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Biomedical subjects

D B Dove

Publications and source records attributed to D B Dove.

8 recordsLinked to original sources
PubMed1987

Diagnostic peritoneal lavage in the management of blunt abdominal trauma: a reassessment.

In order to reassess the value of diagnostic peritoneal lavage (DPL) in patients with blunt abdominal trauma, we conducted a prospective study over a 15-month period involving 138 patients. There were 29 (28.3%) patients with positive DPL and 103 (71.7%) with negative DPL in this series. Of the 29 patients with positive DPL, 28 (96.5%) were found to have significant intra-abdominal injuries; 27 by exploratory laparotomy and in one case at autopsy. One patient with a grossly positive DPL had a negative exploratory laparotomy (3.4% false positive rate). All 109 patients with negative DPL were admitted. In only one case a significant intra-abdominal injury was demonstrated (0.9% false negative rate). The overall mortality in this series was 11.6% and there were no complications related to the DPL. Our results suggest that DPL is indeed an accurate indicator of significant intra-abdominal injuries in patients with blunt abdominal trauma.

Abdominal Injuries↗
PubMed1986

Suspected vascular trauma of the extremities: the role of arteriography in proximity injuries.

We reviewed 72 patients with penetrating trauma to the extremities who underwent arteriography for proximity injury only. None of the patients had clinical evidence of vascular trauma. There were 62 males and ten females, with a mean age of 29.9 years. Gunshot wounds were the most common cause of injury (91.7%) and the thigh was the most common site of injury (47.2%). A normal arteriogram was found in 55 of 72 patients (76.4%). The remaining 17 patients (23.6%) had arteriographic abnormalities that did not warrant surgery. Only one patient was explored (1.4%) for spasm of the popliteal artery. No vascular injury was found at surgery. This study suggests that routine arteriography in proximity injury only may be unnecessary and that these patients could safely be admitted to the hospital for a 24-hour period of observation.

Adult↗
PubMed1986

Negative appendix with suspected appendicitis: an update.

We report a retrospective study of 282 consecutive patients who had appendectomy for suspected acute appendicitis at the University of Miami/Jackson Memorial Medical Center during a 15-month period. The overall incidence of negative explorations of 7.4% was significantly lower than that reported in the literature, and occurred without a significant increase in the incidence of perforation (22%). Since no sophisticated diagnostic tests were used, we suggest that a decrease in the presently accepted negative exploration rate of 15% to 20% can be achieved on the basis of a careful history, detailed physical examination, and basic laboratory and x-ray studies.

Acute Disease↗
PubMed1985

Impalement injuries.

Impalement injuries are unusual, complex surgical problems. We present a case of impalement through the spine and abdomen, describe a two-team approach to operative extraction utilizing simultaneous laminectomy and laparotomy incisions, and outline the management of an infectious complication caused by unusual bacterial and fungal pathogens. General principles of management include: the impaling object must be stabilized and manipulation avoided during extrication and transport. Operative removal requires careful preplanning, and should be tailored to the specific presenting injuries, with early multispecialty involvement as necessary. Extensive exposure is mandatory and may be achieved through a variety of standard or unconventional incisions so as to permit extraction of the impaled object under direct vision. Meticulous care of the traumatic wound is necessary, and careful followup is required for recognition and early management of infectious complications.

Abdominal Injuries↗
PubMed1984

Adult intussusception with autoamputation and preservation of bowel continuity.

We present a case of adult intussusception with autoamputation and preservation of bowel continuity. Our patient, a 65-year-old man, passed a 65-cm segment of large bowel per anus with spontaneous recovery and with a two-month follow-up free of symptoms secondary to the intussusception. Mesenteric ischemia secondary to angiography with distal embolization two weeks prior to the event may have been a precipitating factor in this unusual form of intussusception.

History, 19th Century↗