, we highly recommend that this training course be taught to final-year medical students before they practice in hospital.