Diagnostic paracentesis in the acute abdomen.
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A bladder neck obstruction was suspected after ultrasound investigation at 16 weeks' gestation. Evaluation of protein content in the amniotic fluid, fetal ascites, and fluid from the overdistended bladder supported the diagnosis. Bladder outflow obstruction in the second trimester of pregnancy was not associated with raised alphafetoprotein levels in the amniotic fluid and maternal serum.
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A proposed new electrode for measurement of foetal auditory brain stem response (ABR) is presented, the structure of which resembles a syringe needle. It can be placed subdermally in the head of the guinea pig foetus through the wall of the maternal abdomen. In the anterior end of the electrode a special device similar to a hook is situated. The device may be controlled from outside the maternal abdomen. In comparison with the placement of electrodes through the surgical incision, its placement is simple and injury to tissue is relatively small. It is not only firmly fixed in the subcutaneous tissue of the foetus to satisfy the need for the measurement of foetal ABR, but is easily removed from the foetus. To our knowledge no other similar electrode has been reported.
We describe a quick and effective technique for performing safe anterior chamber paracenteses. The technique consists simply of inserting a small gauge disposable hypodermic needle without an attached syringe into the anterior chamber. The intraocular pressure and capillary action of the needle readily cause the rapid drainage of aqueous humor. This technique eliminates the cumbersome manipulations and potential complications associated with using an attached syringe for aspiration.
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A method is described for detecting blood in the peritoneal cavity in cases of blunt abdominal trauma. It involves introducing a peritoneal dialysis catheter through a single puncture site in the anterior abdominal wall and in some cases performing lavage. Fifty cases have been investigated by this method and the results are presented.
BACKGROUND AND OBJECTIVE: Standard needle revision of the filtering bleb after glaucoma filtration surgery has many disadvantages. This study reports the technique and outcome of a modified needling of the failing bleb. PATIENTS AND METHODS: Consecutive patients who presented with increased intraocular pressure (lOP) and open internal ostium were included in this prospective study. When their IOP rose to levels >20 mm Hg despite various therapeutic regimens and visibility of the sclerostomy site was unclear, the modified needling technique was conducted. In each needling, a total dose of 1 mg (0.1 mL) of 5-fluorouracil (FU) was administered subconjunctivally, adjacent and into the bleb. The needle was then passed via the bleb, anterior to the sclera, through the anterior limbus to penetrate intracamerally. Standard treatment to inhibit bleb scarring followed. RESULTS: Twelve 5-FU-needle revisions were performed on 8 eyes. The first needle revision was performed 51.1+/-36.2 days (range, 5-117) postoperatively. IOP decreased from 31.0+/-5.7 (range, 25-43) mm Hg with 0.6+/-0.9 (range, 0-2) hypotensive medications to 15.5+/-2.6 mm Hg (range, 12-19) with 0.9+/-1.1 medications (range, 0-3), 11.3+/-4.9 months (range, 8-23) after the only or second (last) needling (P=0.012). In all eyes, the filtering bleb became diffused; in 7 eyes, it remained diffusely elevated or shallow-diffused. CONCLUSION: Relatively few needle revisions of the filtering bleb by a modified approach that bypassed the activated scarring tissue contributed to the restoration of IOP control. It is possible that the 5-FU-needle revision may offer advantages over the standard approach. A larger sample and a controlled study are required to validate these considerations.
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A retrospective analysis of 242 consecutive diagnostic abdominal paracenteses in patients with liver disease disclosed seven major complications, including serious hemorrhage (four), perforation of bowel with generalized peritonitis (one), perforation of bowel with abdominal wall abscess (one), and a catheter fragment left in the abdominal wall or cavity (one). The results of this study emphasize the potential dangers of this procedure in these patients and raise the possibility that complications may be more common than previously thought.
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