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991.
We reviewed nine patients with Ludwig's angina who required surgical drainage over a 24-month period. This represents the largest series reported in world literature. All of these patients were managed successfully by a combination of tracheal intubation and early surgical intervention. None required tracheostomy, which is the previously recommended procedure of choice for airway management. 相似文献
992.
993.
David B. Soll 《Ophthalmology》1978,85(12):1259-1266
994.
I. Noer J. Præstholm K. H. Tønnesen M.D. 《Cardiovascular and interventional radiology》1981,4(2):73-76
Patients with severe ischemia due to multilevel obstructions in the leg arteries both above and below the groin were assessed
preoperatively by intraarterial brachial and femoral artery pressure measurements. The systolic pressure drop along aortoiliac
obstructions was compared to the angiographic findings. A consistent pressure gradient was found in the various types of arterial
occlusions.
In patients with occlusion of both the aorta and the iliac arteries, the systolic pressure drop was about 60% (range, 50–78%,
SD 9%). The various types of iliac artery occlusions resulted in quite uniform systolic pressure drops of about 50% (range
35–68%, SD 9%). In contrast, the systolic pressure drop along different types of iliac stenoses showed a wide variation, ranging
from a minimal drop to about 60%. The degree of stenosis on the angiogram was correlated significantly with the pressure drop.
Due to large variations, however, this angiographic information was found to be useless in the individual patient. No difference
in the pressure drop was found between cases in which rich and poor collateral networks were visualized.
Presented at the Elsinore Symposium September 1978 相似文献
995.
996.
A.?TsikoudasEmail author X.?Kochillas R.?J.?Kelleher R.?Mills 《European archives of oto-rhino-laryngology》2005,262(7):528-530
The objective was to assess the number of patients with acute oesophageal bolus obstruction that resolves spontaneously and to aid the identification of the best practice. This prospective and retrospective case series study at a teaching hospital and a district general hospital in Scotland, UK, involved 37 patients with acute oesophageal obstruction from a food bolus who were observed for 24 h from the beginning of symptoms. The bolus passed spontaneously in 54% of the patients during the observational period. A short observational period following the admission of patients with acute food bolus obstruction is reasonable as it may reduce exposure to surgical morbidity and decrease inpatient stay. 相似文献
997.
Villegas L Jones D Lindberg G Chang C Tesfay S Fleming JB 《HPB : the official journal of the International Hepato Pancreato Biliary Association》2005,7(2):149-154
The purpose of this study was to develop a method of laparoscopic biliary bypass utilizing a PTFE-covered biliary stent. An animal model of common bile duct obstruction was developed. Three days before the planned choledochojejunostomy, the common duct in 10 female pigs was ligated using mini-laparoscopy instrumentation (2 mm) to create an obstruction model. A laparoscopic choledochojejunostomy was then performed using intracorporal suturing (n=5) or stented (n=5) techniques. In the sutured group, a side-to-side two-layer anastomosis was performed. In the stented group, a Seldinger technique was used to deliver the stent into the abdomen through the small bowel and into the anterior wall of the common bile duct for deployment across both the duct and bowel to create an anastomosis (under fluoroscopic guidance). After the surgery, the animals were followed for 7 days, and then sacrificed to examine the anastomosis grossly and histologically. Statistical analysis was used to compare the two groups. Although the difference was not statistically significant, the mean anastomosis time in minutes was shorter for the stented group (37.8; range 15-74 minutes) than in the sutured group (52.8; range 28-70 minutes). All animals survived for 7 days after the procedure with no detectable biliary leaks or biliary obstruction at autopsy. These gross findings were confirmed by pathologic examination of the anastomoses. Laparoscopic choledochojejunostomy using a PTFE-covered metallic biliary stent can be performed to relieve common bile duct obstruction. In addition, the stent method was as safe and effective as sutured laparoscopic choledochojejunostomy. 相似文献
998.
Background: Both surgical and nonsurgical options are available to treat bowel obstruction in patients with metastatic cancer. The goal
is straightforward: to restore bowel patency and palliate the symptoms of obstruction. Yet the most appropriate management
is often a challenging decision.
Aim of the Study: We sought to review our experience in managing patients with metastatic cancer and bowel obstruction.
Methods: A retrospective review was performed to identify all patients admitted at University of Wisconsin Hospital between 1993 and
2000 with the diagnoses of both bowel obstruction and metastatic cancer. Demographic data, type of management, postoperative
complications, and outcome were analyzed.
Results: A total of 114 patients with primarily colorectal or gynecologic malignancies were identified. Patients’ first bowel obstructions
were managed in one of two ways: (1) definitive surgical intervention (n=47), or (2) conservative management (n=67). The median overall survival was 3 mo for the entire study group. There was no significant difference in overall or obstruction-free
survival based on management, presence of recurrent bowel obstruction, or type of primary cancer. The only factor that was
significant in predicting poor overall survival included a disease-free interval of less than 1 yr (time of diagnosis of primary
cancer to time of bowel obstruction, p=0.002).
Conclusions: Bowel obstruction in patients with metastatic cancer is a terminal event, with a 3-mo median survival. Because there is no
difference in overall or obstruction-free survival based on management, the treatment for palliation of bowel obstruction
in patients with metastatic cancer should be individualized. 相似文献
999.
Etensel B Ozkisacik S Döger F Yazici M Gürsoy H 《Pediatric surgery international》2005,21(12):1018-1020
Intestinal obstruction caused by an anomalous congenital band is very rare in adults and children. A 7-year-old boy was admitted
with acute intestinal obstruction. His parents mentioned that the child always had mild abdominal distention and failure to
thrive from his infancy. On his medical history, there were not any attacks of abdominal pain, fever and hospitalization.
Laparotomy showed an ileal loop compressed by an anomalous band, which extended from the ileum to the sigmoid mesentery resembling
a mesenteric remnant. The band was resected. Histologically, it was composed of loose connective tissue containing mature
vessels. 相似文献
1000.
Three infants with anterior abdominal wall defects (gastroschisis and exomphalos) who presented with obstructive jaundice secondary to biliary obstruction, are described. All three infants had abnormal biliary systems, with mechanical distortion of the biliary tree. Biliary obstruction secondary to structural biliary anomalies should be considered in patients with abdominal wall defects and cholestasis, as prolonged unrelieved biliary obstruction may lead to biliary cirrhosis and portal hypertension. 相似文献