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Biomedical subjects

H F Veen

Publications and source records attributed to H F Veen.

18 recordsLinked to original sources
PubMed1992

The late complications of aorto-ilio-femoral Dacron prostheses: dilatation and anastomotic aneurysm formation.

Dilated prosthetic grafts and anastomotic aneurysms are recognised as a long-term complication of aorto-ilio-femoral reconstruction. In the literature an incidence of 1-24% for anastomotic aneurysms and a mean dilatation of 85.7% for Dacron aortic prostheses is reported. In our own clinic the frequency of these complications was not known, and we started a follow-up study in order to establish: the mean dilatation of the prosthetic grafts, the actual incidence of anastomotic aneurysms and the relationship between these two. All patients (n = 61) who underwent aorto-ilio-femoral reconstruction between 1980 and 1985 were retrospectively studied. During the mean 8 years follow-up period 16 patients died (26%). Complete data were available from 36 patients, who underwent physical examination and ultrasonography. In the whole series the degree of dilatation varied from 0 to 44% with an average of 5.9% at the aortic level and 8.9% at the distal level. The diameters of 25 grafts remained unchanged, and the maximum dilatation observed was 44%. The incidence of anastomotic aneurysms in these patients was 13.8%. The anastomotic aneurysms were located at the following anatomical sites: aortic anastomoses 5.9%, iliac anastomoses 0 and 30.4% for the femoral anastomoses. There was no relationship between the dilated grafts and anastomotic aneurysms. In our clinic the degree of dilatation and the incidence of anastomotic aneurysms seems to be low, especially if we compare these results with the results reported by other investigators. None of the patients who underwent aorto-ilio-femoral reconstruction between 1980 and 1985 died or had to undergo emergency surgery because of graft failure or a ruptured anastomotic aneurysm.

Aged↗
PubMed1991

Local thrombolytic therapy for axillary-subclavian vein thrombosis.

Thrombosis of the axillary-subclavian vein can be primary and secondary. The case histories of three patients with spontaneous idiopathic thrombosis of the axillary vein are presented. Successful treatment with low-dose local streptokinase infusion could be confirmed by daily venography. Instead of weeks of heparine infusions, the patients could leave the hospital after a couple of days (range 10 to 12 days), long-term follow-up (4 months) showed no recurrence.

Adult↗
PubMed1990

Haemorrhagic shock due to primary aortoduodenal fistula.

The case history is presented of a 68-year-old man with a primary aortoduodenal fistula. Primary aortoduodenal fistulas are a rare complication of aortic aneurysms. Given a high degree of suspicion, this otherwise lethal disease can successfully be treated by surgery. The so-called herald bleed usually allows time for investigation and diagnosis. In emergency operations, a primary repair of the duodenum and replacement of the aortic aneurysm with a Dacron prosthesis is advised. Decompression of the duodenum, protection of the graft with an omentum flap and prolonged antibiotics can minimize the risk of postoperative complications. The diagnostic and therapeutic approach is reviewed.

Aged↗
PubMed1989

Aneurysm of the popliteal vein with multiple pulmonary thrombo-emboli: a case report.

Venous aneurysms are uncommon pathologic entities, which can lead to serious complications. A 75-year old patient is reported with a thrombosed aneurysm of the popliteal vein and multiple pulmonary thrombo-emboli. The diagnosis is in general based on venography. In the present case, however, ultrasonography was performed and led to the wrong diagnosis because of unfamiliarity with this entity. When ultrasonography of the popliteal fossa is performed, the possibility of aneurysms of the popliteal vein should be considered.

Aged↗
PubMed1989

Iatrogenic chylous ascites: operative or conservative approach.

Postoperative chylous ascites is a rare complication of aortic surgery. Two patients are presented with postoperative chylous ascites after abdominal aortic surgery. The value of either conservative management or an operative approach or peritoneo-venous shunting is discussed.

Aorta, Abdominal↗
PubMed1988

Diagnosis and management of graft-enteric fistulae.

During a 7-year period 20 patients underwent operation for a graft-enteric fistula after implantation of an intra-abdominal vascular prosthesis months or years before. Eighteen patients had gastrointestinal blood loss as their first symptom; 12 were in shock on admission. Fourteen patients had a fistula between the proximal anastomosis and the duodenum. Graft excision followed by axillobifemoral bypass was performed in 10 patients and four patients underwent local repair. A fistula between the distal anastomosis and the bowel was found in the remaining six patients and a local repair was carried out. Proximal graft-enteric fistula carries a particularly high postoperative mortality rate of more than 50 per cent.

Aged↗
PubMed1987

Fascia closure after midline laparotomy: results of a randomized trial.

Four techniques to close the fascia after midline laparotomy were compared in a prospective randomized multicentre trial. The four techniques were: interrupted closure with polyglactin; continuous closure with polyglactin; continuous closure with polydioxanone-s, and continuous closure with nylon. The early postoperative results in 1491 patients revealed an incidence of wound infection of 8.6 per cent and of wound dehiscence of 2.3 per cent with no statistically significant differences between the four techniques. We reviewed 1156 patients after 1 year. Wound pain was present in 9.7 per cent of the patients, statistically significantly more in the group closed with nylon (16.7 per cent). Suture sinuses developed in 3.5 per cent of the patients, statistically significantly more frequently in the nylon group (7.7 per cent). The total number of incisional hernias detected 1 year postoperatively was high (15.2 per cent) (interrupted polyglactin 16.9 per cent, continuous polyglactin 20.6 per cent, continuous polydioxanone 13.2 per cent and continuous nylon 10.3 per cent). The difference between nylon and continuous polyglactin is statistically significant. The results of this trial indicate that although nylon has the lowest incidence of incisional hernia it also is associated with more wound pain and suture sinuses.

Abdomen↗
PubMed1985

Timing of surgery for acute biliary pancreatitis.

Twenty-five patients with acute biliary pancreatitis were classified according to the severity of disease as determined by Ranson's signs. A significant correlation was found between the severity of pancreatitis estimated in this way and the observed postoperative mortality. Early operation was performed in 15 patients, whereas 10 patients received conservative management for a certain period before operation. The choice of treatment was based on clinical considerations. No significant difference was found in mortality between the two groups. We conclude that early operation does not harm patients with mild pancreatitis whereas patients with severe pancreatitis may benefit from it.

Acute Disease↗
PubMed1979

Gastro-intestinal bleeding and malignancy of the testis.

Three cases of gastro-intestinal bleeding caused by metastasis of a testicular tumour to the duodenum are described. The report illustrates that, particularly in young patients, the possibility of a primary tumour in the testis should be considered when a tumour mass is found in the upper abdomen, even if other symptoms suggestive of primary gastro-intestinal disorders, such as melaena and haematemesis, are also present. As primary malignancies of the small intestine are rare, a presumptive diagnosis of anaplastic duodenal carcinoma should always arouse the suspicion of metastatic rather than primary growth.

Adolescent↗
PubMed1979

Ileal resection potentiates 1,2-dimethylhydrazine-induced colonic carcinogenesis.

The effect of colonic hyperplasia produced by resection of the distal third of the small bowel (DSBR) on the development of chemical carcinogenesis of the colon by dimethylhydrazine (DMH) was tested in rats. For the most part the amounts of RNA and DNA in the small bowel were the same with the combined treatments as with either one alone; quantities of nucleic acids tended to increase only in transverse and distal colon. After 37 weeks the number of neoplasms per rat was increased six-fold by combining DSBR with DMH. Neoplasms were spread throughout the colon after combined treatment as opposed to the ascending colong after DMH alone. Postresectional hyperplasia appears to increase the incidence and distribution of colon tumors.

Animals↗
PubMed1977

Treatment of intussusception in children operative treatment versus hydrostatic reduction.

Intestinal intussusception is a serious abdominal emergency in infancy and childhood, with a high mortality-rate if not diagnosed and treated early. Since the management of intussusception in children is still controversial, the pro's and con's for barium enema reduction and for surgical treatment are discussed. The results of our own series of 19 patients primarily treated by barium-enema reduction compare favourably with a previous series of 14 patients treated by primary surgery.

Barium Sulfate↗
PubMed1977

Compensatory postresectional hyperplasia and starvation atrophy in small bowel: dissociation from endogenous gastrin levels.

Because exogenous gastrin has been implicated as a tropic hormone for mucosal cells of the intestinal tract and as a regulator of mucosal growth, we studied the effects on the gut of endogenous 23-fold variations of serum gastrin produced by various gastric operations. These were pyloroplasty, vagotomy and pyloroplasty, antrectomy, and fundectomy. After jejunal resection, RNA content, DNA content, incorporation of [3H]thymidine into DNA, crypt depth, and villus height in midgut and ileum were independent of gastrin levels. Loss of RNA and DNA during starvation was not prevented by high endogenous concentrations of serum gastrin, and DNA specific activity was not affected. Tropic effects distal to the duodenum produced by exogenous gastrin and pentagastrin may be results of supranormal levels.

Animals↗
PubMed1976

Alien cancers of the duodenum.

Invasion of the duodenum by contiguous cancer or an isolated metastasis can manifest itself with the signs and symptoms of primary cancer of the duodenum. Fourteen patients were identified with this type of diagnostic confusion. All of their tumors were in the second or third portion of the duodenum. Although the median length of survival after excision of the tumor or palliative bypass operations in these patients was nine months, considerably longer survival times have also been described. Barium enema examinations and excretory urograms should be considered as diagnostic tests for any patient with a tumor of the duodenum to identify the contiguous carcinomas of the colon and kidney subject to long palliation.

Adult↗