PubMed Health⌕ Search

Biomedical subjects

R García Guasch

Publications and source records attributed to R García Guasch.

At least 19 recordsLinked to original sources
PubMed1989

[Biliary peritonitis after hepatic biopsy: favorable course with conservative medical treatment].

In a 53-year-old woman a percutaneous liver biopsy was performed with tru-cut to study persistent hypertransaminasemia. The patient did not present extrahepatic cholestasis. Immediately after biopsy the patient had a picture of biliary peritonitis that evolved favorably with conservative medical treatment, including hemodynamic resuscitation, antibiotic therapy, analgesic treatment and monitoring by the resuscitation service. A review is made of the literature on this complication of liver biopsy and treatment is discussed.

Bile Ducts, Intrahepatic↗
PubMedDate not supplied

[Spinal cord ischemia in the postoperative period of aortic surgery].

Paraplegia is a fearful and not uncommon complication of aortic clamping in surgical procedures involving thoracic and abdominal aorta. We report a case of transient spinal cord ischemia during the early postoperative period of aortobifemoral bypass in a 69-year-old male with arteriosclerosis obliterans, hypertension, type II diabetes mellitus and COLD. The anesthetic procedure was combined (peridural + intubation and mechanical ventilation + isofluorane). Two hypotensive episodes of about 80 mmHg developed, one after induction and another in the Reanimation area. The first one had a short duration, whereas the second one required the administration of colloids, crystalloids and blood. The infrarenal aortic clamping time was 35 minutes. In the early postoperative period the patient had clinical features consistent with spinal ischemia, which progressively recovered. To prevent spinal ischemia during surgery a shorter duration than 30 minutes of aortic clamping, a higher distal perfusion pressures higher than 60 mmHg during clamping, and the attempt to exclude the least possible number of intercostal and/or lumbar vessels are recommended. Drugs (corticosteroids, naloxone) and hypothermia can be useful.

Aged↗
PubMedDate not supplied

[Periorbital hematoma as a complication of posterior peribulbar anesthesia].

We report a case of a large periorbital hematoma which furtherly extended to the ipsilateral orbit and appeared after posterior peribulbar blockade in a 70-year-old woman undergoing cataract extraction and intraocular implant. Peribulbar blockade was carried out with a 23-gauge blunt bevel Atkinson's needle introduced at the level of nasal or internal angle of the upper lid without loosing contact with the ceiling of the orbit. Anesthetic solution was bupicavaine at 0.75% with 10 U/ml of hyaluronidase, 3 ml. Usual blockade of lower lid was not carried out as with the first blockade, an almost complete paresis of extraocular muscles together with discrete conjunctival ecchymosis occurred. Ocular compression was conducted with Homan's balloon at 30 mmHg gor 30 minutes. Then, the eyeball was decompressed and a progressive increase of edema with conjunctival hemorrhage becoming bilateral was observed. Coagulation tests were normal. The incidence of conjunctival ecchymosis and palpebral hematoma with such technique ranges from 2% to 9%; it does not represent any intraoperative problem but may difficult surgery.

Aged↗