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Biomedical subjects

J C Patel

Publications and source records attributed to J C Patel.

At least 271 records · Page 15Linked to original sources
PubMedDate not supplied

[Supracoeliac aortic clamping. Technique and indication in traumatic abdominal pathology].

Supracoeliac occlusion of the aorta was performed in two patients with visceral and vascular lesions due to blunt abdominal trauma. In both cases, aortic occlusion was required due to peroperative hypovolaemic shock. The first case was a 30-year-old man hospitalized for blunt thoracic and abdominal trauma. Haemodynamic parameters were unstable at admission with initial blood pressure at 85/45 mmHg. Physical examination indicated a haemoperitonium which was confirmed echographically. At laparotomy, among other injuries, the right supra-hepatologic vein and two posterior veins draining the segment VII were severed. Despite suture and haemostatic procedures, hypovolaemic shock occurred with systolic pressure at 40 mmHg. In the second case, haemoperitonium was also confirmed echographically in a 28-year-old man hospitalized for blunt frontal abdominal trauma. Blood pressure was 70/45 mmHg at admission and emergency laparotomy revealed major avulsion of the left lobe of the liver and lesions to the sub-renal vena cava and the left renal vein in addition to major injury to the pancreas and the stomach. While the supra-coeliac aorta was being prepared, persistent bleeding led to shock with a systolic pressure of 45 mmHg. In both cases, the supracoeliac artery was clamped, for 30 and 35 minutes respectively, making it possible to re-establish satisfactory haemodynamic conditions and allowing favourable outcome. These observations demonstrate that per-operative occlusion of the supracoeliac aorta performed as a salvage manoeuvre in cases of hypovolaemic shock can be an effective means of re-establishing a precarious haemodynamic situation. The technique is simple and rapid and few complications have been reported.

Abdominal Injuries↗
PubMedDate not supplied

[Laparoscopy for appendicular syndromes in young women. Results of a prospective study].

OBJECTIVES: Determine whether laparoscopic surgery for painful syndromes of the right iliac fossa in young women can reduce the number of unnecessary appendectomies and shorten hospital stay. METHODS: Thirty-two women (age range 15-43 years) who were admitted consecutively for "acute appendicitis" were included in a prospective study based on laparoscopic surgery for diagnosis and treatment. RESULTS: There were 14 cases of acute appendicitis (all confirmed histologically), 16 cases involving extra-appendicular tissues (mainly salpingitis, n = 7) and 2 cases in which no cause was found. Two unnecessary appendectomies were performed and only one laparoscopy had to be converted to an open procedure. Mean post-operative hospitalization was 3.43 days. These findings demonstrate that laparoscopic surgery effectively reduces the rate of unnecessary appendectomies and probably the duration of hospitalization. Laparoscopic surgery should be more widely used for young women presenting with appendicular syndromes.

Adolescent↗