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📎𝐏𝐬𝐨𝐚𝐬 𝐀𝐛𝐬𝐜𝐞𝐬𝐬
🟣Definition
- Collection of pus within the iliopsoas compartment.
🟣Causes / Spread
- Hematogenous spread
- Spread from adjacent structures:
- Vertebral osteomyelitis
- Tuberculous spondylitis (Pott disease)
- Pyelonephritis
🟣Risk Factors
- Crohn disease
- Diabetes mellitus
- Immunocompromised states
🟣Causative Organisms
- Staphylococcus aureus — most common
- Mycobacterium tuberculosis — can also cause it
🟣Clinical Findings
- Flank pain
- Fever
- Inguinal mass
- Positive psoas sign: hip extension → exacerbates lower abdominal pain
🟣Labs
- Leukocytosis
🟣Imaging
- CT/MRI: focal hypodense lesion within the muscle plane
🟣Treatment
- Abscess drainage
- Antibiotics
♦Intussusception
🔴Definition
Telescoping of one part of the intestine into an adjacent part. Most common: ileum into cecum = "ileocolic".
🔴Who gets it
- Peak age: 6 months to 3 years. Most common cause of intestinal obstruction in infants
- Adults: Rare. Usually has a lead point like tumor, polyp, Meckel's
🔴Cause
- Idiopathic 90% in kids: Often after viral gastroenteritis. Lymphoid hyperplasia acts as lead point
- Pathological lead point: Meckel diverticulum, polyp, tumor, Henoch-Schonlein purpura, cystic fibrosis
- No lead point found in most infants
🔴Classic triad in infants
1. Colicky abdominal pain: Sudden crying, draws up legs, then appears normal between episodes
2. Vomiting*: Bilious if late
3. "Currant jelly" stool: Blood + mucus. Late sign
Other signs
- Palpable "sausage-shaped" mass in RUQ, often with empty RLQ = Dance sign
- Lethargy between episodes
- Can progress to obstruction, ischemia, perforation
🔴Diagnosis
- Ultrasound: Target sign / doughnut sign on transverse view. First line in kids
- Air contrast enema: Both diagnostic + therapeutic
- X-ray: May show obstruction, but non-specific
🔴Treatment
1. Non-operative: Air or barium enema reduction. Works ∼70-80% in uncomplicated cases without signs of perforation
2. Surgical: If reduction fails, perforation, peritonitis, or lead point suspected. 3-
Laparoscopic/open reduction ± bowel resection.
🔴Complications
1- Bowel ischemia
2- necrosis
3- perforation
4- recurrence ∼10%
🔴Prognosis
Good if treated early.
Delay increases risk of surgery and bowel loss.
Differential Diagnosis (DD) for Neck Swelling: 1. Lymph Node Enlargement: - Reactive lymphadenopathy (due to infection) - Tuberculous lymphadenitis - Lymphoma (Hodgkin’s or Non-Hodgkin’s) - Metastatic lymph node (from head, neck, or chest malignancies) 2. Thyroid Swelling: - Goiter (simple, multinodular) - Thyroid cyst - Thyroiditis - Thyroid carcinoma 3. Salivary Gland Swelling: - Parotitis (e.g., mumps) - Sialolithiasis (salivary stone) - Salivary gland tumors 4. Congenital Lesions: - Thyroglossal duct cyst - Branchial cleft cyst - Cystic hygroma (lymphangioma) 5. Vascular Causes: - Carotid body tumor - Aneurysm 6. Infectious/Inflammatory: - Abscess (e.g., dental, peritonsillar, retropharyngeal) - Cat-scratch disease 7. Miscellaneous: - Lipoma - Sebaceous cyst - Dermoid cyst
1- DDx Of Right Upper Quadrant ( RUQ ) Swelling : ● Right Lobe Of Liver : 1 Amoebic Hepatitis . 2 Hydatid Cyst . 3 Liver Cirrhosis . 4 Cancer . ● Gall-Bladder : 6 Mucocele. 7 Empyema . 8 GB Carcinoma . ● Hepatic Flexure: 9 Colonic Carcinoma. ● Right Kidney : 10 Hydro-nephrosis . 11 Solitary Cystic Kidney. 12 Polycystic Kidney. 13 Wilm's Tumor .
3- DDx Of Right Iliac Fossa Swelling : ● GIT : 1 Crohn's Disease. 2 Colonic Carcinoma. 3 Ileo-Cecal TB / Ileo-Cecal Actinomycosis . 4 Appendicular Mass / Abscess ● Tubo-Ovarian & Uterus: 5 Ovarian Cyst / Tumor . 6 Hydrosalpinx Or Pyosalpinx. 7 Tubal Pregnancy. 8 Uterine Fibroid . ● Renal : 9 Ectopic Kidney . 10 Ptosed Kidney . ● Vascular & Lymphatic: 11 Right Iliac Artery Aneurysm . 12 Right Iliac LNs .
2- DDx Of Epigastric Swelling : ● Left Lobe Of Liver : Same As Right Lobe . 1 Amoebic Hepatitis . 2 Hydatid Cyst . 3 Liver Cirrhosis . 4 Cancer . ● Transverse Colon : 5 Carcinoma. 6 Bilharzial Colitis . 7 Diverticulitis . ● Greater Omentum : 8 TB Peritonitis . 9 Malignant Nodule. ● Stomach : 10 Carcinoma. 11 Epigastric Abscess . 12 Gastric Outlet Obstruction . ● Vascular & Lymphatic: 13 Abdominal Aortic Aneurysm ( AAA ) . 14 Para-Aortic LNs .
Here is the Differential Diagnosis (DD) for Abdominal Pain according to each region : 1. Right Upper Quadrant (RUQ): - Acute cholecystitis - Biliary colic - Hepatitis - Liver abscess - Right lower lobe pneumonia - Fitz-Hugh-Curtis syndrome 2. Left Upper Quadrant (LUQ): - Splenic infarct - Splenic rupture - Gastritis - Gastric ulcer - Pancreatitis (can be central too) - Left lower lobe pneumonia 3. Epigastric Region: - Peptic ulcer disease - Gastritis - GERD - Pancreatitis - Myocardial infarction (referred) 4. Right Lower Quadrant (RLQ): - Appendicitis - Crohn’s disease - Right ureteric colic - Ectopic pregnancy (female) - Ovarian torsion / cyst rupture - Mesenteric adenitis 5. Left Lower Quadrant (LLQ): - Diverticulitis - Left ureteric colic - Ectopic pregnancy (female) - Ovarian torsion / cyst rupture - Constipation - Ulcerative colitis 6. Suprapubic (Hypogastric): - Urinary tract infection - Cystitis - Retention of urine - Pelvic inflammatory disease - Uterine fibroid / menstrual pain 7. Periumbilical Region: - Early appendicitis - Small bowel obstruction - Mesenteric ischemia - Gastroenteritis 8. Diffuse Abdominal Pain: - Peritonitis - Bowel obstruction - Diabetic ketoacidosis - Gastroenteritis - Mesenteric ischemia
Differential diagnosis (DD) for breast swelling includes:
1. Fibroadenoma
2. Fibrocystic changes
3. Breast cyst
4. Breast abscess
5. Mastitis
6. Galactocele
7. Fat necrosis
8. Breast carcinoma
9. Phyllodes tumor
10. Gynecomastia
differential diagnosis (DD) for swelling in the groin region includes:
1. Inguinal hernia
2. Femoral hernia
3. Lymphadenopathy due to infection, malignancy, etc.
4. Undescended testis (in children)
5. Hydrocele of the spermatic cord
6. Psoas abscess
7. Lipoma of the cord or groin
8. Femoral artery aneurysm
9. Saphena varix
10. Sebaceous cyst
🤔🇾🇪 إعلان تدشين أول وأكبر مكتبة طلابية إلكترونية شاملة لكل الجامعات اليمنية ومدعومة بالذكاء الاصطناعي 📚🧠
🤔انطلاقاً من حرص ملتقى الطالب الجامعي على الارتقاء بالبيئة التعليمية، وتيسير سبل التحصيل العلمي، وتوفير مصادر المعرفة.
🔹 وتجسيداً لقوله تعالى: ﴿وَتَعَاوَنُوا عَلَى الْبِرِّ وَالتَّقْوَى﴾، وترسيخاً لقيم التكافل والتعاون والعطاء في الوسط الطلابي، بما يسهم في بناء جيلٍ واعٍ، متعلمٍ، قادرٍ على صناعة مستقبله وخدمة مجتمعه.
📣 يُعلن ملتقى الطالب الجامعي واللجان العلمية عن تدشين: أول وأكبر مكتبة طلابية مركزية في اليمن.
📚وهي مكتبة علمية رقمية شاملة، تجمع وتنظم المحتويات الأكاديمية لمختلف الجامعات والكليات والتخصصات اليمنية، وتضعها بين يدي الطالب في منصة واحدة، سهلة الوصول، منعدمة التكلفة، ومدعومة بتقنيات الذكاء الاصطناعي.
😀وتضم المكتبة(61,377) ألف مادة علمية تشمل الكتب والمراجع، والمحاضرات، ونماذج الاختبارات، والملخصات، والفيديوهات، والتسجيلات الصوتية، بما يتيح للطلاب في مختلف الجامعات والكليات اليمنية الوصول إلى المواد العلمية المرتبطة بتخصصاتهم بسهولة ويسر.
📱 يمكنكم الدخول للمكتبة من خلال الرابط التالي عبر تلجرام:
https://t.me/USFYemenLibraryBot
#معلومة_ اليوم_التشخيص
Ranula (رانيولا) كيس لعابي تحت اللسان.
السبب
يحدث بسبب انسداد أو تمزق قناة الغدة اللعابية تحت اللسان (Sublingual gland).
يؤدي ذلك إلى تسرب اللعاب وتجمعه داخل الأنسجة مكونًا كيسًا ممتلئًا بالمخاط (Mucocele).
الأعراض
تورم أملس شفاف أو مائل للأزرق تحت اللسان.
غالبًا غير مؤلم، لكنه قد يسبب صعوبة في الكلام أو المضغ أو البلع إذا كان كبيرًا.
العلاج
إذا كان صغيرًا: قد تتم المراقبة في بعض الحالات.
إذا كان كبيرًا أو متكررًا:
Marsupialization (فتح الكيس وتثبيت حوافه).
أو استئصال الكيس مع إزالة الغدة تحت اللسان، وهو العلاج الأكثر فعالية لتقليل احتمال عودة الحالة.
إذا وُجدت عدوى تُعالج بالمضادات الحيوية المناسبة، لكن المضادات وحدها لا تعالج الكيس نفسه.
🔰Urethral Injury
🔷Mechanisms Of Urethral Injury
📍1. Anterior (Bulbar) Urethral Injury Due To :
▪︎Blunt Straddle Injury To The Perineum (Falling Astride Injury)
▪︎Falling From Tree/During Cycling/Skating/Industrial Accidents
▪︎Traumatic Catheterization & Penterating Trauma To The Perineum
📍2. Posterior (Prostatic) Urethral Injury Due To :
▪︎Mostly Due To Pelvic Fractures After Road Traffic Accidents
▪︎Dislocation Of The Symphysis Pubis
▪︎During CystoScopy
▪︎Penetrating Injury To The Perineum
▪︎Injury Usually Occurs At BulboMembranous Junction
🔷Clinical Features & Dx Of Urethral Injury
📍1. Blood At Urethral Meatus
📍2. Genital Or Perineal Hematoma Or Bruising
📍3. Urine Retention & Bladder Distention
📍4. Pelvic Fractures & Haemodynamic Instability
📍5. Backward Displacement Of The Urethra (Pubo-Prostatic Ligament Rupture During Posterior Urethra Injury)
📍6. Confirm Dx :
▪︎CT Scan Or MRI Of Pelvis (During Pelvic Fractures)
▪︎Retrograde UrethroGram (RGU Gold Standard)
🔷Mx Of Urethral Injury
📍1. Immediate Resuscitation & Bony Fixation During Pelvic Fractures
📍2. Bladder Catheterization (Using Catheter If Condition Allowed Or SupraPubic CystoStomy) For 10-14 Days
📍3. Then Do RGU :
▪︎No Strictures ➡ Nothing More Done
▪︎Strictures ➡ Do Delayed Anastomotic UrethroPlasty (After 3-6m) Or InternalUrethroTomy
🔷Complications Of Urethral Injury
📍1. Urethral Strictures
📍2. Erectile Dysfunction
📍3. Urinary Incontinence
- اخيراً لطلاب الجامعات،
اشتراك مجااني لمدة سنة gemini،
اهم شرط، تثبت لهم انك طالب جامعي.
- الرابط:
⬇️⬇️⬇️⬇️⬇️⬇️⬇️⬇️⬇️⬇️⬇️
◇ https://one.google.com/ai-student
🔆Diagnostic Clues For the Case of Hematuria
1️⃣Painless hematuria➕️elderly pt➕️smoker=➡️Bladder Cancer
2️⃣Painless hematuria➕️ flank pain ➕️palpable loin mass ➕️elderly pt=➡️Renal Cell Carcinoma
3️⃣Painful hematuria➕️flank pain radiates to groin =➡️Renal Stone
4️⃣Hematuria➕️dysuria➕️suprapubic pain=➡️ UTI(cystitis) or bladder stone
5️⃣Hematuria➕️proteinuria➕️hypertension ➕️oliguria=➡️Glomerulonephritis(Nephritic Syndtome)
6️⃣Hematuria➕️hx of throat or skin infection➕️school aged child =➡️ Post-Streptococcal GN
7️⃣painless progressive Hematuria➕️hearing loss➕️ocular problem(Ant.lenticonus)➕️family history=➡️ Alport Syndrome
8️⃣Hematuria➕️proteinuria➕️hemoptysis➕️cough➕️dyspnea=➡️Goodposture syndrome
9️⃣Sudden onset Hematuria(dark or tea colored urine)➕️sudden onset fatigability&,lethergy , pallor & jaundice➕️child boy➕️hx of triggering factors as recent use of certain drugs or hx of recent infection or hx of eating certain food or hx of applying Henna =➡️G6PD deficency hemolytic anemia
🔟painless terminal hematuria ➕️dysuria➕️frequent urination➕️suprapubic pain=➡️Urinary Belharziasis
#urology
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Revised Atlanta Classification of Acute Pancreatitis (2012)
🟢 Mild Acute Pancreatitis
No organ failure
No local or systemic complications
Usually resolves within the first week
Mortality: <1%
🟡 Moderately Severe Acute Pancreatitis
Transient organ failure (<48 hours) OR
Local complications:
Acute peripancreatic fluid collection (APFC)
Pancreatic pseudocyst
Acute necrotic collection (ANC)
Walled-off necrosis (WON) OR
Exacerbation of pre-existing comorbid disease
🔴 Severe Acute Pancreatitis
Persistent organ failure (>48 hours)
May involve one or multiple organs:
Respiratory
Renal
Cardiovascular
Highest morbidity and mortality
#Surgery
