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R E Ahlquist

Publications and source records attributed to R E Ahlquist.

6 recordsLinked to original sources

Mortality from ruptured abdominal aortic aneurysms. A comparison of two series.

Series of ruptured abdominal aortic aneurysms from a municipal teaching hospital and from a group of private surgeons practicing at four community hospitals were compared for hemodynamic status and time to operation, as well as mortality. The overall mortality rate was 61 percent for the municipal hospital series and 32 percent for the community hospital series, which was significantly different (p = 0.003). The municipal hospital series had a significantly greater number of patients in shock before operation, as well as a greater number of patients transported directly to the operating room. The community hospital series had a significantly greater number of patients with a more than 6 hour delay in diagnosis and delays in surgical exploration. When those patients in shock who were brought directly to the operating room were compared, there was no statistical difference between the two series. Further reviews of ruptured abdominal aortic aneurysms should attempt to identify groups of patients by their hemodynamic status when evaluating treatment.

Aged

The Hartmann procedure for complications of diverticulitis.

A Hartmann procedure was performed on 25 patients with complications of acute diverticulitis. Of the 20 patients in whom both stages were completed, 14 had a smooth course. Total hospitalization for both stages averaged 23 days. Mortality was 8%. The initial resection usually is not difficult. Subsequent reanastomosis is facilitated by an interval of at least three months between stages. The advantages of the Hartmann procedure are as follows: (1) The diseased bowel is removed at the first stage. (2) The risk of primary anastomosis is avoided. (3) Hospitalization and overall time of treatment are reduced. (4) Mortality is relatively low. The Hartmann procedure should be considered for a broader selection of patients with complications of acute diverticulitis.

Abscess

Thoracic outlet compression syndrome.

Forty-nine patients underwent sixty-four procedures for the treatment of the thoracic outlet compression syndrome. Detailed history and careful physical examination are of paramount importance in diagnosing this disease. Our findings strongly suggest that a positive arteriogram is confirmatory evidence of the thoracic outlet compression syndrome. Two problems are identified as the source of unsatisfactory results in this series: poor selection of patients and the regeneration of rib and dense scar tissue with recurrence of compression symptoms. We favor the transaxillary approach to resection of the first rib because it provides satisfactory exposure for removal of the entire rib and utilizes a more cosmetically pleasing incision. Division of muscles, traction on nerves, and entrance into a body cavity are not required, operating time and hospital stay are shortened, and blood loss is minimized. Favorable long-term results were seen in 86 per cent of the patients treated.

Adolescent