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Biomedical subjects

L Zaidenstein

Publications and source records attributed to L Zaidenstein.

5 recordsLinked to original sources
PubMed1999

Spontaneous splenic rupture in infectious mononucleosis: conservative management with gradual percutaneous drainage of a subcapsular hematoma.

Spontaneous splenic rupture (SSR) is a rare but potentially lethal complication of infectious mononucleosis (IM). Because the inflamed spleen is usually enlarged, congested, and friable, emergency splenectomy is recommended. We describe the conservative management of a SSR in a 16-year-old boy with IM. A pigtail catheter was inserted under ultrasonographic guidance and left in place for 36 h. This allowed the successful evacuation of the hematoma without compromising the splenic parenchyma.

Adolescent↗
PubMed1990

Carotid endarterectomy under local anesthesia supplemented with neuroleptic analgesia.

Surgical treatment of the carotid artery is being performed increasingly under local rather than general anesthesia. The advantage of local anesthesia is that neurologic function can be continuously assessed while the carotid arteries are cross-clamped, and unnecessary shunting can, thus, be avoided, with resulting sedation, analgesia, alpha blockade and blood pressure stability. The main objection to the use of local anesthesia is the anxiety of the patient. We overcame this difficulty in a series of 42 patients by supplementing the local anesthetic with neuroleptic analgesia. The possible disadvantages of neuroleptic administration are apnea and prolonged sedation. Only one of the patients we studied required an intraluminal shunt. One patient died of cardiac disease and one suffered an early postoperative stroke, which subsequently resolved. We believe that local anesthesia, supplemented by neuroleptic sedation and analgesia to overcome patient anxiety, should be more widely used for carotid endarterectomy.

Aged↗
PubMed1988

Vertical banded gastroplasty for the treatment of morbid obesity.

We report the technique and results of vertical banded gastroplasty in 86 morbidly obese patients. At 12 months, the patients had lost a mean of 57% of their excess body weight; 36 months, they had lost 70%. The most severe early complication was perforation of the esophagus. Other complications included disruption of the vertical staple line in three cases and migration of the mesh band. We were able to achieve satisfactory weight reduction in all patients over a period of 36 months. In view of the good results, reduced morbidity, and absence of mortality, we feel that vertical banded gastroplasty is the surgical treatment of choice for morbid obesity at present.

Esophageal Perforation↗
PubMed1987

Selective operative cholangiography.

This is a study of 505 patients who underwent surgical treatment of the gallbladder. Of this group, 343 were operated upon without operative cholangiography with an incidence of retained stones of 0.03 per cent. One hundred and ten underwent operative cholangiography according to five indications. These are: stones in the common duct on ultrasound or roentgenography; obstructive jaundice; dilation of the common duct greater than 1.2 centimeters; previous cholangitis, and preoperative pancreatitis. The advantages of selective operative cholangiography versus routine cholangiography are discussed in detail. We concluded that the selective operative cholangiography should be the preferred procedure.

Cholangiography↗