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Biomedical subjects

M C Hutton

Publications and source records attributed to M C Hutton.

2 recordsLinked to original sources

Peripheral vascular surgery.

Patients may present with a wide range of manifestations of arterial occlusive disease. The clinician must be able to assess the magnitude of the arterial flow diminution and thereby determine the appropriate treatment regimen. A careful history, physical examination, and pertinent noninvasive vascular laboratory tests should provide adequate information for the clinician to establish the severity of disease and the need to pursue a medical or surgical treatment plan. Patient evaluation must be carried out expeditiously, especially when limb-threatening conditions such as infection or gangrene exist, because these problems may progress rapidly and result in major lower extremity amputation.

Arterial Occlusive Diseases

Splenic injury: nonoperative management in three patients with infectious mononucleosis.

Three patients with infectious mononucleosis and splenic injury were managed nonoperatively. Mechanisms of injury included significant left upper quadrant trauma during a football game in a 17-year-old boy, a minor fall in a 16-year-old girl, and no apparent trauma in the remaining patient, a 28-year-old man. All had significant abdominal pain and two were hypotensive upon admission. All had computerized tomographic scan documentation of splenic enlargement, significant injury, and free peritoneal blood. Paracentesis was not performed. Only the first patient received transfused blood. The hospitalization period ranged from nine to 14 days. Gradual and finally complete healing (return to normal size) was documented in all three patients. Follow-up is 66, 14, and 10 months. Although clearly controversial and not free from danger, successful nonoperative management of the injured enlarged spleen in select patients with mononucleosis is possible in an appropriate setting.

Adolescent