Background; Perforated duodenal ulcer (PDU) is a common surgical emergency that is associated with high mortality and morbidity. Early diagnosis and prompt surgical treatment is required to prevent grave complications.
Objective; The study was designed to evaluate the diagnostic accuracy of different radiological investigations in the diagnosis of perforated duodenal ulcer.
Methods; A prospective study of 185 pts with PDU at al kindy teaching hospital, Baghdad, Iraq from June 2008- august 2010. patients were examined clinically and investigated by blood test, chest x ray, plain X ray of the abdomen. Ultrasonography (U/S) and CT scanning done for those patients with negative X- ray finding. Resuscitation by intravenous fluid and antibiotic done. Explorative laparotomy done for all patients, repair of perforation done by simple omental patch. Data regarding radiological, ultrasonographic and CT finding and operative finding were recorded.
Results: The study of 185 pts with proven perforated DU revealed 162 (87.5%) male and 23 (12.5%) female with age ranging from 22-70 yrs ,the average was 38 years.
Crescentic shape air under diaphragm was seen in chest or abdominal plain X ray in 121 (65.4%) pts and negative in 64 (34.6%) pts. For those 64 pts, a positive finding of free air or fluid was seen by U/S in 16 (25%) pts and positive CT finding was seen in 62 (96.9%) pts.
The operative finding in those 64 pts were; a small perforation less than 0.5 cm in 24 pts, completely or partially sealed perforation in 19 pts, severe edema and narrowing of the pylorus in 15 pts and perforation larger than 1 cm but with little peritoneal soiling was seen in 6 pts.
Conclusions: Pneumoperitonium was detected radiologically in 65% of pts of perforated DU. CT scan was found to be superior to U/S study for the diagnosis in pts with negative X-ray finding. For pts with perforated DU Conservative treatmentcan be adopted in pts with negative radiological findings.
The research Reviews the sides of highlight importance of the Nano-Accounting which doing the accounting performance functions fully computerized without the intervention of an accountant, to solve the problem of not keeping up the rationalization of recording and accounting systems, with the rationalization of production which fully computerized.(be invisible and hidden accounting), resulting by linking or interaction of the accounting, additive production system represented three-dimensional printers, open source and recycling. That which result the rationalizing the facilities of production, organization and self-control which derived nanotechnology idea, which aims to minimize materials and change it properties, then view the a
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The government spending in Iraq and witnessed the changes and developments, especially after 2003, which outweighed consumer spending at the expense of capital expenditure and increased support and diversity of trends towards improving pension conditions for member
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The current study aims to test the impact of green training and development on sustainable performance and explore its effects within and outside the Iraqi Ministry of Environment. The main research problem revolves around the question of the extent of implementing green training and development and sustainable performance in the ministry (What is the nature of the relationship between green training and development and sustainable performance in the ministry?). To clarify the relationship between the research variables, two main hypotheses were formulated along with sub-hypotheses. The study also aims to assess the level of the ministry's interest in the research variables and provide key recommendations to enhance sustainable performan
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... Show MoreIn Australia, most of the existing buildings were designed before the release of the Australian standard for earthquake actions in 2007. Therefore, many existing buildings in Australia lack adequate seismic design, and their seismic performance must be assessed. The recent earthquake that struck Mansfield, Victoria near Melbourne elevated the need to produce fragility curves for existing reinforced concrete (RC) buildings in Australia. Fragility curves are frequently utilized to assess buildings’ seismic performance and it is defined as the demand probability surpassing capacity at a given intensity level. Numerous factors can influence the results of the fragility assessment of RC buildings. Among the most important factors that can affe
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