Primary hypercoagulable states in general and vascular surgery

Article Abstract:

A hypercoagulable state, when the blood has an increased tendency to clot, can result when there is a deficiency or abnormality of the regulatory proteins in the blood. This may result in thromboembolism (a clot that travels within the circulation). This report describes the experience of treating 10 surgical patients within a one-year period who were diagnosed as having hypercoagulable state. The average age of patients at the time of diagnosis was 32 years, with six patients being under the age of 20; there were seven men and three women. One patient was without thromboembolic symptoms, but nine had venous and/or arterial thrombosis (clot formation). Four patients had a past history of thromboembolism. In order to make an accurate diagnosis, it is essential that a complete family and medical history be obtained. It was found that these patients had a history of thromboembolism at an early age, a family history of thromboembolism, and/or had thromboembolisms occurring at unusual sites. It is important to obtain appropriate studies before the usual treatment with anticoagulant medication is begun. In this group, four patients had antithrombin III deficiencies, three had fibrinolytic abnormalities, two had S-protein deficiencies, and one had C-protein deficiency. Initial treatment with heparin (a drug that reduces clotting) was successful in eight of nine patients. Six patients are maintained on coumadin anticoagulation treatment alone, and two required both coumadin and stanozolol therapy. All patients were asymptomatic at the most recent follow-up. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Complications and side effects, Risk factors, Blood clotting disorders, Blood coagulation disorders, Thromboembolism, Blood protein disorders, Operations, Surgical

---

Role of supraceliac aortic bypass in visceral artery reconstruction

Article Abstract:

For treatment to be successful, occlusive vascular disease of the internal organs must be diagnosed early, prior to intestinal infarction (death of intestinal tissue due to inadequate blood flow). Occlusive visceral artery disease is evaluated by angiography and treated surgically with vascular reconstruction. Bypass grafting is the procedure of choice; it is safe and durable. To avoid graft failure it is important to have good blood inflow into the graft. The aorta, the major systemic artery, above the level of the celiac artery has been reported to be a good inflow source. A report is presented of 12 patients who underwent transabdominal, supraceliac aortomesenteric bypass for visceral artery occlusive disease. Bypass was performed on nine patients for ischemia of the intestine (inadequate blood supply); in five of these patients ischemia was acute. Prosthetic grafts were used in 11 of the 12 operations. One patient who had pre-existing liver necrosis and renal failure died. Average follow-up of the 11 surviving patients was 26 months. One patient developed graft thrombosis and required further surgery. These findings suggest that supraceliac aortomesenteric bypass is safe and effective for visceral revascularization. (Consumer Summary produced by Reliance Medical Information, Inc.)

Blood vessels, Mesentery, Aorta, Intestinal ischemia

---

Pancreaticoduodenectomy for malignant pancreatic and periampullary neoplasms in elderly patients

Article Abstract:

The incidence of pancreatic cancer continues to increase; 80 percent of those diagnosed are between 60 and 80 years of age. The safety of pancreaticoduodenectomy, the only potentially curative surgery, for elderly pancreatic cancer patients has not been determined. A study was undertaken to assess the morbidity and mortality of this procedure in elderly cancer patients. The 42 patients studied ranged in age from 70 to 86 years. Twenty-three patients had cancer of the pancreas; the remaining patients had cancer of the ampulla, common bile duct, duodenal or islet cells. The average operating time was five hours and, on average, each patient received four units of blood. The average hospital stay was 22 days. There were no complications directly related to pancreatic anastomoses, but 6 patients (14 percent) developed other major complications. There were two deaths during surgery. Average survival for the group was 42 months. Patients over the age of 80 survived an average of 35 months. These results suggest that pancreaticoduodenectomy can be performed in elderly patients with acceptable outcome and that elderly patients with pancreatic and periampullary cancer may obtain prolonged survival following this surgery. (Consumer Summary produced by Reliance Medical Information, Inc.)

Aged, Elderly, Demographic aspects, Pancreatic cancer, Pancreas

Similar abstracts:

• Abstracts: Covering the uninsured; interactions among public and private sector strategies. Including the poor: the fiscal impacts of medicaid expansion
• Abstracts: A controlled study of hand function in nodal and erosive osteoarthritis. Radiographic patterns and associations of osteoarthritis of the knee in patients referred to hospital
• Abstracts: Papanicolaou smear screening interval and risk of cervical cancer. Screening for cervical cancer in emergency centers and sexually transmitted disease clinics
• Abstracts: The duration of labor in primiparas undergoing vaginal birth after cesarean delivery
• Abstracts: Invasive carcinoma of the vulva: changing trends in surgical management. The management of diaphragmatic lesions in ovarian carcinoma

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.