Description
Clinical History
A 54-year-old man presented to hospital with 12 hours of severe colicky pain, nausea and vomiting. On history, he was noted to have had a 3-year history of intermittent right subcostal pain for which he had not seen a doctor. He was diagnosed as having an acute bowel obstruction and a laparotomy was performed.
Pathology
This segment of small bowel has been opened to display a large pigmented, ovoid gall stone with a roughened surface. This is an example of gall stone ileus.
Further Information
Gallstone disease is an uncommon cause of bowel obstruction - accounting for only 0.5% of cases with a preponderance for older and female patients. It most commonly secondary to biliary-enteric fistulae (can be to proximal or distal portions of bowel) but can also occur after sphincterotomy. Stones are usually over 2-2.5cm and 70% impact in the ileum, while others obstruct at sites of stricture/narrowing. History may include episodic obstructive symptoms. Diagnosis is confirmed either radiologically (often on CT scan) or at time of removal. Rigler's triad is typical for gallstone ileus and consists of: (1) small bowel obstruction, (2) a gallstone outside the gallbladder, and (3) air in the bile ducts (pneumobilia) seen on imaging and gallstone presence on plane XR. Treatment usually surgical with removal of the obstructing stone, closure of the fistula and cholecystectomy to stop recurrence. These procedures may need to be staged.
Advantages
- Anatomically accurate and identical to real specimen
- No ethical issues - not real human body parts
- Reasonably priced
- Available within a short lead time
- Reproducible, several identical prints can be used as a classroom set
- Can be produced in different sizes to cater for the needs of the teacher
Human Cadavers
- Access to cadavers can be problematic. Many countries cannot access cadavers for cultural and religious reasons
- Cadavers cost a lot money
- High cost for establishing your own plastination suite
- Wet specimens cannot be used in uncertified labs
- Dissection of cadavers is a lot of staff time and that is a cost
- Storage of cadaver material needs special refrigeration etc. which has coast
- If you want another specimen you have to start all over again
Plastinates
- Costs
- Ethical issues
- Timeframe for plastination process
- Many countries do not allow their importation
- One of a kind
Superior 3D print results compared with conventional methods
- Vibrant color offering with 10 million colors
- UV-curable inkjet printing
- High quality 3D printing that can create products that are delicate, extremely precise and incredibly realistic
Clear Support Material
- To avoid breakage of fragile, thin, and delicate arteries, veins or vessels, a clear support material is printed on such spots. This makes the models robust and can be handled by students easily.
