Surgery, gynecology & obstetrics
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Surg Gynecol Obstet · Apr 1979
Case ReportsNonoperative management of intrahepatic hemorrhage and hematoma following blunt trauma.
Four patients with blunt abdominal trauma did not have surgical treatment for intrahepatic hemorrhage and hematoma. Two patients were diagnosed 24 hours after injury as having significant active hemorrhage, although their clinical status was stable. ⋯ Although more patients will have to be evaluated, it is our belief that nonoperative management of selected patients with an intrahepatic hematoma is reasonable and safe. Patients should be observed periodically with radioisotope scans, ultrasound or computerized tomography until the hematoma resolves.
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Surg Gynecol Obstet · Apr 1979
Percutaneous cannulation of the internal jugular vein in infants and children.
A technique for percutaneous catheterization of the internal jugular vein in infants and children was used since January 1975 in 206 patients ranging in age from a few hours to 12 years old. The series included 31 premature infants weighing less than 2,500 grams and 107 babies weighing less than 4,000 grams. Five attempts at cannulation failed. ⋯ The 22 late complications were related to infection; one infant died because of catheter sepsis. To minimize septic complications, an arbitrary limit of seven days was set, after which the catheter was replaced. Cannulation of the internal jugular vein in infants and children should be regarded as a serious surgical procedure to be performed by a trained team and only when properly indicated.