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 military presence in the Gulf region after the British withdrawal from it in 1971 was one of the most important pillars of the American strategy to climb the ladder of global leadership, as the geostrategic features that the region enjoyed provided factors of controlling energy sources and global trade routes. The United States of America guarantees Western Europe and Japan the process of access to energy sources and the exclusion of its opponents from the region, especially the Soviet Union, and the growing American military presence in the Gulf after the invasion of Iraq in 2003. On the other hand, the region experiences many contradictions, some of which threaten its security, such as the exacerbation of disputes between its count
... Show MoreThe concept of aesthetics is one of the postmodern propositions, and it is one of the branches of philosophy that examines beauty, its standards and theories, and it is a holistic concept that includes several concepts, including the beautiful, the ugly, and the sublime.
The concept of aesthetics dealt with several studies in general (and in the field of architecture in particular), and the problem of aesthetics is in the blurring of the relationship between aesthetics and architectural criticism, based on the research hypothesis which states that there is a relationship between aesthetics and architectural criticism. The importance of the research in accommodating aesthetic standards and bases of evaluation that increases the possi
The present study included the effect of chronic exposure for two concentrations of NaC? salt on the biology of fresh water zooplankton species Brachionus calyciflorus (from ^otifera). The concentrations 0.5 , 0.75%o were used for chronic exposure to investigate its effects on the life tables, range of the rate of expectation for further life and reproduction. The rotifer B. calyciflorus was sensitive to salinity and may tried to protect the species by increasing the size (2.22 ind./clutch lor control group and 2.9? for 0.5%o concentration) and number of clutches produced ?.1? clutch/female for control group and 2.9 ' ' ' for 0.75 %0 concentration) beside stimulation the animal to produce the first clutch of eggs earlier? ? small reduction
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Federico Garcia Lorca is considered in european and american literary circles as revolutionary symbol of contemporary literature writer through close association with the concerns of his country and the world, and also through the violent propensity to freedom, emancipation and innovation. This personal multi-talent has a significant impact in the spanish literary movement, in particularly, and in world, in general. If Lorca has andalusia blood, is no stranger to contemporary arab man to read to him, and contemplates his experience analyst and literary critic. This research is serious study of this character. There is no doubt the reader will put in front of many facts about personali
... Show MoreIt is known that the science of jurisprudence is one of the most important Islamic sciences. Because it is a science that regulates the life of man and society and provides them with happiness in this world and the hereafter, if they follow its provisions with precision and care. The importance of this topic lies in the fact that it represents an urgent social need to show the compatibility of tribal customs with social jurisprudence. The job of the jurists was and still is to clarify the legal rulings according to what the Holy Qur’an has shown, and what has been reported on the authority of the Great Prophet (6) and the pure imams (:).It is no secret to everyone that the Islamic civilization is (the civilization of jurisprudence), just
... Show MoreIn his masterpiece ’The Prophet’, Kahlil Gibran presents his unwavering faith and passionate belief in the healing power of universal love that brings humans to sublime ideas and elevates their souls and behavior. The current study aims to find out the stylistic devices utilized to represent the concept of love based on the hypothesis that Gibran tends to use certain stylistic effects to convey his meaning. The study adopts Leech and Short’s (2007) framework of stylistic analysis to analyze the lexical items and figures of speech in selected extracts from the book. The findings reveal that Gibran prefers concrete nouns, dynamic verbs, and physical adjectives over abstract nouns, stative verbs, and psychological adjectives to s
... Show Moreهذه الدراسة مكرسة للخصائص الوظيفية والدلالية المعقدة للفئات اللفظية من التوتر والنوع في اللغة الروسية سيتم الكشف في هذه الدراسة عن السمات الدلالية والأسلوبية للفرق بين الأفعال المكتملة وغير المكتملة، قد تكون الاختلافات مرتبطة بخصائص المعاني المعجمية للكلمات، وكذلك معاني اللواحق المكونة للكلمات) السوابق واللواحق). يعكس استخدام هذه الفئة النحوية في أنماط مختلفة بوضوح تفاصيل كل منها، لأن درجة واقعية ال
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... Show MoreEndometriosis is an estrogen dependent inflammatory disorder plays a pivotal role in the reproductive system of the females which regarded as one of the most important gynecological disorders due to it is a key cause of infertility for women and also it has a remarkable impact on the women's life quality. Indeed, environmental pollution have an extremely importance in the etiology of endometriosis. Hence, the present article submits an abbreviated literature review to the biochemical role of environmental pollutants in the etiology and development of endometriosis. Anyway, this review article represented the major environmental pollutants: the organic pollutants of air, heavy metals, gaseous pollutants and the particulate matter. Th
... Show Moreالمستخلص
يهدف البحث إلى وضع إطار معرفي ومفاهيمي شامل لموضوع البحث, واغناء القارئ والمستفيد بالمعلومات الوافية عنه وتقليص الفجوات المعرفية للمهتمين به وقياس مدى ما هو متوفر وغير متوفر من المتطلبات الأساسية والضرورية لإنشاء صناديق التحوط في البيئة العراقية, وتمثلت صناديق التحوط بالمتغير الرئيس للبحث اما المتغيرات الفرعية فشملت (المتطلبات المالية, المتطلبات البشرية, البيئة التشريعية, الب
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