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Biomedical subjects

E Shocket

Publications and source records attributed to E Shocket.

18 recordsLinked to original sources
PubMed1986

Bedside radionuclide scanning in the postoperative management of intraperitoneal sump drains.

The volume of the peritoneal cavity opacificable by the instillation of 99mTechnetium labeled albumin through a sump drain was studied over successive postoperative days in 19 patients (21 drains) using a portable gamma camera. After operation, a constant gravity drip of saline solution was delivered through the sump "in" port. The "out" port was connected to low constant suction. Encapsulation (opacification of only the catheter) was demonstrated in eight of the catheters on either the initial study (six) or on successive (two) studies. This encapsulation was demonstrated sometime between the first and sixth postoperative day. The volume of the peritoneal cavity which was perfuseable did decrease measurably over several successive days in three of the patients. In nine of 21 drains, a significant volume of the peritoneal cavity was still perfuseable on the third and up to the sixth postoperative day. The classic teaching that a drain placed in the peritoneal cavity promptly encapsulates may apply to static gravity drains but does not apply to perfused sump drains used in this study. The manner in which fluid is instilled may modify the volume of peritoneal cavity perfused. The 99mTechnetium labelled albumin technique is suitable for bedside use because of its simplicity and lack of adverse reactions. Its accuracy facilitates the decision as to when a sump drain should be removed.

Catheters, Indwelling↗
PubMed1982

Small bowel obstruction due to enterolith (bezoar) formed in a duodenal diverticulum: a case report and review of the literature.

An elderly patient with an acute small bowel obstruction due to an enterolith that evolved within a duodenal diverticulum is reported. Twenty-four prior instances of small bowel obstruction due to an enterolith formed within a small bowel diverticulum have been culled from the world literature and tabulated. In toto, 18 subjects are female and seven are male. The median age is 68 yr. Optimal surgical management is either to break up the enterolith and milk the components into the cecum without an enterotomy or, as is more often necessary, to milk the enterolith orad removing the concretion through an enterotomy made in less edematous small intestine. As in managing gallstone ileus, the bowel should be "run" seeking additional enteroliths. The diagnosis can be established only by documenting the normalcy of the gallbladder and the presence of duodenal and/or jejunal diverticula.

Aged↗
PubMed1977

Gastroduodenal perforation after open heart surgery.

During a thirty month period, 319 patients underwent open heart operations, and of these, three experienced a life-threatening explosive abdominal catastrophe. Aggressive radiographic maneuvers established the diagnosis of gastroduodenal perforation. Appropriate abdominal surgery with plication of the perforation and, whenever possible, the establishment of tube gastrostomy for decompression and a tube jejunostomy for feeding is desirable. All three patients required mechanical ventilatory support and tracheostomy prior to the abdominal catastrophe. Prophylactic antacids and sedation seem appropriate, particularly for selected patients (those with a prior peptic history and those with pulmonary dysfunction). Pulmonary toilet for those identified by preoperative pulmonary screening may circumvent the need for postoperative ventilatory support, which increases the risk of stress ulceration. Of the three patients described, all survived the gastrointestinal surgery but only one left the hospital. One died twenty days and another forty-eight days after the intestinal surgery, both of pneumonitis and septicemia.

Abscess↗