The Nigerian postgraduate medical journal
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Niger Postgrad Med J · Mar 2005
ReviewA review of the radiological diagnosis of small bowel obstruction using various imaging modalities.
Radiological investigation is an important tool in the diagnosis of small bowel obstruction (SBO). While plain abdominal radiograph remains the commonest investigation done in SBO, contrast gastrointestinal radiography, ultrasonography (US), computerised tomography (CT) scan -- with or without contrast enhancement are increasingly being advocated particularly in equivocal cases of SBO. We conducted manual, medicine and internet search for relevant literature on diagnosis of SBO using radiological investigations. ⋯ CT scan has an added advantage of predicting the site and cause of obstruction. In developing countries like ours, plain abdominal radiography still remains an important diagnostic tool. The role of abdominal ultrasonography needs further evaluation since it is safe, readily available and affordable.
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Indications for using central venous catheters (CVC) for haemodialysis include patients with: exhausted vascular access sites, no suitable vessels, failed peritoneal dialysis or short life expectancy. Catheter design and technology have changed in recent years to address the perennial problems of poor flow and infection. Permanent CVC offer a real alternative to arteriovenous access as 11-22% of long-term haemodialysis patients use CVC as their permanent vascular access. ⋯ CVC provide mean flow rates of 274-525 ml/min with a one year cumulative catheter survival of 47-93%. Tunnelled CVC provide a safe and effective long-term access for haemodialysis and are particularly suitable for use in developing countries. They are cheaper to maintain and remove the temptation to re-use disposable dialysis needles.