Svay Toeu,MD,GS.

Svay Toeu,MD,GS. Working 7/24(7 days and 24hs)

Low Anterior Resection Syndrome (LARS) is a collection of bowel dysfunction symptoms that can occur after a low anterior...
25/03/2025

Low Anterior Resection Syndrome (LARS) is a collection of bowel dysfunction symptoms that can occur after a low anterior resection (LAR) surgery, a procedure to remove part or all of the re**um, often for re**al cancer treatment

The Child-Pugh score is a universal scoring system used to assess the severity of chronic liver disease and cirrhosis, c...
25/03/2025

The Child-Pugh score is a universal scoring system used to assess the severity of chronic liver disease and cirrhosis, categorizing patients into classes A, B, or C based on factors like ascites, encephalopathy, albumin, bilirubin, and prothrombin time.

Petersen hernias are internal hernias which occur in the potential space posterior to a gastrojejunostomy. This is herni...
27/02/2025

Petersen hernias are internal hernias which occur in the potential space posterior to a gastrojejunostomy. This is herniation of intestinal loops through the defect between the small bowel limbs, the transverse mesocolon, and the retroperitoneum, after any type of gastrojejunostomy. The laparoscopic approach facilitates the occurrence of this type of hernia, due to the lack of post-operative adhesions which prevent bowel motility and hence, herniation.

Dopamine vs Serotonin
08/02/2025

Dopamine vs Serotonin

Dopamine and Serotonin
08/02/2025

Dopamine and Serotonin

👉Water intoxication, also known as water poisoning, hyperhydration, overhydration, or water toxemia, is a potentially fa...
18/01/2025

👉Water intoxication, also known as water poisoning, hyperhydration, overhydration, or water toxemia, is a potentially fatal disturbance in brain functions that can result when the normal balance of electrolytes in the body is pushed outside safe limits by excessive water intake.

👉Postoperative free intraperitoneal gas refers to the presence of gas in the peritoneal cavity following a surgical proc...
05/10/2024

👉Postoperative free intraperitoneal gas refers to the presence of gas in the peritoneal cavity following a surgical procedure and may result from open or laparoscopic surgical techniques.

👉Terminology
Postoperative free intraperitoneal gas is also referred to as postoperative pneumoperitoneum

👉Epidemiology
Free intraperitoneal gas after surgery occurs in up to 60% of laparotomies (air) and 25% of laparoscopic procedures (carbon dioxide) .Larger volumes of gas are associated with a smaller body mass index
👉the point at which all postoperative gas will resolve varies, but most will resolve by 5 days and almost always within 14 days

👉Carbon Dioxide Embolism during Laparoscopic Surgery👉Carbon dioxide embolism is a rare but potentially serious complicat...
05/10/2024

👉Carbon Dioxide Embolism during Laparoscopic Surgery

👉Carbon dioxide embolism is a rare but potentially serious complication of laparoscopic procedures.It is caused by entrapment of carbon dioxide in an injured vein, artery or solid organ, and results in blockage of the right ventricle (RV) or pulmonary artery

Carbon dioxide is well-suited for creating a pneumoperitoneum because it is chemically inert, colorless, inexpensive, readily available, and less combustible than air. Carbon dioxide is highly soluble in blood which allows rapid absorption into the blood stream across the peritoneum.At the same time, carbon dioxide can cause hypercapnea, metabolic acidosis, cardiorespiratory compromise, and greater postoperative pain as well as having adverse effects on intraperitoneal immune function, even increasing the risk of port-site tumor metastases in experimental models.Consequently, alternative gases have been investigated to reduce negative side effects.

Dumping syndrome treatment Dietary guidelinesHealthcare providers recommend following these general guidelines to reduce...
01/10/2024

Dumping syndrome treatment
Dietary guidelines

Healthcare providers recommend following these general guidelines to reduce symptoms:

Eat smaller meals more frequently. Aim for six small meals instead of three. Eat slowly and chew thoroughly.
Avoid simple sugars, carbohydrates and milk products. This will prevent rapid blood sugar shifts. Complex carbs, such as whole grains, are better
Eat more protein and healthy fats to replace carbohydrates in your diet. Fats slow down digestion and provide a steadier form of energy.
Eat more dietary fiber to add bulk to your meal and slow down its transit time. Fiber slows down sugar absorption in your digestive system.
Lie down on your back for 30 minutes after eating. This may slow down gastric emptying and help maintain blood pressure during digestion.
Don’t drink fluids within 30 minutes before or after eating. Fluids encourage motility.

👉Dumping SyndromeDumping syndrome is a collection of symptoms that occur when your stomach empties its contents too rapi...
01/10/2024

👉Dumping Syndrome
Dumping syndrome is a collection of symptoms that occur when your stomach empties its contents too rapidly into your small intestine. It’s usually associated with gastric surgery. Rapid gastric emptying causes large amounts of undigested food to flood your small intestine. You may experience nausea, abdominal cramping and blood sugar reactions.
👉 What causes dumping syndrome?

Surgical causes include:

Gastrectomy. Surgery to remove part or all of the stomach.
Bariatric surgeryfor weight loss, such as gastric bypass.
Pyloroplasty. An operation on the pyloric valve at the bottom of your stomach.
Esophagectomy. Surgery to remove part or all of the esophagus.
Vagotomy. Surgery to cut the vagus nerve in the stomach to reduce stomach acid.
Nissen fundoplication. Surgery to sew the top of the stomach around the esophagus.
👉Disease-related causes include:

Diabetes mellitus.
Cyclic vomiting syndrome.
Autonomic dysfunction.
Exocrine pancreatic insufficiency.
Duodenal ulcers.
Zollinger-Ellison syndrome.
Functional dyspepsia.
Cannabis hyperemesis syndrome.

👉There are two types of problems that can arise from gastric surgery- early and late dumping syndromes.👉Early DumpingIn ...
01/10/2024

👉There are two types of problems that can arise from gastric surgery- early and late dumping syndromes.

👉Early Dumping

In early dumping, the symptoms usually occur within 10 to 30 minutes after a meal. The rapid transit of hyperosmolar chyme from the stomach into the duodenum causes fluid to shift from the vasculature to the intestinal lumen, leading to increased volume in the small bowel. This is believed to be the cause of abdominal cramps, tachycardia, nausea, and diarrhea.

GI hormones such as enteroglucagon, pancreatic polypeptide, peptide YY, vasoactive intestinal polypeptide, glucagon-like peptide, and neurotensin have been evident with higher values after meals. Hormonal imbalances may cause delayed motility, decreased gastric and intestinal secretions, which delays the digestion and transit of food that arrives at the small bowel.

👉Late Dumping

Late dumping, also known as postprandial hyperinsulinemic hypoglycemia, usually occurs 1 to 3 hours after a high-carbohydrate meal. There is an association with hypoglycemia, but the exact mechanism is unknown. It is proposed that the rapid absorption of carbohydrates exaggerates the glucose-mediated insulin response.

Emphysematous PyelonephritisAuthor Information and AffiliationsLast Update: January 11, 2024.Go to:IntroductionEmphysema...
30/09/2024

Emphysematous Pyelonephritis

Author Information and Affiliations
Last Update: January 11, 2024.

Go to:
Introduction

Emphysematous pyelonephritis (EPN) is a severe necrotizing infection that affects the upper urinary tract, involving the renal parenchyma and, in some instances, the perirenal tissues of the kidney. This condition frequently leads to gas formation in the renal parenchyma, collecting system, or perinephric tissue. Emphysematous pyelitis (gas in the renal pelvis) or emphysematous cystitis (gas within the bladder wall and lumen) may occur independently of associated EPN.

Diabetes mellitus represents the most prevalent risk factor, found in over 90% of patients diagnosed with EPN.EPN is a life-threatening disease, with reported mortality rates ranging from 40% to 90%.Clinical diagnosis of the condition closely mirrors acute pyelonephritis, which requires accurate evaluation through imaging, particularly computed tomography (CT) scans. Treatment options for EPN have evolved, with aggressive surgical intervention and more conservative therapeutic approaches, primarily involving percutaneous drainage and antimicrobials.

Go to:
Etiology

Escherichia coli and Klebsiella pneumoniae are the most common pathogens associated with EPN, accounting for 49% to 67% and 20% to 24% of cases, respectively. Other reported organisms include Proteus, Enterococcus, Clostridium, Aspergillus, and, rarely, Candida spp. In some instances, infections exhibit polymicrobial characteristics.

Go to:
Pathophysiology

Uncontrolled diabetes can cause bacterial propagation and disease progression due to high tissue glucose levels, impaired oxygen supply to the kidneys, and microvascular disease.Gas accumulation observed in EPN is likely a consequence of microbial fermentation of glucose and lactate, producing gases such as carbon dioxide, hydrogen, and nitrogen.Urinary tract obstructions can reduce renal blood flow and tissue perfusion, exacerbating the infection.

Address

Phnom Tbeng Meanchey

Telephone

012242446

Website

Alerts

Be the first to know and let us send you an email when Svay Toeu,MD,GS. posts news and promotions. Your email address will not be used for any other purpose, and you can unsubscribe at any time.

Contact The Practice

Send a message to Svay Toeu,MD,GS.:

Shortcuts

Share

Category