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 is based on an important subject according to the researchers' estimations. It is the disclosure of the nature of the relationship between Watching to cultural programs in satellite channels and the book's vision of the intellectual, and the pursuit of purchasing and acquiring it It is a scientific addition to the scientific research media because it deals in the field of new about the nature of the relationship between satellite programs and writers, and it provides a scientific development on the importance of satellite channels in the promotion of the book and sales of intellectual elite. The study examined the audience of the recipients of literature for cultural programs, the nature of the public, characteristic
... Show MoreThe culture of theatre performance has a vital role in the process of reading the linguistic and visual signs of the performance. And the process of transforming a theatre performance from its original context into a new hosting cultural context starts from the actual reading of the text. Directors derives their new signs out of his personal culture, depending on the society where they lives and the culture that forms the social conventions, traditions and beliefs. The text is usually written within its own historical and temporal culture. The process of its production usually takes it away from its original culture, when it interprets the codes of the original writer and their visual and linguistic signs and instils new alternative sign
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Abstract
Due to the lack of previous statistical study of the behavior of payments, specifically health insurance, which represents the largest proportion of payments in the general insurance companies in Iraq, this study was selected and applied in the Iraqi insurance company.
In order to find the convenient model representing the health insurance payments, we initially detected two probability models by using (Easy Fit) software:
First, a single Lognormal for the whole sample and the other is a Compound Weibull for the two Sub samples (small payments and large payments), and we focused on the compoun
... Show MoreProtection study of the corrosion behavior of Copper surface was conducted with several concentrations of drug. Experimentally, voltammetric measurements were used to check the inhibition efficiency (% IE) in saline solution of 3.5% NaCl. The results showed an increase in the inhibition efficiency with increasing the concentration of the drug was 95.90%. Theoretical treatment of the drug in the gas phase was performed using the (hyperchem-8.07) program for molecular mechanics and semi-empirical computations. The (PM3) approach was used to determine the heat of formation (1H˚f), binding energy (1Eb), and total energy (ET