Severe haemorrhagic complication following needle or open biopsy of a breast mass: suspect angiosarcoma.
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Adult↗
Biomedical subjects
A Assalia
Publications and source records attributed to A Assalia.
Treatment of uncontrolled hemorrhagic shock by hypertonic saline and external counterpressure.
The effect of an external counterpressure device (ECPD) on hypertonic saline treatment of uncontrolled hemorrhagic shock (UCHS) was studied in rats. The rats were divided into five groups. In group 1 (n = 11) UCHS induced by incision of three radicals of the ileocolic artery was treated by 5 mL/kg NaCl 0.9% (normal saline). In group 2 (n = 20), UCHS was treated by 5 mL/kg NaCl 7.5% (hypertonic saline). In group 3 (n = 6), UCHS was treated by inflation of ECPD to 50 torr. In group 4 (n = 7), UCHS was treated by ECPD and normal saline; in group 5 (n = 9), UCHS was treated by ECPD and hypertonic saline. Incision of the ileocolic artery in group 1 rats led to a fall in mean arterial pressure to 33 torr (P less than .001) followed by a spontaneous rise to 48 torr (P less than .01) with a mortality rate of 27% and a mean survival time of 161 +/- 9 minutes. Infusion of hypertonic saline during UCHS was followed by a further fall in mean arterial pressure to 18.5 torr (P less than .001); mortality was 80% within 80 minutes with a mean survival time of 35.5 minutes, which was significantly lower than in group 1 (P less than .01). Inflation of ECPD during UCHS in group 3 or treatment with ECPD and normal saline in group 4 did not alter the hemodynamic response and mortality, which were similar to those of group 1.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
Is hypertonic saline resuscitation safe in 'uncontrolled' hemorrhagic shock?
Hypertonic saline treatment of hemorrhagic shock (HS) results in increased systemic blood pressure, cardiac output, and splanchnic blood flow. To determine whether this elevation in blood pressure and flow would augment blood loss from injured intra-abdominal vessels and thus enhance mortality rate, "controlled" HS was induced by bleeding of 20 ml/kg from an arterial cannula that was immediately occluded after hemorrhage, and "uncontrolled" HS was induced by incision of three major radicals of the ileocolic artery leading to continuous intra-abdominal blood loss. Seventy rats were divided into eight groups: Group I (n = 5) underwent carotid artery and jugular vein cannulation and was observed for 3 hr; in Group II (n = 10) "controlled" HS was induced by arterial hemorrhage of 20 ml/kg; in Group III (n = 7) "controlled" HS was treated by 5 ml/kg NaCl 0.9%; in Group IV (n = 8) "controlled" HS was treated by 5 ml/kg NaCl 7.5%; in Group V (n = 4) midline laparotomy and identification of the ileocolic artery was performed; in Group VI (n = 9) "uncontrolled" HS was induced by incision of three major branches of the ileocolic artery; in Group VII (n = 9) "uncontrolled" HS was treated by 5 ml/kg NaCl 0.9%, and in Group VIII (n = 18) "uncontrolled" HS was treated by 5 ml/kg NaCl 7.5%. In untreated "controlled" HS (Group II), mean arterial pressure (MAP) fell to 35 torr followed by a spontaneous rise to 62 torr (p less than 0.001) after 3 hr with a survival of 80% of the animals.(ABSTRACT TRUNCATED AT 250 WORDS)
Animals↗
Minicholecystectomy vs conventional cholecystectomy: a prospective randomized trial--implications in the laparoscopic era.
The objective of this study was to compare results of elective "open" conventional cholecystectomy (CC) to those of minicholecystectomy (MC). A clinical prospective, randomized trial was designed. The setting was an academic general surgical unit. In the CC group were 26 patients; in the MC group were 24 patients. In the CC group a conventional open cholecystectomy was performed through a subcostal incision; in the MC group operation through an initial 5-cm subcostal incision was done. Mean length of wound was 14.4 cm and 5.4 cm in the two groups, respectively (p < 0.001). Mean operative time was 60 and 59 minutes, respectively. Mean operative difficulty, estimated on a 1-10 scale, was 3.4 and 5.6, respectively (p < 0.05). Mean postoperative analgesia requirements (number of doses of 10 mg morphine sulphate) were 5.8 and 4.0, respectively (p = 0.002). Mean duration of hospitalization was 4.7 and 3.0 days, respectively (p < 0.001). Mean "overall patient satisfaction," estimated on 1-10 scale, was 6 and 8.3, respectively (p = 0.002). We conclude that Minicholecystectomy offers less pain, earlier recovery, and better cosmetic results than the conventional "open" procedure. Published results of MC compare favorably with those of laparoscopic procedures. The implications of these results in the "laparoscopic era" are discussed.
Cholecystectomy↗
Transient chylous ascites following a distal splenorenal shunt.
The development of chylous ascites following abdominal surgery is an infrequent yet alarming complication. We present a patient in whom chylous ascites was diagnosed 6 days after a distal splenorenal shunt. Ten days following bed rest, sodium restriction, and a low-fat diet with medium-chain triglyceride supplementation the ascites resolved.
Aged↗
Vascular prosthetic bypass grafting in obstructive jaundice. Experimental and clinical perspectives.
The use of artificial grafts was proposed to facilitate the construction of palliative bilio-enteric bypass in proximal malignant biliary obstruction. Previous reported clinical experience is favorable. We present herein our preliminary clinical and experimental experience with Dacron and PTFE (Goretex) vascular grafts for the construction of bilio-duodenal bypass. Although our clinical results appear encouraging, the use of these prosthetic conduits is not supported by experimental data obtained in dogs.
Aged↗