📲 https://t.co/AUTrSGj37h | #Manabí 🚨 El doble crimen ocurrió en la vía Canoa–Jama. Las víctimas habían trasladado a un herido en un siniestro de tránsito.
SEPSIS 2026 (The Lancet): lo MÁS importante para cirugía y UCI
La sepsis NO es “infección grave”. Es disfunción orgánica potencialmente mortal por una respuesta del huésped desregulada ante una infección. 👉 Por eso 2 pacientes con el mismo germen pueden evolucionar completamente distinto.
🔬 En #cirugíabiliar compleja, anticiparse a las complicaciones mejora la seguridad y la toma de decisiones en quirófano.
El Dr. Pablo Beltrán Miranda y la Dra. Teresa Moreno (@CirugiaHJRJ) comparten un caso sobre el valor de los modelos 3D.
🧷 https://t.co/I2T6mXLX8V
A patient develops ecchymosis around the umbilicus two days after severe acute abdominal pain. Which condition is this sign most associated with?
A. Ruptured spleen
B. Hemorrhagic pancreatitis
C. Liver laceration
D. Renal artery thrombosis
🩻 𝗢𝗯𝘀𝘁𝗿𝘂𝗰𝗰𝗶𝗼́𝗻 𝗶𝗻𝘁𝗲𝘀𝘁𝗶𝗻𝗮𝗹: 𝗵𝗮𝗹𝗹𝗮𝘇𝗴𝗼𝘀 𝗿𝗮𝗱𝗶𝗼𝗴𝗿𝗮́𝗳𝗶𝗰𝗼𝘀✅
⬇️⬇️⬇️⬇️
🧩𝘾𝙖𝙪𝙨𝙖𝙨 𝙘𝙤𝙢𝙪𝙣𝙚𝙨: cáncer colorrectal, vólvulo sigmoideo o cecal.
🩻𝙃𝙖𝙡𝙡𝙖𝙯𝙜𝙤𝙨 𝙚𝙣 𝙍𝙭:
📌Dilatación de asas de colon (>6 cm) y ciego (>9 cm).
📌Haustras visibles (pliegues que no cruzan todo el diámetro).
📌Colapso del intestino distal.
📌Neumoperitoneo si perforación (aire subdiafragmático).
📌Nivel hidroaéreo y distensión periférica.
💥𝘾𝙤𝙢𝙥𝙡𝙞𝙘𝙖𝙘𝙞𝙤𝙣𝙚𝙨: isquemia, necrosis y perforación (>10-12 cm).
Acute cholecystitis is a pattern, not a single sign.
🫀 Key ultrasound findings:
• Gallstones or obstructing stone in the neck
• Gallbladder wall thickening (>3 mm)
• Sonographic Murphy sign
• Gallbladder distension
• Pericholecystic fluid or hyperemia
Stay posted #FOAMed
🖐️ Recurrent motor branch of the median nerve
It arises from the median nerve at or distal to the carpal tunnel, with a highly variable origin: it may be extraligamentous, subligamentous, or transligamentous (passing through the flexor retinaculum).
In the palm, the branch courses toward the thenar eminence and becomes superficial as it curves around the superficial head of the flexor pollicis brevis.
On ultrasound, its origin can usually be identified approximately at the level where the proper palmar digital nerves to the thumb arise: once these digital branches are recognized, a third branch may be seen coursing proximally and radially, becoming superficial and skirting the superficial head of the flexor pollicis brevis. This corresponds to the recurrent motor branch.
At this level, it follows a very superficial course, making it particularly vulnerable to traumatic or iatrogenic injury, especially during carpal tunnel release.
⚠️ It is essential to recognize its anatomy and variants, as they are common.
The transligamentous variant, in which the branch passes through the flexor retinaculum, carries the highest surgical risk.
🎯 Function: innervates the thenar muscles responsible for thumb opposition.
#mskrad