IntroductionIntrauterine devices are often accompanied by various complications, of which the uterine perforation constitutes the most dangerous one.Case presentationWe present a case of a 41-year-old woman complaining of right upper quadrant pain. She had an intrauterine device inserted 12 years earlier without regular follow-up. Abdominal plain X-ray revealed the intrauterine device trans-located into the right subdiaphragmal area. Abdominal ultrasound showed gallbladder stones without any other sonographic pathologic finding. Patient underwent simultaneous laparoscopic cholecystectomy and removal of the intrauterine device from the right subdiaphragmal area.ConclusionLaparoscopy is an appropriate method for removal of intrauterine device translocated to the right subdiaphragmatic region.
A cute Gastrointestinal bleeding-Massive acute bleeding from gastrointestinal section is one of the most frequent forms of acute abdomen. The mortality degree in emergency surgery is about 10 %. It's very difficult to identify the place of bleeding and etiology. Purpose: The important purpose of this research is to present the cases of acute gastrointestinal bleeding from the patients which were monitored and treated at The University Clinical Center of Kosova-Emergency Center in Pristina. Material and methods: These inquests included 137 patients with acute gastrointestinal bleeding who were treated in emergency center of The University Clinical Center in Pristina for the period from January 2005 until December 2006.Results and discussion: From 137 patients with acute gastrointestinal bleeding 41% or 29% was female and 96% or 70.1 % male. Following the sex we gained a high significant difference of statistics (p <0.01). The gastrointestinal bleeding was two times more frequent in male than in female. Also in the age-group we had a high significant difference of statistics (p<0.01) 63.5 % of patients were over 55 years old. The mean age of patients with an acute gastrointestinal bleeding was 58.4 years SD 15.8 age. The mean age for female patients was 56.4 age SD 18.5 age. The patients with arterial systolic pressure under 100 mmHg have been classified as patients with hypovolemic shock. They participate with 17.5% in all prevalence of acute gastrointestinal bleeding. From the number of prevalence 2{1.5%} patients have been diagnosed with peptic ulcer, 1{0.7%} as gastric perforation and 1{0.7% }with intestine ischemia. Abdominal Surgery and Intensive Care 2 or 1.5% died, 1 at intensive care unit and 1 at nephrology. Conclusion: As we know the severe condition of the patients with gastrointestinal bleeding and etiology it is very difficult to establish, we need to improve for the better conditions in our Emergency Center for treatment and initiation base of clinic criteria. Key words: acute gastrointestinal bleeding, emergency centre, university clinical center of Kosova. corresponding author: Basri lenjani, md. emergency medicine. university clinical center of Kosovo, prishtina, Kosovo. tel.:00 381 385 78 41. e-mail: basrilenjani@yahoo.com.
Spinal disc herniation, also known as a slipped disc, is a medical condition affecting the spine in which a tear in the outer, fibrous ring of an intervertebral disc allows the soft, central portion to bulge out beyond the damaged outer rings. Disc herniation is usually due to age-related degeneration of the outer ring, known as the anulus fibrosus, although trauma, lifting injuries, or straining have been implicated as well. Tears are almost always postero-lateral (on the back of the sides) owing to the presence of the posterior longitudinal ligament in the spinal canal.[1] This tear in the disc ring may result in the release of chemicals causing inflammation, which may directly cause severe pain even in the absence of nerve root compression. Disc herniations aare normally a further development of a previously existing disc protrusion, a condition in which the outermost layers of the anulus fibrosus are still intact, but can bulge when the disc is under pressure. In contrast to a herniation, none of the central portion escapes beyond the outer layers. Most minor herniations heal within several weeks. Anti-inflammatory treatments for pain associated with disc herniation, protrusion, bulge, or disc tear are generally effective. Severe herniations may not heal of their own accord and may require surgery. The condition is widely referred to as a slipped disc, but this term is not medically accurate as the spinal discs are firmly attached between the vertebrae and cannot "slip" out of place. Lumbar disc herniations occur in the lower back, most often between the fourth and fifth lumbar vertebral bodies or between the fifth and the sacrum. Symptoms can affect the lower back, buttocks, thigh, anal/genital region (via the perineal nerve), and may radiate into the foot and/or toe. A hernia in the lumbar region often compresses the nerve root exiting at the level below the disk. Thus, a herniation of the L4/5 disc will compress the L5 nerve root. In the Neurosurgery Clinic in Pristina we have analyzed the operating cases of Herniated lumbar disc during the period 2014/2016 ie a period of three years. In total, there were 673 cases operable in this period, of which 418 were females and 256 male males. In 2014, 174 patients were operated, out of which 98 were female and 74 male males. In 2015, 220 patients were operated, 145 of them were female and 65 of male males. In 2016, 289 patients were operated, including 175 females and 15 males. We have also analyzed the nursing treatment, where according to our statistics, the patients during these three years have stayed and are treated in a ward with an average of 6.1 days.
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