Articles: postoperative-complications.
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Randomized Controlled Trial Clinical Trial
Unexplained in-hospital fever following cardiac surgery. Natural history, relationship to postpericardiotomy syndrome, and a prospective study of therapy with indomethacin versus placebo.
In Part I of this study, the in-hospital course of 219 patients who had undergone a cardiac operation is analyzed. Fever (greater than or equal to 37.8 degrees C, rectal) was present after postoperative day 6 in 159 patients (73%) and was of unexplained cause in 118. Fever decay in the population of unexplained fever patients was exponential. ⋯ Indomethacin resulted in a shorter duration of fever (2.4 vs 3.5 days, P is less than 0.01) and in a shorter duration of chest pain, malaise, and myalgias compared to placebo. Sixty-seven percent of the patients in Part I and all of the patients in Part II were contacted 2-8 months following hospital discharge. Five percent had experienced an illness that we considered to be acute pericarditis, but its occurrence was unrelated to whether the patient had had in-hospital unexplained postoperative fever, in-hospital rub or chest pain, or in-hospital administration of indomethacin.
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J. Thorac. Cardiovasc. Surg. · Apr 1978
Case ReportsChylothorax and chylopericardial tamponade following Blalock-Taussig anastomosis.
A case of chylothorax following a right-sided Blalock-Taussig shunt is presented. Chylopericardial tamponade eventually developed, because the mediastinal leakage of chyle was sealed off from the pleural cavity and diverted into the pericardium. Chylopericardium is a rare cause of an enlarged cardiac silhouette on a postoperative chest roentgenogram, but the importance of differentiating it from congestive heart failure is illustrated. When chylopericardial tamponade occurs, treatment consists of (1) aspiration for immediate relief and, if there is recurrence, (2) surgical evacuation of the pericardium with tube drainage or pericardiectomy and (3) ligation of the source of chylous drainage.
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Surg Gynecol Obstet · Apr 1978
Case ReportsSevere hyperchloremic acidosis complicating jejunoileal bypass.
In summary, severe hyperchloremic acidosis developed in two patients as a late complication after jejunoileal bypass for morbid obesity. This acidosis was associated with episodes of dizziness, ataxia, headache, weakness, confusion and transient loss of consciousness. ⋯ Revision of the intestinal bypass was required for correction. Special studies to rule out renal tubular acidosis were performed and definitely excluded the kidney as a source of the acidosis.