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K Kasirajan

Publications and source records attributed to K Kasirajan.

10 recordsLinked to original sources

Systemic consequences of oxidative stress following aortic surgery correlate with the degree of antioxidant defenses.

The purpose of this study was to correlate the preoperative level of antioxidant defenses, measured by the plasma total antioxidant capacity (TAC), to the degree of postoperative systemic inflammatory response, measured by the severity of pulmonary injury following elective aortic surgery. Twenty-four patients had TAC measured preoperatively and 24 hr postoperatively. Chest radiography and arterial blood gases were obtained preoperatively and serially during the first 24 hr after surgery. Using objective radiologic criteria and blood gas analysis, the degree of pulmonary edema and pulmonary dysfunction were quantified. All patients showed evidence of pulmonary dysfunction in the first 24 hr following surgery. Fifteen of the 24 patients showed radiographic evidence of noncardiogenic pulmonary edema in the immediate postoperative period. In this group, the TAC was lower than in those without pulmonary edema immediately following surgery (p = 0.03). Preoperative TAC was associated with the degree of pulmonary edema in the postoperative period (r = -0.372, p = 0.067). These results suggest that preoperative antioxidant supplementation may favorably impact the severity of systemic inflammatory response following ischemia and reperfusion injury.

Aged↗

Delayed onset of ascending paralysis after thoracic aortic stent graft deployment.

Delayed spinal cord ischemia after thoracic aortic aneurysm repair is an infrequent but devastating complication. The use of stent grafts to exclude aortic aneurysms is thought to decrease the incidence of the neurologic deficit because there is no period of significant aortic occlusion. We report a case of paraplegia that progressed to quadriplegia occurring 48 hours after the apparently successful deployment of a thoracic aortic stent graft.

Aged↗

Synchronous laparoscopic vasectomy and hernia repair.

Over the last few years, general surgery has seen the use of more and more laparoscopic techniques in the management of common surgical problems. This expanded use is attributable not only to the excellent results seen with laparoscopic procedures but also to patient demand. A 48-year-old man requested a laparoscopic hernia repair with synchronous vasectomy. The technique of synchronous laparoscopic hernia repair and vasectomy is discussed, and a literature review is provided. Certain disadvantages along with the difficulty in reanastomosis after a laparoscopic vasectomy will prevent the replacement of traditional vasectomy with the laparoscopic technique.

Hernia, Inguinal↗

Necrotizing esophagitis presenting as a black esophagus.

A case of necrotizing esophagitis discovered during upper endoscopy is described. An 88-year-old woman was admitted to our hospital with complaints of multiple episodes of coffee ground emesis and dysphagia over 3 months. Ischemia is proposed as the etiology of necrotizing esophagitis on the basis of the patient's significant cardiac history, her age, and low-flow state.

Aged↗

Microinvasive laparoscopic cholecystectomy in pediatric patients.

Although cholelithiasis is uncommon in children, its laparoscopic treatment has progressively become more popular among pediatric surgeons. This is due in part to the fact that compared with the open technique, laparoscopic treatment is less invasive as well as more cost-effective. A review of the literature indicates that it has been customary to use at least one 10-mm port to permit application of the 10-mm endoscopic clip applier for ligation of the cystic duct and artery. We report our experience with two patients in whom a laparoscopic cholecystectomy was performed by use of a 5-mm endoscopic clip applier and a 3-mm laparoscope. The application of a 5-mm clip applier obviated the need for a 10-mm port. It also saved an additional step by eliminating the exchange from the laparoscope to the 10-mm endoscopic clip applier through the 10-mm port. Furthermore, the use of a 3-mm telescope through the smallest port (<5 mm) would achieve a better cosmetic outcome.

Child↗

Laparoscopic technique in the management of Spigelian hernia.

Spigelian hernias are uncommon, and preoperative diagnosis is often difficult. The use of the laparoscope has simplified the diagnosis and subsequent repair of these rare hernias. We report a case diagnosed and repaired using laparoscopic techniques of fascia approximation, mesh reinforcement, and reperitonization.

Female↗

Stump appendicitis: a case report.

Residual appendicitis is a rare event that occurs when there is incomplete resection of the organ. A recent report suggested that this may be a complication of laparoscopic surgery. Following a case of stump appendicitis in a young patient, we thoroughly reviewed the literature and found that most reported cases have occurred in open appendectomy. Awareness of the existence of this uncommon condition will help in the early diagnosis and prompt treatment of this pathology.

Appendectomy↗

Portal pyelophlebitis identified by CT scan in a patient with ischemic bowel.

A 65-year-old male was found to have hepatic portal venous gas (HPVG) by computed tomogram secondary to ischemic bowel. Despite aggressive surgical and antibiotic treatment, the patient died within 12 hours. Portal pyelophlebitis, when identified by air in the portal venous system, is a grave indicator of ischemic bowel with a very high mortality rate, except in patients with inflammatory bowel disease.

Aged↗