摘要:

AbstractThe case histories of three brothers, the only siblings of one family, all of whom underwent surgery for the treatment of a previously asymptomatic ruptured abdominal aortic aneurysm, are recorded.The possibility of underlying constitutional and hereditary factors is discussed and the suggestion of a primary familial incidence of atheromatous, non‐dissecting aortic aneurysm is raise

ISSN:0007-1323    

DOI:10.1002/bjs.1800641102

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractA retrospective study has been carried out on 124 consecutive patients with abdominal aortic aneurysms admitted during the period 1960–74. The mortality rate after emergency operation was 56 per cent and after elective operation 15 per cent. As in other vascular centres during these years the mortality rate has decreased among electively operated patients. We have tried to answer two questions: which patients without signs of rupture should undergo operation and which patients with a ruptured aneurysm should not be operated upo

ISSN:0007-1323    

DOI:10.1002/bjs.1800641103

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractIntra‐operative haemodynamics were studied in a case of axillofemoral grafting. When the normal axillary artery acted as the donor artery no steal from the arm occurred, even after vasodilatation in the leg. When, conversely, the very poor arterial collaterals to the leg were required to serve as donor arteries because the axillary artery proximal to the anastomosis was occluded by a clamp, a steal from the leg to the arm was observed. The study supports the concept that only if the donor artery has a high resistance to flow can a steal develo

ISSN:0007-1323    

DOI:10.1002/bjs.1800641104

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractCadaveric donor saphenous veins subjected to proteolytic enzymatic digestion, crossbonding and heparin bonding were used for arterial reconstruction in the legs of 13 patients threatened with amputation and without suitable autogenous saphenous veins. Distal anastomoses were to the tibial and peroneal vessels. Twelve patients (92 per cent) were discharged from hospital with functioning grafts; 9 grafts (69 per cent) continue to function 2–16 (average 8) months after operation. Amputation was avoided in 11 patients (85 per cent). Although early results are encouraging, late results are yet to be determine

ISSN:0007-1323    

DOI:10.1002/bjs.1800641105

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractTwo double‐blind controlled clinical trials of the effectiveness of prophylactic low dose subcutaneous calcium heparin (dose based on body weight) in the prevention of deep vein thrombosis (DVT) have been completed. The first was concerned with upper abdominal operations in 242 patients over 21 years of age, and the second with 50 patients presenting with a fracture of the neck of the femur. There was no increase in the incidence of bleeding or wound complications in the patients given heparin. In each trial, the incidence of DVT as diagnosed by125I‐labelled fibrinogen was significantly reduced in the treated group.The incidence of DVT in the control groups varied significantly during the period of the trials. The incidence was much higher in the cold half of the year than in the hot months.In the first trial, this variation in incidence was directly correlated with the average temperature and the diurnal variation in temperature in the perioperative period. These results may help to explain the considerable variation in the incidence of postoperative DVT reported from various parts of the world, and also from within Austra

ISSN:0007-1323    

DOI:10.1002/bjs.1800641106

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractTwo patients with mesenteric venous thrombosis which occurred late after splenectomy are reported. In the first case the thrombosis was seen, with preceding thrombocytosis, 3 years after splenectomy. In the second case the thrombosis occurred 2 years and 5 months postoperatively. Platelet counts had not been obtained before the mesenteric thrombosis in this case. In both instances persistent severe anaemia for several weeks preceded the symptoms and signs of mesenteric venous thrombosis. Both patients were treated by extended resection of the affected small bowel. Thus, dangerous thrombocytosis may occur in the presence of persistent severe anaemia even late after splenectomy. Thrombocytosis occurring immediately after splenectomy, which is almost inevitable, should be treated with heparin or other anticoagulants. In the late period the avoidance of persistent severe anaemia seems to be important in the prevention of thrombotic complications due to reactive thrombocytosis in splenectomized patients.

ISSN:0007-1323    

DOI:10.1002/bjs.1800641107

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractSurgical excision of extracranial arteriovenous malformations may be indicated for cosmetic or urgent medical reasons, such as haemorrhage or high output cardiac failure. However, serious haemorrhage, incomplete removal and poor cosmetic results are well‐known complications encountered after this operation. Preoperative embolization under angiographic control is recommended to reduce the incidence of these problem

ISSN:0007-1323    

DOI:10.1002/bjs.1800641108

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractPlasma catecholamines have been measured before, during and after operation in 40 patients undergoing elective major abdominal surgery and in 12 patients during open heart surgery. Plasma concentrations did not increase during abdominal surgery and showed only small increase during cardiopulmonary bypass. It appears that it is not possible to assess individual intra‐operative sympatho‐adrenal responses to surgical trauma by measurement of plasma catecholamine concentrations because of the efficiency of catecholamine uptake mechani

ISSN:0007-1323    

DOI:10.1002/bjs.1800641109

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractThe increasing incidence of perforated duodenal ulcer among Black patients admitted to the Johannesburg General Hospital between 1966 and 1976 is described against a background of the different forms of peptic ulcer disease seen in this hospital population. Admission for perforation during the years 1973–6 was as common among Black as among White patients. Perforation occurred principally in young (20–40 years) Black males (sex ratio 14 : 1), with a short history of preceding symptoms, and treatment was usually by simple closure. In the White group the age range was broader (20–70 years) and the male : female ratio only 2·7:1. Duodenal ulcer occurred predominantly in males (ratio 6 : 1), and the spectrum of the disease among the Black population in this urban environment resembled that among the White population in Johannesburg and in Western countries in the relative frequency of perforation and haemorrhage, rarity of stenosis and ratio of duodenal to gastric ulce

ISSN:0007-1323    

DOI:10.1002/bjs.1800641110

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractThe intrinsic factor (IF) output during basal and Histalog‐stimulated gastric secretion has been estimated in two series of patients with chronic duodenal ulcer before and 3 months or more after treatment by either highly selective vagotomy or truncal vagotomy and pyloroplasty. The effects of the two different vagotomy operations appear to be virtually identical and each produced significant reductions in intrinsic factor secretion after Histalog stimulation. This confirms the view expressed by previous workers that it is the vagotomy as such which is responsible, excluding the drainage procedure from any possible role. Furthermore, as these results were demonstrated 3 months after operation, it is likely that the depressed IF secretion is a permanent feature and one which, it is postulated, may become progressively more severe.In both series there is a marked reduction in IF output during the second hour of stimulated gastric secretion, indicating an early wash‐out of preformed IF. This persists after vagot

ISSN:0007-1323    

DOI:10.1002/bjs.1800641111

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY