This video is a step-by-step approach to the technique of laparoscopic repair of perforated peptic ulcer with omental patch. The operation was carried out on a 49 yr old male patient. He was admitted via our Accident & Emergency Department few hrs earlier.
He developed epigastric pain whilst at home the previous evening. His pain spread to the rest of his abdomen through the night. He had been fit & well with no history of indigestion and was not on any regular medications.
An erect chest X-ray on admission did not show free air under the diaphragm. A CT scan, however revealed both free air and fluid throughout his abdominal cavity. It was more prominent in the right upper quadrant though. The CT scan did not show the source of perforation.
Clinically, we suspected a perforated peptic ulcer and opted to undertake a diagnostic laparoscopy and proceed depending on the operative findings. The plan was fully discussed with the patient who consented to this course of action. Pre-operative resuscitation was instigated with intravenous fluids, antibiotics and proton pump inhibitor as well as adequate pain relief.
Post-operatively the patient made quick recovery. He was mobile from day one; the top drain was removed after 36 hrs, and the pelvic one after 48hrs. He was allowed diet from day two. He was advised to continue antibiotics and proton pump inhibitors for two weeks (triple therapy) with the latter for a further six weeks. He was discharged after three days with a plan to have a follow up gastroscopy two months later.

Esophagogastroduodenoscopy showing Duodenal Ulcer among other findings.
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SmartyPants Women’s Complete Daily Gummy Vitamins: Gluten Free, Multivitamin, CoQ10 & Omega 3 Fish Oil (DHA/Epa Fatty Acids), Folate (Methylfolate), Non-GMO, 120 Count (20 Day Supply) Reviews

SmartyPants Women's Complete Daily Gummy Vitamins: Gluten Free, Multivitamin, CoQ10 & Omega 3 Fish Oil (DHA/Epa Fatty Acids), Folate (Methylfolate), Non-GMO, 120 Count (20 Day Supply)

  • This chewable vitamin for women contains 15 essential nutrients including vegan omega-3 (from flaxseed oil), Vitamin C, probiotics for digestive health*, vitamin D for bones*, vitamin B12 for energy*, and zinc (as zinc citrate) for immune support*
  • Certified Organic and vegetarian. Includes vegetarian omega-3 α-Linolenic acid, sourced from organic flaxseed oil.
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  • Includes naturally spore-forming probiotics (Bacillus subtilis) with a 99% survivability rate to support digestive health and gut function*
  • Non-GMO Project Verified. No synthetic colors, artificial flavor or sweeteners. Free of gluten, gelatin, milk, eggs, shellfish, soy, peanut, wheat, fish and tree nuts. No refrigeration required.
SmartyPants Women’s Complete is a premium, multifunctional supplement that delivers omega-3s from fish oil, CoQ10, and essential nutrients including folate as methylfolate, vitamin B12 for energy, vitamin D3 for immunity, and vitamin K2 for bone health—all-in-one delicious gummy.*

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How to Get Relief for Joint Pain

Osteoarthritis causes pain in your joints and can make it hard to move. Although OA can be painful, you can get relief with a number of treatments from pain relievers to surgery. Find what these treatments are and how they work.
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Sulakhan’s story – high cholesterol

Sulakhan had a heart attack due to high cholesterol in 2000. By making simple changes to his lifestyle, he lowered his cholesterol to a healthy level. https://www.bhf.org.uk/heart-health/risk-factors/high-cholesterol
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Learn more about licensing this video for content marketing or patient education purposes: http://www.nucleushealth.com/?utm_source=youtube&utm_medium=video-description&utm_campaign=highcholest-081613

This video, created by Nucleus Medical Media, explains hyperlipidemia, commonly known as “high cholesterol.” The animation includes common diet and lifestyle treatments as well as cholesterol-lowering medications. The animation includes both LDL, what is called “bad” cholesterol, and HDL, or “good” cholesterol.

ANH13104

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Just Keep Swimming 4″ x 2.5″ Box Sign Primitives by Kathy

Just Keep Swimming 4" x 2.5" Box Sign Primitives by Kathy

  • This small and inspirational sign makes a great gift as well as a perfect addition to an office or student's room.
  • Vintage style sign reads "Just Keep Swimming"
  • Sign measures 4-in W x 2-1/2-in H
  • Beveled edges with hollowed out back
  • Can be displayed freestanding or on a wall
Primitives by Kathy is a leading producer of high quality decorative box signs and home decor.

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Plus Size Women Tankini Sets with Boy Shorts Swimming Costume Two Piece Swimsuit

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s m o k e these m e a t s

sweet baby rays barbecue sauce, that is going on the ribs
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