Abdominal simulation

The peritoneal dialysis access catheter placement simulation is ideal to teach aviation safety principles emphasizing the importance of knowing basic facts, such as the tools and instruments needed for the procedure and how the use of checklists improves patient safety. An abdominal simulator is currently under development for the laparoscopic technique of placing the peritoneal dialysis catheter [12]. 

Abstinence from alcohol is the most important factor in preventing abdominal pain in the early stages of alcoholic CP, although reports of the effect of abstinence from alcohol have varied. Small and frequent meals (six meals per day) and a diet restricted in fat (50 to 75 g/day) are recommended to minimize postprandial pancreatic secretion and resulting pain. Parenteral or enteral nutrition (elemental diets) may be necessary, especially if the patient is chronically debilitated, and these nutritional approaches are less likely than oral ingestion of ordinary food to simulate pancreatic secretion, as stimulation of the pancreas is of some concern in that it may contribute to pain. ... 

Increased paracellular permeability such as that induced by the majority of nonselective NSAIDs favors the entry of pathogens, allergens, and bacterial translocation, giving rise to enteropathy and septic shock. Simple tests performed in animals by measurement of permeability to macromolecules in basal and simulated conditions may provide relevant information. Similarly, drugs may directly affect both functional and nociceptive sensitivity of the gut and subsequently inhibit enzyme secretion and many upstream inhibitory reflexes, and initiate abdominal pain in response to normal mechanical stimuli. 

Acute appendicitis is the most common cause of emergency abdominal surgery. Since clinical diagnosis is difficult, appendectomy after false-positive diagnosis of appendicitis is still performed in up to 20% of cases [38]. In women of fertile age, the error rate reaches up to 40%, because acute gynecological processes tend to clinically simulate acute appendicitis [39]. 

Condino S, et al. How to build patient-specific synthetic abdominal anatomies. An innovative approach from physical toward hybrid surgical simulators. Int J Med Robotics Comput Assisted Surg 2011 7(2) 202—13. 

Computer simulations of flow in the abdominal aorta were carried out by Artoli et al., and Ahmadi and Joseph. Sample pressure and surface shear stress contours are shown in Figs. 63 and 64. The upper arteries connected to the abdominal aorta are also identified in Fig. 63. The computational domain actually included the inferior mesenteric artery and iliac bifurcation at the end of abdominal aorta. It is seen that there is noticeable pressure drop from the main abdominal aorta to the bifurcating arteries. The celiac and superior mesenteric arteries are at higher pressure compared with the left and right renal arteries. While not shown in the figures, the inferior mesenteric and iliac arteries are at lower pressure. Figure 63 also shows that the pressure decreases rapidly along the smaller arteries. 

Ahmadi, G. and Joseph, R. (2007). Simulations of Pulsatile Blood Flow in the Abdominal Aorta with Newtonian and Non-Newtonian Models. Comput. Biol. Med. (submitted for publication). 

The patients have either complained of right upper quadrant abdominal pain simulating gall bladder disease or their doctors have found an abdominal mass below the right arcus. Some have been acutely ill with severe abdominal pain and shock. In these women laparotomy has shown haemorrhage into the peritoneal cavity. Some of these cases have been fatal (46, 47 -, 48 52, 59C, 6QC, 73C). 

---