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Biomedical subjects

C O Brantigan

Publications and source records attributed to C O Brantigan.

13 recordsLinked to original sources
PubMed1979

Obstructive complications of the Nissen fundoplication.

The obstructive complications of the Nissen fundoplication can be devastating. They are much more easily prevented than treated. The technical considerations in avoiding these complications are conceptually simple. The fundoplication should be done over a large intraesophageal stent. A no. 50 or 60 French dilator is appropriate and, in addition, the fundoplication should be left loose. If the fundoplication is to be left in the chest, the hiatus must be widely enlarged so that there is not the slightest hint of obstruction at the level of the diagphragm. Care must be taken in this case to approximate stomach to diaphragm. The Nissen fundoplication should be carried out using heavy sutures with generous bites of the stomach on both sides as well as bites of the esophageal wall and perhaps also the proximal stomach. If careful attention is paid to these technical details, the obstructive complications of the Nissen fundoplication should be eliminated.

Adult↗
PubMed1979

The broken wire suture.

The body is a hostile environment for wire sutures. Although the problems of electrochemical corrosion, direct chemical attack on the suture, and inflammation produced in reaction to the suture have been largley eliminated by the use of austenitic stainless steel wires, failure of the wires may still occur due to mechano-chemical cracking -- the combined effect of insignificant stresses, usually from cold working, and insignificant chemical potentials produced by body fluids. Although stainless steel wire remains a satisfactory material for sternotomy closure or for reattaching costal cartilages, the two spectacular complications of a broken wire point out the need for care in using wire sutures. Bending, twisting, kinking and knotting must be avoided as much as possible.

Adult↗
PubMed1978

Evaluation of technetium scanning for myocardial contusion.

Myocardial contusion is a serious problem not easily diagnosed. Laboratory and clinical studies carried out on myocardial infarction suggested that Technetium scanning might clarify this diagnostic dilemma. Radionuclide imaging with Technetium was carried out in 29 patients suspected of having myocardial contusion. Of 13 patients in whom contusion was confirmed electrocardiographically, scan was positive in only two. Use of the technique in diagnosis of myocardial contusion is not recommended.

Adolescent↗
PubMed1978

Left ventricular outflow obstruction produced by a pedunculated fibroma in a newborn: clinical, angiographic, echocardiographic and surgical observations.

An unusual case of a one-day-old infant with significant left ventricular outflow obstruction produced by a pedunculated fibroma is described. The clinical findings were indistinguishable from severe valvular or subvalvular aortic stenosis. The tumor was difficult to detect by echocardiography. It produced an echo-free widening of the left ventricular outflow tract. Left ventricular cineangiography clearly demonstrated a mobile mass beneath the aortic valve.

Aortic Valve Stenosis↗
PubMed1977

Tension pneumomediastinum.

Tension pneumomediastinum is an infrequently diagnosed but potentially fatal condition. The collection of air under pressure in the mediastinum compromises venous return to the heart and compresses major bronchi, leading to sudden and profound cardiovascular collapse. Although its mechanism was elucidated in the 1940's, when tension pneumomediastinum was most commonly a complication of tuberculosis, the same mechanism explains its formation in neonates with respiratory distress and in patients ventilated with volume respirators. Awareness of this condition will lead to more frequent diagnosis, but, more important, will also lead to prompt mediastinotomy and relief of this rapidly fatal condition.

Diagnosis, Differential↗