The American surgeon
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The American surgeon · Nov 1995
Review Case ReportsPharyngo-esophageal perforation due to blunt trauma.
Pharyngoesophageal perforation due to blunt external trauma is a relatively rare and unreported injury. A patient is presented with such an injury secondary to assault, and the modes of diagnosis and management are discussed.
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The American surgeon · Nov 1995
Comparative StudyIncreased incidence of nosocomial infections in obese surgical patients.
Obesity has long been considered a potential risk factor for poor outcome following surgical procedures. However, controversy exists regarding the clinical impact of this problem because of a paucity of data regarding the incidence and risk of nosocomial infections in obese surgical patients. This retrospective study was undertaken to compare the nosocomial infection rate in obese and normal weight surgical patients. ⋯ No differences in distribution between groups were evident. Mortality was similar among the groups. These data support the hypothesis that obesity is a significant risk factor for clinically relevant nosocomial infections in surgical patients.
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Pseudoaneurysms of the splenic artery have been well described in association with pancreatic pseudocysts secondary to pancreatitis. We present a case of a ruptured splenic artery pseudoaneurysm 14 years after splenectomy for trauma which, at that time, was complicated by a subphrenic abscess.
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The American surgeon · Nov 1995
The effect of epidural analgesia on the return of peristalsis and the length of stay after elective colonic surgery.
Epidural analgesia has been shown to improve pulmonary function and analgesia after abdominal surgery. Although epidural analgesia may increase colonic motility, its effect on the clinical outcome following colonic surgery is unclear. Therefore, the purpose of this study was to determine the effect of epidural analgesia on return of peristalsis and length of stay after elective colonic surgery as compared with traditional analgesia. ⋯ No statistically significant difference was found between epidural and traditional analgesia with regard to return of peristalsis or length of stay. Similarly, when considering the location of the anastomosis (left versus right colon), no statistically significant difference was demonstrated between the two groups. Also, there was no increased incidence in anastomotic leaks or mortality.