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Biomedical subjects

K Solheim

Publications and source records attributed to K Solheim.

At least 163 records · Page 9Linked to original sources
PubMed1985

Changing trends in the diagnosis and management of rupture of the spleen.

In this series of 80 consecutive patients with injured spleens scintigraphy was the diagnostic mainstay and was performed in 63 patients. Fifty-five patients were initially managed without operation. Two of them, however, underwent laparotomy respectively 1 and 2 days after admission because of increasing symptoms and signs. Twenty-seven patients underwent laparotomy, with successful conservative surgery in 8 and splenectomy in 19. However, in at least five of these it was thought in retrospect that repair of the spleen might have been possible. There were no deaths or serious morbidity from the injury to the spleen. It is concluded that no operation or operative repair of the spleen is the treatment of choice in the majority of patients with blunt injuries. In order to avoid loss of life as well as loss of the spleen, strict adherence to an aggressive, exact diagnostic process, using non-invasive diagnostic imaging and close clinical observation, as well as experienced, painstaking surgical techniques, is necessary.

Adolescent↗
PubMed1985

Predictive ability of choledocholithiasis indicators. A prospective evaluation.

To assess the predictive ability of various indicators of common bile duct calculi, 457 patients undergoing cholecystectomy for gallstone disease were prospectively screened for the presence of 11 predefined criteria of possible choledocholithiasis. The predictive ability of the criteria, individually and in combinations, was determined. For all criteria, except a history of pancreatitis, a significantly increased incidence of choledocholithiasis was found. The number of positive criteria correlated positively with the frequency of common bile duct calculi. The negative predictive value and sensitivity of the total set of criteria were 98% and 89.5%, respectively. Following common duct exploration, the number of complications and the duration of postoperative hospitalization were significantly increased as compared with simple cholecystectomy. Peroperative cholangiography with cholecystectomy is recommended in all patients, with one or more criteria of possible choledocholithiasis. Routine peroperative cholangiography in patients with no positive criteria does not seem to be necessary.

Cholangiography↗
PubMed1985

Scintigraphic follow-up of splenic rupture.

Scintigraphic and clinical follow-up were performed one to six years after splenic rupture in 49 patients. Splenosis was found in 11 of 12 patients subjected to splenectomy. In six patients subjected to splenic repair, and in 31 patients managed nonoperatively, the scan was normal or almost normal. Scintigraphy is a useful tool in follow-up of patients with splenic injuries. Splenosis is common after splenectomy only for trauma; and pseudocyst development must be very rare in patients managed nonoperatively for splenic rupture.

Accidents, Traffic↗
PubMed1985

Laparoscopy in patients admitted for acute abdominal pain.

In 81 patients with acute abdominal pain, laparoscopy was performed because of diagnostic doubt. Diagnosis by clinical methods proved to be correct in 42 of the patients and laparoscopy gave correct diagnosis in 70. Appendectomy revealed acute appendicitis in 19 patients and normal appendix in five. Failure to establish a diagnosis by laparoscopy was due to incomplete visualization of appendix in nine patients, pelvic adhesions in one patient, and failure to enter the peritoneal cavity in another. A clinical diagnosis of acute appendicitis could be invalidated by laparoscopy in 17 of 40 patients. Negative laparotomy is potentially avoidable by use of laparoscopy when a diagnosis of appendicitis is questionable. Laparoscopy may therefore be warrantable in such cases.

Abdomen, Acute↗
PubMed1985

Ligation of the left renal vein.

In abdominal aortic reconstruction it is sometimes necessary to ligate and divide the left renal vein in order to avoid injury to this vessel and to secure better access to the aorta and/or the renal arteries. The procedure was utilized in 11 such patients, who were followed up clinically and with renography. No untoward sequelae were found, and it is concluded that the procedure as a rule may safely be performed.

Aged↗
PubMed1983

Splenic artery ligation in splenic injuries.

The risk of sepsis after splenectomy is well known. This chiefly concerns the surgeon, who should make every effort to save an injured spleen. This may be achieved by not operating on selected cases, by partial resection, or by suturing the splenic ruptures. Another treatment is ligation of the splenic artery, which is simple and effective in controlling even severe bleeding without splenectomy. Five patients have been treated in this way without complications.

Adolescent↗