Preoperative Assessment of Ultrasonographic Measurement of Antral Area for Gastric Content

Clinical Assessment of the Ultrasonographic Measurement of Antral Area for Estimating Preoperative Gastric Content and Volume

Anesthesiology ◽

10.1097/aln.0b013e31820dee48 ◽

2011 ◽

Vol 114 (5) ◽

pp. 1086-1092 ◽

Cited By ~ 139

Author(s):

Lionel Bouvet ◽

Jean-Xavier Mazoit ◽

Dominique Chassard ◽

Bernard Allaouchiche ◽

Emmanuel Boselli ◽

...

Keyword(s):

Characteristic Curve ◽

Preoperative Assessment ◽

Gastric Fluid ◽

Fluid Volume ◽

Solid Particles ◽

Cross Sectional ◽

Gastric Contents ◽

History Of ◽

And Performance ◽

Antral Area

Background This prospective observational study aimed to assess the feasibility and performance of the ultrasonographic measurement of antral cross-sectional area (CSA) for the preoperative assessment of gastric contents and volume in adult patients and for the diagnosis of risk stomach (defined by the presence of solid particles and/or gastric fluid volume >0.8 ml/kg). Methods A preoperative ultrasonographic measurement of the antral CSA was performed for each patient by a physician (L.B.) blinded to the history of the patient. Immediately after tracheal intubation, an 18-French multiorifice Salem tube was inserted and gastric contents were aspirated in five different patient positions; during this time, the patient's epigastrium was massaged and the tube was moved backward and forward in the stomach. The relationship between the antral area and the volume of aspirated gastric contents was analyzed, as was the performance of ultrasonographic measurement of antral area for the diagnosis of risk stomach. Results The measurement of antral CSA was performed on 180 of 183 patients. A significant positive relationship between antral CSA and aspirated fluid volume was found. The cutoff value of antral CSA of 340 mm(2) for the diagnosis of risk stomach was associated with a sensitivity of 91% and a specificity of 71%. The area under the receiver operating characteristic curve for the diagnosis of risk stomach was 90%. Conclusions The ultrasonographic measurement of antral CSA could be an important help for the anesthesiologist in minimizing the risk of pulmonary aspiration of gastric contents due to general anesthesia.

Download Full-text

Gastric Ultrasound for Preoperative Assessment of Gastric Content in Diabetic Patients

Case Medical Research ◽

10.31525/ct1-nct04181814 ◽

2019 ◽

Author(s):

Keyword(s):

Gastric Content ◽

Preoperative Assessment ◽

Diabetic Patients

Download Full-text

Surgical Management of Patients With 22q11.2 Deletion Syndrome

Perspectives of the ASHA Special Interest Groups ◽

10.1044/2019_pers-sig5-2019-0004 ◽

2019 ◽

Vol 4 (5) ◽

pp. 857-869

Author(s):

Oksana A. Jackson ◽

Alison E. Kaye

Keyword(s):

Surgical Management ◽

Preoperative Evaluation ◽

Preoperative Assessment ◽

22Q11.2 Deletion Syndrome ◽

Deletion Syndrome ◽

22Q11.2 Deletion ◽

Surgical Decision ◽

Obstructive Sleep ◽

Spine Abnormalities ◽

Speech Assessment

Purpose The purpose of this tutorial was to describe the surgical management of palate-related abnormalities associated with 22q11.2 deletion syndrome. Craniofacial differences in 22q11.2 deletion syndrome may include overt or occult clefting of the palate and/or lip along with oropharyngeal variances that may lead to velopharyngeal dysfunction. This chapter will describe these circumstances, including incidence, diagnosis, and indications for surgical intervention. Speech assessment and imaging of the velopharyngeal system will be discussed as it relates to preoperative evaluation and surgical decision making. Important for patients with 22q11.2 deletion syndrome is appropriate preoperative screening to assess for internal carotid artery positioning, cervical spine abnormalities, and obstructive sleep apnea. Timing of surgery as well as different techniques, common complications, and outcomes will also be discussed. Conclusion Management of velopharyngeal dysfunction in patients with 22q11.2 deletion syndrome is challenging and requires thoughtful preoperative assessment and planning as well as a careful surgical technique.

Download Full-text

Fractionation of the Biologically Active Large Molecular Components of Human Gastric Content

Gastroenterology ◽

10.1016/s0016-5085(19)35388-0 ◽

1959 ◽

Vol 37 (4) ◽

pp. 439-444 ◽

Cited By ~ 1

Author(s):

Ranwel Caputto ◽

William O. Smith ◽

Jordan Tang ◽

Raul E. Trucco ◽

Walter Joel ◽

...

Keyword(s):

Gastric Content ◽

Biologically Active ◽

Molecular Components

Download Full-text

Open Reduction for Dorsal Dislocation of Second to Fifth Carpometacarpal Joints: A Case Report

Journal of Wrist Surgery ◽

10.1055/s-0040-1715802 ◽

2020 ◽

Author(s):

Hiroo Kimura ◽

Akira Toga ◽

Taku Suzuki ◽

Takuji Iwamoto

Keyword(s):

Closed Reduction ◽

Open Reduction ◽

Delayed Diagnosis ◽

Preoperative Assessment ◽

Radiographic Examination ◽

Clinical Images ◽

Left Hand ◽

Carpometacarpal Joints ◽

Joint Deformity ◽

Poor Outcomes

Abstract Background Fracture-dislocations of all four ulnar (second to fifth) carpometacarpal (CMC) joints are rare hand injuries and frequently overlooked or missed. These injuries can be treated conservatively when closed reduction is successfully achieved, though they are sometimes irreducible and unstable. Case Description We report the case of a 17-year-old boy involved in a vehicular accident. Clinical images showed dorsal dislocation of all four ulnar CMC joints of the left hand associated with a fracture of the base of the fourth metacarpal. Although closed reduction was attempted immediately, the affected joints remained unstable and easily redislocated. Therefore, we performed open reduction and percutaneous fixation of all ulnar CMCs. He showed excellent recovery after 1 year postoperatively, reported no pain, and demonstrated complete grip strength and range of motion of the affected wrist and fingers. Literature Review Accurate clinical diagnosis of this lesion is difficult because of polytrauma, severe swelling masking the dislocated CMC joint deformity, and overlapping of adjacent metacarpals and carpal bones on radiographic examination. As for the treatment strategy, it has yet to obtain a consensus. Some reports value open reduction to guarantee anatomical reduction, and it is definitely needed in the patients with interposed tissues to be removed or with subacute and chronic injuries. Clinical Relevance Delayed diagnosis or treatment could lead to poor outcomes. Therefore, surgeons must be aware that precise preoperative assessment is critical, and anatomical open reduction of interposed bony fragments, like our case, may be required even in an acute phase.

Download Full-text