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L R Larsen

Publications and source records attributed to L R Larsen.

4 recordsLinked to original sources

Wound amylase levels as an early indicator of orocutaneous fistulae.

The formation of an orocutaneous fistula following ablative head and neck surgery is a common complication. Early fistula detection could permit prompt management, hopefully preventing further wound breakdowns. Amylase is quantitatively the most prominent enzyme in saliva. This study prospectively evaluated whether the amylase content of wound drainage could predict the formation of an orocutaneous fistula earlier than clinically evident. Patients undergoing procedures that required postoperative wound drainage represented the study population. Baseline serum and salivary amylase determinations were obtained. The drainage was assayed for amylase content twice daily. Wound amylase values were then correlated with the patient's clinical course. Results showed wound amylase had a downward trend in uncomplicated postoperative courses. An upward trend of wound amylase was correlated with early fistulization. No pattern was identified in patients with delayed fistulae.

Aged↗

Intraoperative angiography in intestinal angiodysplasia.

Intraoperative angiography is quite useful in locating the site of bleeding in patients with angiodysplasia of the small intestine. We recommend the placement preoperatively of an angiographic catheter in these patients. We have described a technique that complements this procedure with metallic clip labeling to locate precisely the area of bleeding. This method of treatment is illustrated in the present study by reports of patients bleeding from vascular malformations of the ileum, duodenum and the head of the pancreas.

Aged↗

Liver abscess.

A liver abscess may occur secondary to an umbilical vein catheterization or infection in other parts of the body, and is associated with immune deficiencies, especially chronic granulomatous disease. There are no specific signs and symptoms, but an unexplained fever with upper abdominal tenderness and an enlarged liver were present in all of our cases. A liver-spleen scan is the most useful diagnostic test, demonstrating a filling defect in the liver. A single abscess may be unroofed and drained. When multiple abscesses are found, as many as possible are drained, but long-term specific antibiotic therapy is the most important treatment.

Child↗