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Biomedical subjects

M Hashmonai

Publications and source records attributed to M Hashmonai.

At least 127 records · Page 7Linked to original sources
PubMed1975

Hypertensive crisis, erythrocytosis, and uraemia due to renal-artery stenosis of kidney transplants.

Two patients with kidney transplants had hypertensive encephalopathy and rapidly progressive kidney failure 10 weeks and 18 months postoperatively. In one patient renal failure was associated with erythrocytosis. Absence of proteinuria, despite progressive renal insufficiency in both patients, suggested that these abnormalities were not due to rejection episodes. Subsequently, angiography proved that each of these patients had renal-artery stenosis. Surgical repair of this lesion increased creatinine clearance at least threefold, and the hypertension and erythrocytosis disappeared. Apparent "rejection" episodes in which there is no proteinuria should alert clinicians to the possiblity of renal-artery stenosis of the graft. Restoration of kidney function and amelioration of hypertension may follow revascularisation, even after many months of renal ischaemia producing severe uraemia.

Adult↗
PubMed1975

Reconstructive surgery in major vein injuries in the extremities.

1) In major vein trauma, an attempt should be made to repair the vein. 2) Whenever possible, lateral suture seems to be the ideal type of repair. However, excellent results can be obtained with end-to-end anastomosis. 3) When the damaged segment of the vein is too long to permit end-to-end approximation, a vein interposition graft (and if necessary, a composite tube) appropriate to the width of the injured vein and length of the gap should be employed. Use of synthetic grafts should be avoided. 4) Although the importance of a distal temporary A-V fistula is still disputed, the present authors have adopted this method in the graft repair of the femoral vein in the groin. Better results were obtained in the cases in which the fistula functioned than in those in which it became occluded.

Arteriovenous Shunt, Surgical↗
PubMed1975

Acute abdomen due to torsion of a pedunculated mesenteric fibroma.

A case history of a boy with an acute abdomen due to torsion of a pedunculated mesenteric fibroma is presented. A review of the literature shows that only a relatively small number of mesenteric fibromata have been reported. In these cases the tumor was described as growing between the two leaves of the mesentery. The symptoms these tumors gave usually were due to the size of the tumor and compression of adjacent organs. The present case is unusual because of the pedunculated nature of the fibroma and its presentation as an acute abdomen.

Abdomen, Acute↗
PubMedDate not supplied

Minicholecystectomy vs conventional cholecystectomy: a prospective randomized trial--implications in the laparoscopic era.

The objective of this study was to compare results of elective "open" conventional cholecystectomy (CC) to those of minicholecystectomy (MC). A clinical prospective, randomized trial was designed. The setting was an academic general surgical unit. In the CC group were 26 patients; in the MC group were 24 patients. In the CC group a conventional open cholecystectomy was performed through a subcostal incision; in the MC group operation through an initial 5-cm subcostal incision was done. Mean length of wound was 14.4 cm and 5.4 cm in the two groups, respectively (p < 0.001). Mean operative time was 60 and 59 minutes, respectively. Mean operative difficulty, estimated on a 1-10 scale, was 3.4 and 5.6, respectively (p < 0.05). Mean postoperative analgesia requirements (number of doses of 10 mg morphine sulphate) were 5.8 and 4.0, respectively (p = 0.002). Mean duration of hospitalization was 4.7 and 3.0 days, respectively (p < 0.001). Mean "overall patient satisfaction," estimated on 1-10 scale, was 6 and 8.3, respectively (p = 0.002). We conclude that Minicholecystectomy offers less pain, earlier recovery, and better cosmetic results than the conventional "open" procedure. Published results of MC compare favorably with those of laparoscopic procedures. The implications of these results in the "laparoscopic era" are discussed.

Cholecystectomy↗
PubMedDate not supplied

Unusual presentation of ruptured splenic artery aneurysms.

Two cases of ruptured splenic artery aneurysms with unusual clinical presentation are reported. In one case an inflammatory abdominal process was suspected, while in the other the operation was delayed by several hours due to the unexplained coma, high blood sugar levels and lack of signs of shock until an advanced stage of the disease. As there was no active bleeding during the operation, the presence of free blood in the abdomen and clots in the omentum provided the clue for localization of the source of the bleeding.

Abdomen, Acute↗
PubMedDate not supplied

Indications for exploration of the bile ducts.

A series of 477 choledochotomies for suspected choledocholithiasis is presented. The indications for exploration of the common bile duct are reviewed. Absolute indications are: palpable stones in the common bile duct, stones seen on intravenous cholangiography and jaundice during the operation. When there are only relative indications, an intraoperative pre-exploratory cholangiogram should be performed so that unnecessary exploration can be avoided.

Adolescent↗