[Puncture metastasis after percutaneous endoscopic gastrostomy].
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Biomedical subjects
Publications and source records attributed to H Massoun.
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Between 1973 and 1989 a total of 388 patients underwent laparotomy because of abdominal trauma. In 98 cases, injuries of the small bowel, the colon or the mesentery were found. The injuries were caused by motor vehicle accidents in 55 patients; 12 had gunshot or stab wounds and 12 committed suicide. There were 78 patients who had sustained a blunt abdominal trauma and 20 patients with a penetrating trauma. Only 21 patients had suffered a solitary injury of the gastrointestinal tract. In 41 patients there were also lesions to other intraabdominal organs, in 11 patients, thoracic injuries and in 24 patients, a craniocerebral trauma. Combined injuries of skull, thorax and abdomen were present in 24 patients. Neither ultrasound nor peritoneal lavage allows reliable prediction of injuries of the gastrointestinal tract. In 51 cases a defect of the mesentery or serosa was repaired. In 54 patients there was a rupture of the small or large intestine: in 20 of these cases primary repair without resection was performed and in 34, resection and anastomosis. Ileostomy or colostomy was done in only 8 patients. An anastomotic leak developed in 2 patients. Lethality is correlated to the extent of concomitant injuries. Solitary injury of the small bowel or colon was followed by lethality of only 4.1%, increasing to 50% in patients with combined injuries of skull, thorax and abdomen.
Operations were performed on 75 cases of acute occlusion of the aorta and bilateral iliac arteries, between 1972 and 1987. The occlusions had been caused by embolisation in 48.6 per cent of these cases and by thrombosis in 31.4 per cent. Amputations had to be performed on 22 per cent, while the mortality rate at hospital amounted to 42.8 per cent. Surgical and anaesthetic risks were extremely high in 71 per cent of all patients. Complete ischaemia lasted more than six hours in 48 per cent. Intraoperative angioplasty was applied to twelve patients to control occlusion-induced stenoses and is believed to be capable of reducing hospital mortality.