Nonsurgical management of uncomplicated intrahepatic hematomas following blunt abdominal trauma.

A 45-year-old man who sustained blunt abdominal trauma was found to have a huge intrahepatic hematoma. Although early abdominal exploration is usually recommended for suspected hepatic injury, this case was managed nonsurgically by careful observation, with gradual resolution of the hematoma as seen on serial liver scans.

[Initial clinical experience using Dermodress, a new temporary biological skin substitute]. / Erste klinische Erfahrungen bei der Verwendung von Dermodress, einem neuen temporären biologischen Hautersatz.

A chemically treated bovine skin, Dermodress, is presented as a long-term skin substitute. Dermodress was applied over denuded surfaces of debrided deep burns and was kept in place up to 56 days. At this time it was totally replaced by autograft, so we have no idea yet of how much longer it could have remained. It adheres to all contours of the debrided area, has hemostatic effect, and does not present any sign of infection or rejection. Dermodress can be removed in stages according to the availability of autografts, which may be applied immediately, since the exposed areas are clean and suitable for immediate grafting. Our clinical experience shows that Dermodress has most of the required properties of a long-term temporary skin substitute.

Benign hamartoma of the lung presenting as massive hemoptysis.

A case is presented of benign pulmonary hamartoma causing episodes of hemoptysis. This is an extremely unusual manner of presentation for such lesions.

"Dermodress", a new temporary skin substitute: pilot study on donor sites.

"Dermodress" is a new temporary biological dressing (heterograft) composed of a pure neonatal bovine collagen I. The authors present their first trial with this skin substitute. Ten consecutive patients who required skin grafts were included in the pilot test group. The "Dermodress" was tested on their donor sites and compared with "Furacin" gauze. It was found that "Dermodress" provided a covering that adhered excellently to debrided surfaces, without disturbing the healing processes underneath, for up to three weeks after application. The results point to the potential value of the "Dermodress" for open wounds.

Smooth muscle tumors of the small bowel: a case report and review of the literature.

We report a rare case of peritonitis caused by perforation of smooth muscle tumor of the jejunum. In spite of having all the reported presenting symptoms of these tumors, the diagnosis was not made preoperatively. Although histopathologically diagnosis was that of a benign tumor, the subsequent course was rapid and malignant. A complete review of the literature is presented.

Dermodress: a new, temporary skin substitute for extensive deep burn coverage.

A chemically treated bovine skin, Dermodress, is presented as a long-term skin substitute. Dermodress was applied over denuded surfaces of debrided deep burns and was kept in place for up to 56 days. Dermodress adheres to all contours of the debrided surfaces, has hemostatic effect and does not present any signs of infection or rejection. Dermodress can be removed in stages according to the availability of autografts, which may be applied immediately, since the exposed areas are clean and suitable for immediate grafting. Our clinical experience shows that Dermodress has most of the required properties of a long-term temporary skin substitute.

Thyroglossal duct remnant carcinoma.

Thyroglossal duct remnant carcinoma is a very rare malignancy arising from aberrant thyroid tissue. This diagnosis, however, should be considered in patients presenting with anterior neck masses. If there is no invasion of the capsule of the tumor, local excision with diligent follow-up is recommended as the treatment of choice.

Shell splinter in the common bile duct: a rare cause of obstructive jaundice.

A foreign body in the common bile duct is a rare cause of obstructive jaundice. In the present case a shell splinter migrating into the common bile duct caused obstructive jaundice 9 years after the original injury.

Antibody pattern to human cytomegalovirus in patients with adenocarcinoma of the colon.

The role of human cytomegalovirus (CMV) was examined according to serological patterns in 37 patients with adenocarcinoma of the colon (ACC). The sera were examined for the presence of IgG antibodies by the immunoperoxidase antibody to membrane antigens (IPAMA) method and by the complement-fixation (CF) test. Antibody determinations were also performed by the IPAMA method for three other members of the herpesvirus group: Epstein-Barr virus (EBV), herpes simplex virus (HSV) and varicella-zoster virus (VZV). Comparison groups included normal subjects, ACC patients treated with chemotherapy, and patients operated on for benign diseases. No significant difference was found in the geometric mean titers (GMTs) for CMV and the other herpesviruses in the sera of nontreated ACC patients when compared with the control groups. However, a significantly elevated antibody titer to CMV was found in chemotherapy-treated ACC patients by both the IPAMA and CF methods. In this group, elevated titers were found by the IPAMA method for EBV and HSV, but not for VZV. The significance of serological studies in elucidating the role of CMV in ACC patients is discussed.

Aberrant (ectopic) adrenocortical tissue along the spermatic cord.

Aberrant adrenocortical tissue along the spermatic cord is a far more common finding than has previously been reported. During a period of 12 consecutive months, 360 children, aged 13 days to 13 yr, underwent 386 operations for common inguinoscrotal pathology at the Soroka Medical Center. In 12 cases ectopic adreno-cortical tissue was found along the spermatic cord, an overall incidence of 3.8%. None was found in females. Considering the group operated upon for undescended testis, in which by nature of the procedure the spermatic cord was dissected throughout its length, the frequency of ectopic adrenal tissue found rose to 9.3%, the highest figure cited for this location. The nature of aberrant adrenocortical tissue is briefly discussed, including its embryology, histology, and clinical implications. It usually appears as an incidental finding during surgery. Its removal is indicated whenever found although no special attempt should be made to search for it.

Mesenteric vein thrombosis. The importance of a second-look operation.

Mesenteric vein thrombosis is an abdominal emergency that is rarely diagnosed early. Review of the literature has shown that most cases have been treated by intestinal resection, a few by thrombectomy with or without resection. Three cases of mesenteric vein thrombosis were treated by resection, heparinization, and a second-look operation after 24 hours. When necessary, resection was carried out at the second surgical procedure followed by a third-look operation after 24 hours. After the last inspecting operation without further resection, full heparinization was continued and anticoagulation was ultimately maintained with warafin sodium (Coumadin) for at least three months. The authors believe that optimal treatment for mesenteric vein thrombosis should include anticoagulation with heparin sodium and a mandatory second-look operation.