Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 3 de 3
Am J Emerg Med ; 49: 52-57, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1244700


PURPOSE: During the COVID-19 pandemic, emergency department (ED) volumes have fluctuated. We hypothesized that natural language processing (NLP) models could quantify changes in detection of acute abdominal pathology (acute appendicitis (AA), acute diverticulitis (AD), or bowel obstruction (BO)) on CT reports. METHODS: This retrospective study included 22,182 radiology reports from CT abdomen/pelvis studies performed at an urban ED between January 1, 2018 to August 14, 2020. Using a subset of 2448 manually annotated reports, we trained random forest NLP models to classify the presence of AA, AD, and BO in report impressions. Performance was assessed using 5-fold cross validation. The NLP classifiers were then applied to all reports. RESULTS: The NLP classifiers for AA, AD, and BO demonstrated cross-validation classification accuracies between 0.97 and 0.99 and F1-scores between 0.86 and 0.91. When applied to all CT reports, the estimated numbers of AA, AD, and BO cases decreased 43-57% in April 2020 (first regional peak of COVID-19 cases) compared to 2018-2019. However, the number of abdominal pathologies detected rebounded in May-July 2020, with increases above historical averages for AD. The proportions of CT studies with these pathologies did not significantly increase during the pandemic period. CONCLUSION: Dramatic decreases in numbers of acute abdominal pathologies detected by ED CT studies were observed early on during the COVID-19 pandemic, though these numbers rapidly rebounded. The proportions of CT cases with these pathologies did not increase, which suggests patients deferred care during the first pandemic peak. NLP can help automatically track findings in ED radiology reporting.

Appendicitis/diagnostic imaging , Diverticulitis/diagnostic imaging , Emergency Service, Hospital , Intestinal Obstruction/diagnostic imaging , Tomography, X-Ray Computed/statistics & numerical data , Abdomen/diagnostic imaging , COVID-19/epidemiology , Humans , Massachusetts/epidemiology , Natural Language Processing , Retrospective Studies , SARS-CoV-2 , Utilization Review
Cir Cir ; 89(3): 390-393, 2021.
Article in English | MEDLINE | ID: covidwho-1244414


Posponer cirugías electivas durante el proceso pandémico de Covid-19 aumentó el riesgo de complicaciones graves de enfermedades benignas. El íleo biliar es una de las raras complicaciones de la colelitiasis (0,3-0,5%). Los episodios recurrentes de colecistitis aguda están involucrados en la fisiopatología. La demostración de la tríada de Rigler en tomografía computarizada es diagnóstica. Para reducir la morbilidad se recomienda la cirugía dos etapas: extirpar el cálculo por enterotomía en la primera operación, cirugía biliar en la segunda operación. El íleo biliar debe estar en el diagnóstico diferencial de las obstrucciones intestinales mecánicas, especialmente en pacientes con antecedentes de ataques de colecistitis durante el proceso pandémico de Covid-19 porque las cirugías electivas se detuvieron.Postponing elective surgeries during the coronavirus disease-19 (COVID-19) pandemic process increased the risk of severe complications of benign diseases. Gallstone ileus is one of the rare complications of cholelithiasis (0.3-0.5%). Recurrent episodes of acute cholecystitis are involved in pathophysiology. Demonstration of Rigler's triad on computed tomography is diagnostic. To reduce morbidity stepped surgery is recommended: remove the stone by enterotomy at the first operation and biliary surgery at the second operation. Gallstone ileus should be in the differential diagnosis of mechanical intestinal obstructions, especially in patients with a history of cholecystitis attacks during the COVID-19 pandemic process because elective surgeries stopped.

COVID-19/epidemiology , Cholecystectomy , Gallstones/complications , Ileus/etiology , Intestinal Obstruction/etiology , Withholding Treatment , Aged , Cholecystitis, Acute/diagnosis , Cholecystostomy , Elective Surgical Procedures , Female , Gallstones/diagnostic imaging , Humans , Ileus/diagnostic imaging , Intestinal Obstruction/diagnostic imaging , Pandemics , Time Factors
BMJ Case Rep ; 14(4)2021 Apr 28.
Article in English | MEDLINE | ID: covidwho-1207483


We report a case of right paraduodenal hernia with strangulation of almost the entire small bowel at presentation. Since resection of all bowel of doubtful viability would have resulted in too little residual length to sustain life, a Bogota bag was fashioned using transparent plastic material from an urine drainage bag and the patient monitored intensively for 18 hours. At re-laparotomy, clear demarcation lines had formed with adequate length of viable bowel (100 cm) and resection with anastomosis was done with a good outcome on follow-up, 9 months after surgery. Our description of a rare cause of strangulated intestinal obstruction and a novel method of maximising length of viable bowel is reported for its successful outcome in a low-resource setting.

Gangrene , Intestinal Obstruction , Colombia , Gangrene/surgery , Hernia , Humans , Intestinal Obstruction/diagnostic imaging , Intestinal Obstruction/etiology , Intestinal Obstruction/surgery , Intestine, Small/diagnostic imaging , Intestine, Small/surgery , Paraduodenal Hernia