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Biomedical subjects

P Sandblom

Publications and source records attributed to P Sandblom.

At least 37 records · Page 2Linked to original sources
PubMed1977

Formation and fate of fibrin clots in the biliary tract: a clinical and experimental study.

Fibrin clots may form in the biliary tract from hemobilia or in inflammatory disease. There is a wide variation in the clinical course of such clots which is exemplified by 9 patients. They may either dissolve through fibrinolysis, get ejected into the intestine, remain and obstruct the biliary tract, or may even transform into gallstones. In order to elucidate the mechanisms involved, the behavior of blood clots in bile was studied in vitro. A model was constructed of the biliary tract and, drained by a T-tube, where human bile circulated with a flow rate resembling that in vivo. When a small amount of human blood was injected, it flowed immiscibly to the lowest level, displaced the bile, and formed a clot of pure blood. Even a minor bleeding may thus form a coagulum. This is different from the mixed clot of blood and bile that forms in experiments simulating major hemorrhage. These findings are related to clinical experience and especially to the disappearance of "retained stones" with or without the use of dissolving agents.

Biliary Tract↗
PubMed1976

The healing of liver wounds.

Cases of traumatic hemobilia are often characterized by a protracted history with recurrent episodes of hemorrhage over many years. It seems that while the liver regenerates quickly and profusely it heals slowly and poorly. This is in contradistinction to the kidneys where lesions often heal within a short time. In order to investigate the cause of this peculiar behavior a series of experiments was performed where local lesions were produced in the musculature, in the kidneys and in the liver of dogs. The healing process was studied at different intervals. There was essentially no difference between the rate and character of healing in the three localities. As the lesions that produce hemobilia are open to the biliary tract, another series of experiments was performed where the healing took place in presence of bile. The effect of this was striking with a very diminished production of fibrinous exudate, granulating tissue and fibrous scar.

Animals↗
PubMed1975

Wound healing in man: tensile strength of healing wounds in some patient groups.

The healing of test wounds was studied in 108 patients, in whom some impairment of wound healing was suspected. A 5 cm skin wound was performed in the forearm and the strength of the wound was tested after 5 days using the technique described by Sandblom and associates with two measurements in each wound. No differences in wound strength could be registered between the two wounds in each patient, between males and females nor in patients with malignant disease compared to other patients. Patients with low serum protein or serum albumin values had significantly weaker wounds than patients with normal protein values. Patients over 80 years of age had wounds somewhat weaker than those below 70, the difference having a statistical significance of 6%. The wound strength in patients was compared to values found elsewhere for wounds in rabbits, rats, and piglets. The pigs had much higher values than others, rabbits slightly stronger than and rats about equal to humans.

Age Factors↗
PubMed1975

[Hemobilia. (Apropos of 5 cases)].

Hemobilia or hemorrhage through the biliary tract is increasing in frequency. With spreading knowledge of the syndrome, the diagnosis is now rarely missed. There is also a real increase due to traffic accidents which often cause liver injuries. The typical triade with digestive hemorrhage, biliary colic and jaundice should always arouse suspicion of hemobilia. Hepatic angiography is the best and most accurate diagnostic method. Accidental or operative trauma constitute the major cause of macroscopic hemobilia where as microscopic hemobilia is a very frequent symptom in gallstone-disease. In this report five cases of different ethiology are described. Three were caused by abdominal trauma. The fourth case illustrates the risk of hemobilia from instrumental exploration of the common duct. Even when this is done carefully it might cause a hemorrhage with formation of obstructing clots. In the last patient there was severe hemobilia due to errosion of the cystic artery by a gallstone, penetrating into the duodenum. The treatment given in the five cases are examples of different methods which may be used, according to the nature of the lesion. In the three cases of traumatic hemobilia one healed spontaneously under angiographic control, one was cured by local hemostasis in the central liver rupture and the third had a successful hepatic resection. In the case with post-operative hemobilia, an obstructing clot had to be removed from the common duct. Simple cholecystectomy cured the patient with hemorrhage from the eroded cystic artery.

Aged↗
PubMed1975

Repair of common bile duct defects using the gallbladder or cystic duct as a pedicled graft.

To repair defects in the common bile duct, part of the gallbladder and the cystic duct may be used as a pedicled graft. This has the advantage of an independent blood supply and a related mucosal lining. The method is illustrated by four patients who had excellent primary and short term results. In two patients, the defect was due to large cholecystocholedochal fistulas caused by migrating large gallstones. In one patient with marked stenosis of the duct, the defect occurred when the stenosis was opened through a longitudinal incision. The fourth patient had a large duodenal ulcer that penetrated into the common duct, causing a defect that could not be closed by suture. A definite evaluation of the procedure must await a longer period of follow-up study.

Adult↗
PubMed1973

Hemobilia.

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Angiography↗