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Biomedical subjects

J S Freed

Publications and source records attributed to J S Freed.

31 records · Page 2Linked to original sources
PubMed1978

Massive colonic variceal bleeding secondary to abnormal splenocolic collaterals: report of a case.

Even in the absence of demonstrable esophagogastric varices in the cirrhotic patient, a diagnosis of variceal bleeding from unusual sites should be entertained in the differential diagnosis of massive lower gastrointestinal hemorrhage. The varices may reflect the increased pressure in the superior or inferior mesenteric systems or in the splenic system through abnormal splenocolic anastomoses. This case has the unique feature of bleeding from varices interposed between the splenic and inferior mesenteric venous systems, as opposed to the previously described cases of varices draining directly into a portosystemic conduit.

Collateral Circulation↗
PubMed1978

Immediate revascularization of the popliteal artery and vein: report of a case.

A case demonstrating the successful use of Silastic shunts for immediate limb revascularization is presented. Temporary limb revascularization may reduce the rate of amputation in combined popliteal vessel injuries. A major cause of limb loss is delay between injury and revascularization, including transport time and time spent dealing with other injuries. Repair of the popliteal vein increases the chance of successful limb salvage. Temporary Silastic shunts can alleviate time loss while others problems are dealt with and allow rapid venous, as well as arterial, revascularization. The technical ease and rapidity of shunt placement converts a catastrophic vascular emergency into a manageable problem.

Adult↗
PubMed1978

Dopamine and the aged.

Regardless of the age of the patient, dopamine is a valuable agent for treating shock associated with an abdominal catastrophe. However, when the time is appropriate for withdrawal of dopamine, the aged do not react as do younger patients. Despite apparent adequate hydration, additional volume loading is required to avert renal failure, and the dosage of dopamine has to be decreased gradually until withdrawal is complete.

Abdominal Injuries↗
PubMed1978

The interneural incision for biliary tract operations.

The interneural incision has clearly been demonstrated to be efficient, being executed rapidly and providing excellent exposure to the right upper abdominal quadrant. The postoperative period is marked by less subjective complaints; decreased narcotic requirements, and increased ease of walking, coughing and deep breathing. The result is improved pulmonary toilet and a negligible incidence of pulmonary complications. At long term observation, there is a scar which is cosmetically preferable, without neuroma or hernia formation and with no complaints of numbness or paresthesias in the area of the incision. For all these reasons, we have concluded that the interneural incision is superior, in the appropriate anatomic situation, than is either a vertical or subcostal incision for biliary tract operations.

Adult↗
PubMed1976

Primary torsion of the greater omentum mimicking duodenal ulcer.

The diagnosis of primary torsion of the omentum is a diagnostic enigma and is made almost exclusively at laparotomy. The difficulty is enhanced when the patient has a chronic problem mimicking a specific entity, e.g. peptic ulcer disease. The case presented is an example of this situation. The patient's history and acute presentation were compatible with chronic peptic ulcer disease with acute perforation. At laparotomy, the findings of torsion of the right lower omentum with infarction, along with marked scarring of the remainder of the greater omentum explained the clinical picture. Torsion of the greater omentum, therefore, must be added to the list of differential diagnoses when one is considering peptic ulcer disease.

Adult↗