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Biomedical subjects

E L Bitseff

Publications and source records attributed to E L Bitseff.

6 recordsLinked to original sources
PubMed1987

Infected abdominal aortic aneurysms.

We report five cases of infected abdominal aortic aneurysm managed at the St. Thomas Hospital between 1975 and 1985. Two patients died, one before operation, and another during surgical repair of aneurysmal rupture. Three patients survived, all of whom had primary repair of the aorta or in situ Dacron graft reconstruction. One patient is still living nine years after operation. The availability of organism-specific antibiotic agents has enabled us to use the in situ reconstruction method to successfully manage these patients without increased morbidity or mortality from recurrent infection. A high index of suspicion, prompt surgical resection, and aggressive specific antibiotic therapy are necessary for patient survival.

Aged↗
PubMed1985

Abdominal vascular injuries.

Treatment of major abdominal vascular injuries is a challenge. Since 1973, 93 patients have been treated at our institution for 147 abdominal vascular injuries. The majority of these injuries (67%) resulted from penetrating trauma in young men between 21 and 30 years of age. Upon admission 72% of the patients were in shock. Injured most frequently were the iliac vessels (36%) and the inferior vena cava (20%). Suture repair with preservation of function was possible in 61%; ligation of the damaged vessel was necessary in 24 cases (26%). Overall mortality was 29%. Military anti-shock (MAS) trousers were used in the management of ten patients who had an average admission systolic blood pressure of 52 mm Hg; 50% survived. In six cases of refractory hypotension or cardiac arrest, thoracotomy was done in the emergency room; mortality in this group was 100%. For some abdominal vascular injuries, ER thoracotomy has a very limited application. The key factors for increasing the survival rate in patients with major abdominal vascular injuries include rapid stabilization, reversal of hypotension (especially by the use of MAS trousers), and prevention of coagulopathy, combined with prompt surgical exploration and thoracotomy when indicated.

Abdomen↗
PubMed1984

Splenic trauma: a trial at selective management.

The experience with splenic trauma at the Metropolitan Nashville General Hospital and at Vanderbilt University Hospital between 1972 and 1983 is the subject of this report. Of 154 emergency cases involving splenic injury, 134 were due to blunt trauma, with 20 cases resulting from penetrating injury. In 124 patients, exploratory laparotomy was done immediately after resuscitation and evaluation. Splenectomy was done in 113 (92%) cases, and in ten cases the spleen was repaired. Thirty patients (19.4%) were initially managed by observation of vital signs, serial hematocrit determinations, and serial physical examination. Of these 30 patients, 21 (70%) required exploratory laparotomy for continued bleeding after observation of 12 hours to six days. Eighteen of this group had splenectomy, and three had splenorrhaphy. Nine (5.8% of the total and 30% of the observed group) were successfully managed nonoperatively. Complications were encountered in 53 of the total 154 cases. There were 19 deaths (12.3%), 11 of them from head injuries. Splenectomy should be done promptly in cases of concomitant splenic and cerebral injury and in patients with injury of multiple organ systems. Nonoperative management of suspected splenic injury should be reserved for patients in stable condition and with few if any associated injuries.

Accidents, Traffic↗