The European journal of surgery = Acta chirurgica
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Avulsion of the gallbladder from its liver bed with detachment from both cystic duct and artery is an exceedingly rare consequence of blunt abdominal injury. A case is reported in which early recognition by diagnostic peritoneal lavage led to successful treatment.
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To find out if preoperative and postoperative dehydration adversely affect anastomotic and subcutaneous healing. ⋯ Preoperative and postoperative dehydration has a deleterious effect on subcutaneous, and to a lesser extent on anastomotic healing in rats.
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To assess the value of 99mTc-HMPAO-labelled-leucocyte scintigraphy in the detection of abdominal abscesses, the results of 74 examinations in 69 patients suspected of having abscesses on clinical grounds were reviewed retrospectively. Of a final total of 29 abscesses in 28 patients, leucocyte scanning diagnosed 26, giving a sensitivity, specificity, and accuracy of 90%, 91%, and 91%, respectively. In 22 patients abscesses were diagnosed within 30 min. In 13 of the 74 examinations (18%) an infection or inflammatory lesion other than an abscess was diagnosed. 99mTc-HMPAO-labelled-leucocyte scintigraphy is an accurate and rapid method of diagnosing abscesses in acutely ill patients.
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Randomized Controlled Trial Comparative Study Clinical Trial
Amoxicillin-clavulanate prophylaxis against wound infections after clean-contaminated surgery. A controlled, randomized, prospective study.
In a single-blind, prospective randomized and controlled trial, amoxicillin-clavulanate was compared with gentamicin plus clindamycin as perioperative prophylaxis for 24 hours in clean-contaminated abdominal surgery. Proven infections of the abdominal incision occurred in one of 59 evaluable patients given amoxicillin-clavulanate and one of 43 with gentamicin/clindamycin. ⋯ Intraperitoneal infection occurred in one patient of that group, and in three of the gentamicin/clindamycin group. Both regimens thus were effective and safe as prophylaxis in clean-contaminated abdominal surgery.
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Upper gastrointestinal haemorrhage in 978 unselected patients during a 9-year period was reviewed in regard to incidence, diagnosis, treatment and mortality rate. The annual incidence was 1/1,000 of the catchment population. The source of bleeding was established in 89% of cases. ⋯ The perioperative mortality was 13% and the overall mortality 6%. It is concluded that current treatment policy resulted in low rates of operation and mortality in these unselected cases of upper gastrointestinal haemorrhage. The results support the theory that a hypercoagulable state in gastrointestinal bleeding is counteracted by citrated stored blood.