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Biomedical subjects

L T Hibbard

Publications and source records attributed to L T Hibbard.

13 recordsLinked to original sources
PubMed1987

Laparoscopy--a diagnostic aid in cases of suspected appendicitis. Its use in women of reproductive age.

In women of reproductive age the usefulness of laparoscopy in diagnosing acute appendicitis was evaluated. Eighty-six women underwent diagnostic laparoscopy. There was complete visualization of the appendix in 93% of the patients. Twenty-two patients were spared laparotomy. In the nonpregnant patients, salpingitis was the disease most often confused with appendicitis. Eighty-five percent of the patients with salpingitis had the onset of symptoms within 14 days of the last menstrual period, whereas acute appendicitis was found in 86% of the patients with the onset of symptoms greater than 14 days after the last menstrual period. The onset of symptoms relative to the first day of the last menstrual period differed in these two groups of patients (p less than 0.01). Patients who were spared unnecessary laparotomy had significantly diminished hospital stays (p less than 0.001). Laparoscopy was found to be a safe and effective way to diagnose acute appendicitis in women of reproductive age, and its liberal use is recommended.

Adolescent↗
PubMed1979

Corpus luteum surgery.

The corpus luteum is responsible for a substantial number of emergency operations, some of which prove to be unnecessary and others which are unnecessarily complex. The routine utilization of culdocentesis and pregnancy testing will identify the large majority of those patients who can safely be treated by expectant observation or who should first be investigated by a diagnostic operative technique, such as laparoscopy, before an exploratory laparotomy is performed. When a laparotomy is performed, the ovary should be conserved whenever possible. An analysis of two hundred consecutive emergency operations for ruptured corpus luteum or corpus luteum cyst support these observations.

Corpus Luteum↗
PubMed1979

Urinary tract endometriosis: enigmas in diagnosis and management.

The diagnosis and management of endometriosis presents several enigmas. This review, of eight patients with endometriosis involving the urinary tract, from three large clinical services in the City of Los Angeles, highlights some very difficult problems. Not only diagnostic errors but also inappropriate conservatism and inadequate surveillance have led to compromised function, resection, and/or destruction of the kidneys, ureters, or bladder. The series indicates those findings which are likely to result in urinary tract destruction and points out those clinical situations in which delays or conservative management must be undertaken only with pressing indications and then only with continued and careful surveillance.

Adult↗
PubMed1978

Surgical management of rectovaginal fistulas and complete perineal tears.

Twenty-four patients with traumatic rectovaginal fistulas and 27 patients with complete perineal tears underwent secondary operative repair. Primary healing occurred in 50 cases and partial healing in the 51st case. Six patients had previously undergone one to three unsuccessful repairs. The advisability of early repair and the benefits of prophylactic antibiotics and of use of a Martius graft for operative failures are discussed.

Episiotomy↗
PubMed1976

Spontaneous rupture of the liver in pregnancy: a report of eight cases.

Seven cases of ruptured subcapsular hematoma and one case of ruptured hepatoma are reported. Six of the patients died, four following an unsuccessful operation. One patient survived following an operation, and another patient survived without surgical intervention. Both survivors were treated with a gravity suit to control internal hemorrhage.

Adult↗
PubMed1976

Changing trends in cesarean section.

There have been considerable changes in obstetric practice in the past 5 years, with corresponding changes in the application of ceasarean section to obstetric complications. In this paper, 4,003 cesarean sections done in a public hospital during four time periods dating back to 1948 are compared, and the changing applications of section are discussed. Breech presentation, fetal distress, and dystocia have contributed substantially to the increasing use of abdominal delivery.

Anesthesia, Inhalation↗
PubMed1976

Maternal mortality in diabetes mellitus: an 18-year survey.

Over the past 50 years, maternal mortality for the pregnant diabetic has been reduced by half. In the period from 1957 to 1974, 24 pregnant diabetic women died in Los Angeles County. Seven deaths were directly attributed to the metabolic complications of diabetes. Fatal ketoacidosis occurred in the second and third trimesters, while hypoglycemia led to death in the first trimester or postpartum period. Of 15 patients alive at the onset of labor, 8 were delivered by cesarean section. Four of these women died from sepsis and 3 from hemorrhage. In contrast to other reports, vascular disease contributed to only 1 fatality.

California↗