ABSTRACT
A 23-year-old female underwent uneventful caesarian section, which was followed by massive pulmonary embolism. Pulmonary embolectomy on cardiopulmonary bypass was performed, and was complicated by massive intraabdominal haemorrhage due to a hepatic subcapsular rupture. To our knowledge, this is the first surgically orientated case of postpartum pulmonary embolectomy to be reported in the literature.
Subject(s)
Cesarean Section/adverse effects , Puerperal Disorders/etiology , Puerperal Disorders/surgery , Pulmonary Embolism/etiology , Pulmonary Embolism/surgery , Adult , Cardiopulmonary Bypass , Embolectomy , Female , Humans , Liver Diseases/etiology , Pregnancy , Rupture, Spontaneous , Treatment OutcomeABSTRACT
Fear of leakage has inhibited many surgeons from performing one-layer anastomosis with a continuous absorbable suture for the outer layer. Ninety-three one-layer colonic anastomoses were performed using polyglycolic acid sutures in 92 patients. Mortality was low (1.1%) and intra-abdominal septic complications occurred in only 4 patients (4.4%). Superficial wound infections occurred in a further 6 patients (6.5%). The mean postoperative hospital stay was 13.2 d with more than 79% being discharged in 15 d.
Subject(s)
Colon/surgery , Polyglycolic Acid , Suture Techniques , Sutures , Adolescent , Adult , Aged , Anti-Bacterial Agents/therapeutic use , Female , Humans , Male , Middle Aged , Postoperative Care , Postoperative Complications , Prospective StudiesSubject(s)
Geriatric Nursing , Urinary Incontinence/nursing , Aged , Empathy , Female , Humans , Male , Nurse-Patient Relations , Urinary Incontinence/etiologyABSTRACT
The effects of intrarectal metronidazole and intraincisional povidone iodine on sepsis after emergency appendicectomy were compared in a double-blind randomised controlled trial in 496 patients. Wound sepsis occurred in 12.3% of metronidazole-treated patients compared with 24% in the povidone-iodine group and 23.5% in an untreated control group. The metronidazole-treated patients left hospital approximately 2 days earlier than patients in the other two groups. They returned to work sooner and receiver fewer visits from the district nursing service. A short six-dose course of metronidazole significantly reduces the wound-infection rate in patients over the age of 12 undergoing emergency appendicectomy. If the clinical and economic benefits of metronidazole shown by this study are confirmed, the drug should be considered for routine use in emergency appendicectomy.
Subject(s)
Appendectomy , Metronidazole/therapeutic use , Povidone-Iodine/therapeutic use , Povidone/analogs & derivatives , Surgical Wound Infection/prevention & control , Clinical Trials as Topic , Costs and Cost Analysis , Double-Blind Method , Emergencies , Humans , Length of Stay/economics , Random AllocationABSTRACT
The risk of malignant change developing in the hamartomatous polyps in Peutz-Jeghers syndrome is widely held to be negligible. However an association with tumours of the upper gastro-intestinal tract, ovary and other diverse multiple neoplasms is now recognized. Previously reported cases of malignant change in Peutz--Jeghers polyps may represent 'pseudoinvasion' and we report such a case. This was associated with carcinomas of the bile ducts, left tonsil and a papillary adenoma of the pancreatic duct. It lends further support to the view that there may be a genetic predisposition to the development of neoplasms in this condition. Pathologists and clinicians must be aware of this entity of 'pseudoinvasion' in order to avoid unnecessarily radical surgery in Peutz-Jeghers syndrome.
