Nederlands tijdschrift voor geneeskunde
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Gastric volvulus in children is rare and can be life-threatening if not recognised in time. ⋯ The diagnosis of gastric volvulus can be difficult. Easily accessible additional diagnostics in the form of ultrasonography, possibly followed by a barium study, may be helpful.
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Studies have shown that the reliability and validity of the Netherlands Triage Standard (NTS) is comparable to the Manchester Triage System. The NTS has good sensitivity and specificity in the emergency room. The Dutch Society of Emergency and Accident Nurses, the Dutch College of General Practitioners and Ambulancezorg Nederland use the NTS as the guideline for both physical and telephone triage in ambulance care, primary care and hospital care with the competence of the triage nurse in a pivotal role.
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Malrotation occurs when there is a failure in the intestinal rotation leading to abnormal fixation to the abdominal wall and a mesentery with a short root. Volvulus is a life-threatening complication of malrotation. It can lead to irreversible intestinal necrosis and requires immediate attention. ⋯ Case B, a 1-month-old female, was taken to the general practitioner after acute onset of crying and flexing of the legs. Case C, a 5-year-old-boy with no medical history, had started vomiting hourly. In presenting these 3 cases, we highlight the dangers of untreated malrotation and make recommendations on how to manage a patient suspected of having this congenital abnormality.
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A 42-year-old woman had symptoms of unilateral flushing and sweating of her face during exercise. The clinical diagnosis was 'harlequin syndrome'. This condition is caused by a defect of the sympathetic nervous system and is in most cases idiopathic.
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Ned Tijdschr Geneeskd · Jan 2015
Case Reports[Spontaneous, atraumatic rupture of the spleen in a young man].
A spontaneous, atraumatic splenic rupture is a splenic rupture without a history of trauma. Rupture of this type may occur in a healthy patient but may also be seen in the context of an underlying neoplastic, haematological, infectious or local inflammatory condition. ⋯ It is clinically difficult to diagnose a spontaneous, atraumatic rupture of the spleen due to the overlap in presentation with other, more common abdominal and thoracic conditions. A CT scan is essential to detect such a rupture promptly in order to provide appropriate surgical intervention.