Abstract：
:Typhlitis is a neutropenic enterocolitis of varying severity. Its incidence is increasing, particularly in patients with acute myelogenous leukemia undergoing high dose cytosine arabinoside chemotherapy. The onset is heralded by prodromal fever, watery or bloody diarrhea, abdominal distension, and nausea during the phase of severe neutropenia. The symptoms may then localize to the right lower quadrant with an associated increase in systemic toxicity. The diagnosis can be confirmed in these and other less specific cases by serial reexamination and abdominal radiographs, ultrasonography, computerized tomograms, or radionucleotide scans. The mainstay of management is complete bowel rest with nasogastric suction and total parenteral nutrition. Broad-spectrum combination antibiotics are essential, as is the avoidance of laxatives or antidiarrheal agents. Granulocyte support may be helpful. Patients with a history of nonspecific gastrointestinal complaints or of true typhlitis, successfully managed nonoperatively, should have prophylactic bowel rest and total parenteral nutrition instituted at the beginning of further chemotherapy. Patients with ongoing severe systemic sepsis who do not respond to chemotherapy and those with overt perforation, obstruction, massive hemorrhage, or abscess formation require surgical intervention. All necrotic material must be resected, usually by a right hemicolectomy, ileostomy, and mucous fistula. Divided ileostomy for less severe cases may be useful. Failure to remove the necrotic focus in these severely immunocompromised patients is fatal. With adequate recognition of typhlitis and its precipitating factors, the incidence of complications can be reduced through prevention and timely surgical intervention. Although typhlitis developed in a quarter of our acute myeloblastic leukemia patients, use of this combined approach was successful in all cases.
journal_name
Am J Surgjournal_title
American journal of surgeryauthors
Moir CR,Scudamore CH,Benny WBdoi
10.1016/0002-9610(86)90547-7subject
Has Abstractpub_date
1986-05-01 00:00:00pages
563-6issue
5eissn
0002-9610issn
1879-1883pii
0002-9610(86)90547-7journal_volume
151pub_type
杂志文章abstract：BACKGROUND:Previous studies on the efficacy of primary treatments for ductal carcinoma-in-situ (DCIS) have focused on local recurrence rates. Our objective was to detail the outcomes of local invasive recurrence, distant recurrence, and breast cancer mortality in patients previously treated for DCIS. METHODS:Clinical,...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2006.06.005
更新日期：2006-10-01 00:00:00
abstract：:The difficulties created by an unsuccessful initial operation can usually be avoided by choosing experienced surgeons, identifying four glands, and selectively excising grossly abnormal parathyroid tissue. Patients with multiple endocrine adenomatosis or familial hyperparathyroidism should have a subtotal parathyroide...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(82)90412-3
更新日期：1982-10-01 00:00:00
abstract：:A new S-shaped cystic duct metal cannula was developed and used successfully in 200 cystic duct cholangiograms. It has the advantage of being easy to manipulate because the configuration does not obscure the vision and the resistance is less than that of plastic tubes, facilitating injection with lower pressure. It is...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90106-5
更新日期：1979-06-01 00:00:00
abstract：BACKGROUND:Current evidence-based guidelines provide recommendations for prophylaxis and treatment of venous thromboembolism (VTE) in a variety of surgical patients. DATA SOURCES:A systematic Ovid Medline search (from 1950 to the present) was conducted for relevant articles using the following search terms: "venous th...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/j.amjsurg.2009.10.007
更新日期：2010-01-01 00:00:00
abstract：BACKGROUND:The extent of tissue loss amenable to primary healing after revascularization is unknown. Salvage of limbs with large soft-tissue defects with exposed tendon, joint, or bone lies beyond the limits of conventional techniques. We report our results using free tissue transfer as an adjunct to lower extremity va...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(97)00175-x
更新日期：1997-12-01 00:00:00
abstract：BACKGROUND:Preoperative imaging for early-stage cutaneous melanoma is not recommended by current guidelines. Our goal was to investigate our institutional usage and utility. METHODS:Patients with clinically node-negative cutaneous melanoma undergoing surgery with sentinel lymph node biopsy were identified retrospectiv...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2013.08.017
更新日期：2013-12-01 00:00:00
abstract：BACKGROUND:Gastroesophageal reflux is frequently associated with abnormal motility in the body of the esophagus. Concern for dysphagia has led surgeons to perform less competent procedures in this group, or to avoid surgery altogether. The current study was undertaken to evaluate our experience with the laparoscopic Hi...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/S0002-9610(96)00062-1
更新日期：1997-05-01 00:00:00
abstract：BACKGROUND:The purpose of this study was to evaluate the involvement of inflammatory mediators in patients undergoing Lichtenstein tension-free hernioplasty (LH) using polypropylene prosthetic materials or conventional Bassini hernia repair (BH). METHODS:Thirty patients male with unilateral inguinal hernia without com...
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0002-9610(00)00445-1
更新日期：2000-09-01 00:00:00
abstract：:Increased strength of healing incisions infected with E coli was demonstrated in this experiment. Efforts to measure respiratory gas tensions and pH in these incisions were unsuccessful. Therefore, these moieties were measured in normal and infected wound fluid contained in implanted wire cylinders. The wound fluid fr...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90292-0
更新日期：1976-07-01 00:00:00
abstract：BACKGROUND:This study explores assistance-seeking and reporting behaviors in surgical residents faced with stressful circumstances. METHODS:Three surgical societies distributed a multiple choice, free-text response survey to residents. RESULTS:One hundred sixty-four residents (39% male) responded; 58% of women (43% m...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2015.05.011
更新日期：2015-10-01 00:00:00
abstract：BACKGROUND:It has been suggested that division of the short gastric vessels (SGV) provides a more floppy Nissen fundoplication, for the treatment of reflux disease. The aim of the study was to assess whether Nissen fundoplication with division of SGV is associated with improved clinical outcome and laboratory findings....
journal_title：American journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验
doi：10.1016/s0002-9610(01)00695-x
更新日期：2001-09-01 00:00:00
abstract：BACKGROUND:Currently, there is no consensus in the literature regarding which patients with calf vein thrombi are at high risk for proximal propagation. This study examined patients with isolated calf vein thrombi with serial duplex scans in order to identify risk factors that would predict outcome. PATIENTS AND METHO...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(99)80261-x
更新日期：1995-08-01 00:00:00
abstract：:Surgical clips (metallic or plastic) are frequently used for hemostasis and tumor marking. This study evaluated the radiographic and computerized tomographic appearance of different clips and their relative interference with computerized tomographic scans. Metallic clips (stainless steel, tantalum, and titanium) can a...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(84)90142-9
更新日期：1984-05-01 00:00:00
abstract：BACKGROUND:Increased anesthesia time may lead to respiratory complications in patients receiving tracheostomy, which contributes to patient morbidity. METHODS:The American College of Surgeon's National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for cases of planned tracheostomy (CPT 31600) f...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2018.07.059
更新日期：2018-10-01 00:00:00
abstract：:Splenic infarction is rare in inflammatory diseases of the pancreas, although the spleen and its vessels have an intimate relation with the pancreas. Most reported cases are of focal infarction, and treatment is mostly conservative. The authors report a case of diffuse splenic infarction in a 17-year-old boy with seve...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2010.03.020
更新日期：2011-03-01 00:00:00
abstract：:This review of the literature has revealed that isotonic fluids, such as 0.9 percent sodium chloride and Ringer's lactate, are effective plasma volume expanders. Despite the continued use of a variety of colloid solutions in resuscitation, there is no good evidence to document a benefit of these solutions over the cry...
journal_title：American journal of surgery
pub_type： 杂志文章,评审
doi：10.1016/s0002-9610(88)80106-5
更新日期：1988-03-01 00:00:00
abstract：:Over a ten year period, four patients with inflammation or perforation of non-Meckelian, small intestinal diverticula were treated on the surgical services of Bellevue Hospital. This entity remains uncommon but may be increasing in incidence. The patients presented with a short history of severe abdominal pain, usuall...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(76)90364-0
更新日期：1976-11-01 00:00:00
abstract：:Normal volunteers and patients were studied to determine the relative importance of NMTT and patient risk factors in the production of hypoprothrombinemia. The normal volunteers demonstrated in vivo NMTT production, but the order of magnitude (cefoperazone, moxalactam, and cefotetan in descending order) was different ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80210-1
更新日期：1988-05-31 00:00:00
abstract：BACKGROUND:The aim of this study was to calculate and analyze the cost of treatment for stage IV pressure ulcers. METHODS:A retrospective chart analysis of patients with stage IV pressure ulcers was conducted. Hospital records and treatment outcomes of these patients were followed up for a maximum of 29 months and ana...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2009.12.021
更新日期：2010-10-01 00:00:00
abstract：BACKGROUND:Diabetes mellitus (DM) is associated with adverse events or complications in various gastrointestinal diseases. In this study, we examined whether diabetic patients had higher risk for the development of complicated acute appendicitis than nondiabetic patients. The relevant risk factors also were determined....
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2007.05.042
更新日期：2008-07-01 00:00:00
abstract：:Surgical extirpation of the primary tumor has traditionally been utilized as initial treatment for sarcomas in children. The present report, however, demonstrates that sarcomas are optimally treated by means of a coordianted multidisciplinary approach. The latter offers the potential for achieving improved survival an...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(77)90123-4
更新日期：1977-04-01 00:00:00
abstract：:Silver biopsies of the common bile duct were obtained from 15 patients with clinical and surgical evidence of cholangitis. The most pronounced histologic changes were edema, congestion, and marked mucous gland hypertrophy and hyperplasia. No ulceration, intramural abscess, or areas of necrosis were found. Clinical cho...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90089-8
更新日期：1979-06-01 00:00:00
abstract：BACKGROUND:The effect of postsurgical radiotherapy (PSRT) among T1-3 gallbladder cancer (GBC) patients with one to three lymph node metastases remains controversial. The aim of this study was to assess the impact of PSRT on gallbladder cancer-specific survival (GBCSS) in patients with stage IIIB. METHODS:The data of G...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2020.08.007
更新日期：2020-08-15 00:00:00
abstract：:A patient with pancreatic ascites is presented who had neither a pseudocyst nor demonstrable pancreatic duct disruption, despite the presence of both calculi and strictures in a dilated duct of Wirsung. Concurrently, the patient exhibited intractable abdominal pain characteristic of end-stage chronic alcoholic pancrea...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(79)90356-8
更新日期：1979-11-01 00:00:00
abstract：:The value of bacteriologic findings in patients with acute appendicitis was studied. Routine urinary culture specimens were taken preoperatively from 194 children (mean age 11 +/- 3 years) undergoing emergency appendectomy. Bacteria were found in culture specimens of urine from 26 of 156 patients with acute appendicit...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(88)80731-1
更新日期：1988-02-01 00:00:00
abstract：BACKGROUND:Incision and drainage of perianal sepsis has appreciable success in the immunocompetent population, but outcomes after incision and drainage in the immunosuppressed population are unknown. METHODS:13,666 patients (n = 930 immunosuppressed) undergoing incision and drainage of perianal sepsis between 2011 and...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2019.01.036
更新日期：2019-09-01 00:00:00
abstract：BACKGROUND:Native arterial venous fistulas (NAVF) are generally considered preferable to synthetic grafts for chronic dialysis access. As increasing numbers of diabetic and elderly patients are treated, adequate NAVFs become more difficult to establish. Vascular ultrasonography (US) prior to NAVF surgery has received l...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/s0002-9610(02)01103-0
更新日期：2002-12-01 00:00:00
abstract：:Appendicitis in preschool children is not uncommon. A duration of greater than 40 hours usually implied perforation. The most common findings were abdominal pain, tenderness, temperature elevation and vomiting. In the presence of perforation or abscess formation, appendectomy followed by copious wound irrigation, absc...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/0002-9610(80)90265-2
更新日期：1980-02-01 00:00:00
abstract：OBJECTIVE:We aimed to identify potential variables predictive of a resident achieving faculty future entrustment as a way to enhance attending surgeons' planning of teaching in the operating room leading to improved resident operative autonomy in practice. METHODS:We reviewed 273 resident performance evaluations from ...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2021.01.020
更新日期：2021-01-19 00:00:00
abstract：INTRODUCTION:Newborns with gastroschisis have historically undergone surgical repair under general anesthesia. Our institution recently transitioned to the sutureless umbilical closure for gastroschisis. We sought to evaluate the feasibility of bedside gastroschisis repair without endotracheal intubation. METHODS:A re...
journal_title：American journal of surgery
pub_type： 杂志文章
doi：10.1016/j.amjsurg.2017.03.017
更新日期：2017-05-01 00:00:00
