Biomedical subjects

M R Pearson

Publications and source records attributed to M R Pearson.

21 records · Page 2Linked to original sources

PubMedDate not supplied

Posterior sternoclavicular dislocation: a case report.

Posterior sternoclavicular dislocation is a relatively rare form of trauma, but one that must be recognized by the emergency physician. Such a case is presented here. Due to the proximity of the clavicle to critical thoracic outlet structures, serious complications can arise from a posterior dislocation: impingement on and possible trauma to the trachea, pneumothorax, laceration of underlying great vessels, brachial plexus injury, esophageal trauma, and laryngeal trauma that may cause permanent vocal cord changes. Many of these potential complications are life-threatening, and it is important that this injury not be triaged in the emergency department as a minor injury, thereby leading to its improper or delayed treatment.

Adolescent↗

PubMedDate not supplied

Intraoperative hemorrhage during patent ductus arteriosus ligation in dogs.

OBJECTIVE: To determine the prevalence of intraoperative hemorrhage in a consecutive series of dogs undergoing patent ductus arteriosus (PDA) ligation at a veterinary teaching hospital, and to describe strategies to reduce the risk of ductus perforation and deal with hemorrhage when it occurs. STUDY DESIGN: Retrospective clinical study. ANIMALS: Sixty-four dogs. METHODS: The records of all dogs undergoing PDA ligation at the University Veterinary Center, Sydney between May 1989 and February 1998 were reviewed and the prevalence and nature of complications identified. RESULTS: Serious hemorrhage occurred in 4 of 64 dogs (6.25%) that underwent PDA ligation. In all cases, hemorrhage resulted from perforation of the craniomedial aspect of the ductus while attempting to expose the tips of the dissecting forceps. Hemorrhage was controlled in 3 dogs by clamping the main pulmonary artery, digital compression of the descending aorta, and completion of ductus ligation during an approximately 5-minute period of circulatory arrest. The remaining dog exsanguinated during an unsuccessful attempt to locate, clamp, and ligate the bleeding point. The mortality rate for PDA ligation was I of 64 dogs (1.6 %). CONCLUSIONS: The technique described in this report permits simple ligation of a range of different ductus morphologies in dogs of varying breeds, weights, and ages. In the event of serious hemorrhage, prompt ventricular outflow occlusion and ductus ligation followed by rapid whole blood transfusion is life saving in most cases.

Animals↗

PubMedDate not supplied

Transportal approach for attenuating intrahepatic portosystemic shunts in dogs.

A novel surgical approach, using portal venotomy during total hepatic vascular occlusion, was used to locate and attenuate congenital intrahepatic portosystemic shunts in nine dogs. Shunt location was consistent with a persistent ductus venosus in only two dogs. In the remaining seven dogs the shunts were window-like orifices arising from either the left (two dogs) or right portal vein branch (five dogs) and communicating with the ipsilateral hepatic vein or caudal vena cava. The transportal approach using total hepatic vascular occlusion consistently provided good access to the portosystemic shunts, including those with window-like communications. A 7 to 16 minute period of total vascular occlusion was well-tolerated hemodynamically, with few intraoperative complications. Intrahepatic shunts were successfully attenuated in eight dogs, while one dog with portal atresia was euthanatized. The postoperative course was complicated by high protein pulmonary edema (one dog), an encapsulated biliary pseudocyst (one dog) and uncontrollable hemorrhage caused by an uncharacterized coagulopathy (one dog). Three dogs required a second operation to further attenuate their shunts. The clinical condition of all seven surviving dogs was improved after surgery.

Animals↗