Southern medical journal
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Southern medical journal · Sep 1988
Case ReportsOvarian cancer manifested as exertional hypotension due to obstruction of the inferior vena cava.
We have reported a case of inferior vena cava obstruction caused by recurrent ovarian carcinoma. This case is noteworthy first because it shows that physical findings in inferior vena cava obstruction may be minimal. Secondly, we believe ours is the first reported case of exertional hypotension caused by obstruction of the inferior vena cava. Finally, ovarian cancer has rarely been reported as a cause of inferior vena cava obstruction.
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Southern medical journal · Sep 1988
Case ReportsBronchopulmonary endometriosis: a rare cause of hemoptysis.
We have reported a case of hemoptysis caused by pulmonary parenchymal endometriosis which was apparently successfully treated with danazol. Bronchopulmonary endometriosis is a very unusual cause of hemoptysis, and should be suspected on the basis of cyclic hemoptysis with menstruation. Danazol is effective therapy, but information regarding optimal dosage and rates of recurrence after completion of therapy is limited at this time.
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We present a seven-year experience with cranial nerve injuries due to carotid artery endarterectomy. A total of 433 carotid endarterectomies were done on 355 patients by senior surgical residents, with a staff surgeon assisting. Thirteen cranial nerve injuries were identified, five of which were permanent. Knowledge of the anatomic features of the cranial nerves and their branches in the operative field, as well as technical maneuvers during surgery, can reduce such injuries to a minimum.
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Southern medical journal · Aug 1988
Diaphragmatic rupture due to blunt trauma: morbidity and mortality in 42 cases.
We present an analysis of 42 cases of acute rupture of the diaphragm by blunt trauma. There were 31 men (74%) and 11 women (26%); the mean age was 32.8 years +/- 2.4 SEM. At admission, hypovolemic shock was present in 45% of the cases, pelvic fracture in 36%, and severe respiratory distress in 21%. ⋯ There were 14 deaths, for a mortality of 33%. Seven were operative and due to massive hemorrhage; the late deaths were caused by systemic sepsis in five and neurologic trauma in two. We conclude that (1) diaphragmatic rupture after blunt trauma must be suspected when specific radiologic findings are present; (2) solitary diaphragmatic injuries seldom occur; (3) in most cases, morbidity or mortality is caused by the severity of the associated injuries; and (4) most diaphragmatic injuries can be repaired through a celiotomy, and all of them should be repaired to avoid the sequela of entrapment of abdominal organs in the thorax.