Abstract:
:A 75-year-old woman suffering from symptomatic cholelithiasis was admitted to our hospital for elective laparoscopic cholecystectomy (LC). Intraoperatively, because of severe inflammation and dense adhesions in the region of the Calot triangle and bleeding arising from the porta hepatis which obscured the operating field, the method was converted to a conventional open approach. Copious hemostasis was achieved using sutures, clips and diathermy, and no bile duct or vascular injuries were recognized intraoperatively. Because of severe right upper quadrant abdominal pain and significant deterioration of the liver function tests (LFTs) on the first postoperative day, the patient underwent a Doppler ultrasound scan which showed absence of blood flow at the level of porta hepatis. Urgent relaparotomy revealed an ischemic liver on the right, a transected common bile duct at the level of its confluence, a divided and ligated right hepatic artery and thrombosed portal vein down to its confluence. Thrombectomy and reconstruction of the portal vein were performed to salvage the left hemiliver, and after restoration of blood flow to the left hemiliver, a right hemihepatectomy and a Roux-en-Y hepaticojejunostomy on the left were performed. Liver resection serves an important role in the case of parenchymal necrosis due to combined biliary, hepatic artery and portal vein injury following laparoscopic cholecystectomy and moreover, the operation can be safely performed in the acute setting.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Felekouras E,Megas T,Michail OP,Papaconstantinou I,Nikiteas N,Dimitroulis D,Griniatsos J,Tsechpenakis A,Kouraklis Gdoi
10.1097/01.smj.0000242793.15923.1asubject
Has Abstractpub_date
2007-03-01 00:00:00pages
317-20issue
3eissn
0038-4348issn
1541-8243journal_volume
100pub_type
杂志文章,评审abstract::Food safety is an increasing concern to Americans. Recent recalls of peanuts and pistachios, and Food and Drug Administration (FDA) warnings to pregnant women to avoid eating fish have increased government oversight of food processing and handling. Consumers can play an important role in alerting their healthcare prov...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3181be29af
更新日期:2010-04-01 00:00:00
abstract::The risks of morbidity and mortality associated with transfusion are so great that no transfusion should be given until it is decided that it is absolutely necessary and then only with the utmost care. The unfavorable effects of transfusion reviewed are: hemolytic reaction; bacterial contamination; febrile reaction du...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1976-04-01 00:00:00
abstract::While in most states information physicians obtain from the about patients is confidential and cannot be disclosed without the patient's permission, a recent California Supreme Court decision affirms that when the doctor reasonably believes his patient can cause violent harm to third persons, he had an overriding duty...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197903000-00030
更新日期:1979-03-01 00:00:00
abstract::Hypokalemic periodic paralysis is an unusual disease that may begin dramatically. Although terrifying to the patient, the attacks can usually be controlled if the proper diagnosis is made. Although much has been done to determine the pathogenesis, many questions remain unanswered. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198409000-00046
更新日期:1984-09-01 00:00:00
abstract::A 27-year-old man had recurrent abscesses of the thigh caused by organisms typical of mouth flora. The unusual identity of these organisms from a thigh abscess led to the recognition that the illness was induced by self-injection with saliva, and that the patient had many of the characteristics of Münchausen's syndrom...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1979-02-01 00:00:00
abstract::We describe two patients who had tuberculomas that were initially misdiagnosed as neurosarcoidosis, leading to prolonged steroid therapy before initiation of antituberculous medications. Neither patient was infected with the human immunodeficiency virus, and one of the patients had a negative tuberculosis skin test. ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000048150.02504.99
更新日期:2003-05-01 00:00:00
abstract::The objective of this study was to determine the effect(s) of pregnancy and of advancing gestation on maternal serum amylase and lipase levels. Thus, serum amylase and lipase concentrations were quantitated in three groups of women. Groups included (1) 118 pregnant women whose serum amylase and lipase levels were meas...
journal_title:Southern medical journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00007611-199602000-00008
更新日期:1996-02-01 00:00:00
abstract:OBJECTIVES:Peripheral vascular disease (PVD) is underdiagnosed in primary care due to the absence of established criteria to warrant diagnostic testing. Our goal was to establish a risk factor hierarchy to enable earlier diagnosis of PVD. METHODS:Data sets of 142 patients with abnormal ankle brachial indices (ABI) wer...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000141303.47034.46
更新日期:2004-10-01 00:00:00
abstract:BACKGROUND:The management of acute pain is an aspect of hospital-based practice that has been neglected. Control of pain is important for ethical reasons, for compliance with new guidelines and standards, and for optimizing patient satisfaction and outcomes. METHODS:Be review the rationale for establishing priority to...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-199905000-00003
更新日期:1999-05-01 00:00:00
abstract::As with our case, patients with rupture of the atrium may survive untreated for prolonged periods. Although three survivors have been reported after rupture of the right or left ventricle, ventricular injuries are usually fatal. With improvements in transportation methods, rapid recognition and diagnosis, and early op...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198604000-00027
更新日期:1986-04-01 00:00:00
abstract::Shoulder pain is a frequent clinical problem facing primary care physicians. Despite its common occurrence, many clinicians are unfamiliar with the diagnosis and treatment of many common shoulder ailments. Because therapy for most shoulder disorders can be made at the initial consultation, a good history and physical ...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/SMJ.0b013e3181f5e85f
更新日期:2010-11-01 00:00:00
abstract::We reviewed the operative complications in 333 living related donor nephrectomies done at our institution over the past 12 years. The overall complication rate was 17.1%; only three patients (0.9%) had major complications, and none died. The major complications were a delayed splenectomy because of bleeding, an adrena...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199401000-00013
更新日期:1994-01-01 00:00:00
abstract::We found magnetic resonance imaging helpful in the localization of both an adrenal and an extra-adrenal pheochromocytoma, since these tumors produced a high-intensity "light bulb" image. MRI is an excellent method for localizing pheochromocytomas because it detects adrenal and extra-adrenal pheochromocytomas missed by...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198911000-00017
更新日期:1989-11-01 00:00:00
abstract::Reported is a case of mesenteric venous thrombosis occurring in a 46-year-old woman who had taken an oral contraceptive for six years. Seventeen cases of mesenteric venous thrombosis have been reported in young women taking oral contraceptives. An association between oral contraceptive agents and mesenteric venous thr...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197703000-00033
更新日期:1977-03-01 00:00:00
abstract::Using continuous wave Doppler ultrasound, we studied the umbilical and uterine flow velocity waveforms in 68 pregnant women who had chronic hypertension and/or preeclampsia. The systolic-diastolic (S/D) ratio was considered an expression of vascular resistance peripheral to the point of insonation. Abnormal umbilical ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199002000-00005
更新日期:1990-02-01 00:00:00
abstract::A prospective study of 45 granulocyte transfusions in children using continuous flow centrifugation is reported. During 13 episodes of proven or presumed infection, only two children failed to show a favorable response to granulocyte transfusion. The neutropenic child shows a significantly increased absolute granulocy...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197703000-00017
更新日期:1977-03-01 00:00:00
abstract::Coronary artery spasm can occur in the presence of excessive alpha-adrenergic tone. A decrease in protective coronary vasodilator substance and enhanced alpha-adrenergic responsiveness, which occurs in the setting of hypothroidism and beta blockade, predisposes to coronary artery spasm. The case presented supports the...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197907000-00004
更新日期:1979-07-01 00:00:00
abstract::We report the case of a 55-year-old woman who was thought to have systemic lupus erythematosus (SLE) for more than 13 years before Crohn's colitis was correctly diagnosed. The differentiation of Crohn's disease from SLE may be difficult, as illustrated by our case. Gastrointestinal symptoms, laboratory studies, and ra...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199510000-00018
更新日期:1995-10-01 00:00:00
abstract::Prednisone therapy induced prompt clinical remission in a 38-year-old woman with hypereosinophilic vasculitis. Smoldering vasculitis accounts for the 38% fatality rate in treated patients with the Churg-Strauss syndrome. Complete suppression of the peripheral hypereosinophilia will reflect the efficacy of therapy more...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198702000-00035
更新日期:1987-02-01 00:00:00
abstract::The use of stress echocardiography (SE) in an elderly population was retrospectively evaluated and compared with myocardial perfusion scintigraphy (MPS) in a similar group. Patients > or = 80 years of age were evaluated by treadmill or pharmacologic SE (group 1; n = 65) to determine its predictive value for cardiac ev...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199612000-00007
更新日期:1996-12-01 00:00:00
abstract::A 74-year-old man was admitted with rhabdomyolysis after undergoing initial treatment for gastrointestinal cancer with irinotecan. The syndrome partially resolved after the discontinuation of all of his usual medications, including his chronic selective serotonin reuptake inhibitor (SSRI). The rhabdomyolysis was exace...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000084311.35864.D6
更新日期:2003-10-01 00:00:00
abstract::With the advent and increased use of chemotherapeutic agents and radiation therapy, cancer survival rates have increased. With increased survival, both acute and chronic cardiotoxic adverse effects have emerged. The growing need for managing the treatment of individuals with chemotherapy-induced cardiotoxicity has led...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.14423/SMJ.0000000000000232
更新日期:2015-02-01 00:00:00
abstract::Diaphragmatic flutter is a rare phenomenon characterized by high-frequency, pulsatile contractions of the thorax and abdominal wall associated with breathlessness. We describe the case of a patient previously treated for status asthmaticus who had physical signs of diaphragmatic flutter. Respiratory inductive plethysm...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199702000-00015
更新日期:1997-02-01 00:00:00
abstract::To make informed career decisions, physicians must acquire a basic knowledge in medical management and health care economics as they evaluate the potential survival and growth of a primary care practice. Health care providers considering a specific community and local leaders and hospital administrators attempting to ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199404000-00006
更新日期:1994-04-01 00:00:00
abstract::[This corrects the article on p. 232 in vol. 113.]. ...
journal_title:Southern medical journal
pub_type: 杂志文章,已发布勘误
doi:10.14423/SMJ.0000000000001121
更新日期:2020-07-01 00:00:00
abstract::Noninvasive positive pressure ventilation (NPPV) has been used in treatment of a variety of clinical conditions, including acute respiratory failure (ARF) due to status asthmaticus. We present the case of a patient admitted with acute exacerbation of asthma who had ARF and required mechanical ventilation. After extuba...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199701000-00017
更新日期:1997-01-01 00:00:00
abstract::Rapidly growing mycobacteria have occasionally been reported to cause catheter-related infections. We report a case of a central venous catheter-related bacteremia, caused by Mycobacterium smegmatis, in a patient with cancer. Cultures of the catheter tip and blood cultures grew M smegmatis and Enterococcus faecalis. T...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-199801000-00007
更新日期:1998-01-01 00:00:00
abstract::We have described a case of malignant schwannoma (MS) originating from the posterior mediastinum with subsequent pathologic rupture of the thoracic aorta. The patient presented with acute retrosternal pain radiating to the back, and she died on the day of admission. Necropsy revealed a large hemothorax and a tumor mas...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198011000-00035
更新日期:1980-11-01 00:00:00
abstract::Three members of a family with Peutz-Jeghers syndrome had intussusception due to intestinal hamartomas. In addition, the grandfather had carcinoma of the jejunum, and the granddaughter had benign ovarian sex cord/stromal tumor causing sexual precocity. Benign and malignant tumors, not often associated with Peutz-Jeghe...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199110000-00011
更新日期:1991-10-01 00:00:00
abstract::This is a case which highlights unique diagnostic challenges in the evaluation of a previously healthy patient presenting with a myelopathy initially most concerning for malignancy. However, timely recognition and nonoperative therapy of unexpected spinal sarcoidosis with corticosteroidal therapy was crucial in averti...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e3181e90745
更新日期:2010-09-01 00:00:00