Canadian journal of surgery. Journal canadien de chirurgie
-
The authors reviewed and analysed the records of 75 patients with omental and bowel evisceration as a result of abdominal stab wounds to discover whether omental prolapse makes laparotomy mandatory. Major intraabdominal injuries were found in 82.7% of the total group, 82.9% in those with omental protrusion and 82.5% in patients with bowel prolapse. ⋯ Negative laparotomy did not cause important morbidity. The authors conclude that omental herniation after stab wounds of the abdomen should routinely prompt exploratory celiotomy.
-
Subdural empyema is a surgical emergency, which, if not recognized and managed promptly, is rapidly fatal. The clinical features, diagnosis, infecting organisms, treatment and results in 15 patients with subdural empyema admitted to the University and Saskatoon City hospitals between 1956 and 1982 are evaluated. There were 11 males and 4 females; 80% were under 50 years of age. ⋯ Follow-up ranged from 1 month to 15 years. Eleven patients recovered with minimal or no neurologic deficit, 2 patients had permanent major deficits and 2 died. Successful management of subdural empyema depends on early diagnosis, prompt evacuation of the pus and appropriate antibiotic therapy.
-
Cardiac tamponade is a well-known result of fluid collection within the pericardial sac. That air in the pericardial sac can produce a similar clinical picture is not so well known. The author describes the case of a 38-year-old patient with acute cardiac tamponade produced by air within the pericardial sac after trauma.
-
Three cases of immobilization hypercalcemia are presented and the incidence, clinical symptoms, laboratory investigation, pathophysiology and treatment of this metabolic abnormality are reviewed. Immobilization hypercalcemia is more common that has previously been suspected. Vague clinical symptoms may not suggest the diagnosis of hypercalcemia. ⋯ Treatment is directed towards lowering the serum calcium level using intravenous hydration, furosemide and salmon calcitonin. Definitive treatment consists of mobilizing the patient. Exercises in bed have not been effective in preventing or treating immobilization hypercalcemia.
-
Possible intra-abdominal injuries were sought in 101 patients admitted with blunt abdominal trauma. The serum amylase level was measured in the first 12 hours after the accident. ⋯ The mean value of the serum amylase for those who had laparotomy was 1190 IU, while it was only 363 IU for those not operated upon. The authors conclude that hyperamylasemia in blunt abdominal trauma is not specific to pancreatic injury, but may suggest the presence of a serious intra-abdominal lesion.