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Biomedical subjects

G H Sullivan

Publications and source records attributed to G H Sullivan.

7 recordsLinked to original sources

Deep venous thrombosis associated with heterotopic ossification.

The differential diagnosis of the swollen lower extremity in the patient with spinal cord injury includes deep venous thrombosis, fracture, cellulitis, joint sepsis, heterotopic ossification, hematoma formation, and neoplasm. A patient with an asymmetrically swollen limb who was found to have concurrent ipsilateral acute deep venous thrombosis and active heterotopic ossification is described. The diagnostic workup included various laboratory and radiologic studies. Therapy included anticoagulation with heparin and warfarin. To treat the heterotopic ossification, indomethacin, etidronate, and graded range of motion were used. We learned from this patient and several similar cases that acute deep-venous thrombosis and active heterotopic ossification may occur concurrently, and therapeutic anticoagulation did not lead to bleeding within or around the area of active heterotopic ossification. The possibility of a relationship between heterotopic ossification and deep venous thrombosis is presently being studied at our institution.

Diagnosis, Differential

Modified endometrial ablation: electrocoagulation with vasopressin and suction curettage preparation.

Patient preparation and a modified operative technique are described for electrocoagulation ablation of the endometrium using a roller-bar electrode. No preoperative or postoperative endometrial suppression was used. Rather, the endometrial cavity was denuded by suction curettage just before ablation, which was performed in the early proliferative phase of the menstrual cycle. Lidocaine paracervical block containing vasopressin was injected at the start of the procedure to control pain and to minimize bleeding and irrigation fluid absorption. Pulsed irrigation of the uterus was used to improve visibility through uterine debris and the bubbles generated by the electrical current. The first 20 patients who had electrocoagulation ablation of the endometrium with these modifications were compared with the first 18 patients who had laser coagulation ablation using standard technique and preoperative endometrial suppression. Compared with the laser method, the modified coagulation method resulted in a comparable rate of satisfactory bleeding decrease at 6 months (90 versus 94%), but involved a clinically significant reduction in total anesthesia time (66.8 versus 117.3 minutes) and volume of irrigation fluid used (5.7 versus 15.9 L).

Adult