Biomedical subjects

W J Plaus

Publications and source records attributed to W J Plaus.

7 recordsLinked to original sources

PubMed1993

Laparoscopic trocar site hernias.

Five patients with laparoscopic trocar site incisional hernias are presented. These occurred following laparoscopic cholecystectomy (4) and pelvic laparoscopy (1). The hernias appeared from 1 week to 4 months postoperatively. Both 5-mm and 10-mm fascial defects were involved. Hernias occurred only in the abdominal midline. The brief literature on this complication is reviewed, and recommendations for hernia prevention are suggested. The use of laparoscopy for more complex procedures will result in an increased incidence of trocar site hernias. Suture closure of the larger fascia defects will minimize this complication. Other techniques for hernia prevention have been described but never have been rigorously tested.

Adult↗

PubMed1991

The surgical management of superficial infections caused by atypical mycobacteria.

We have recently treated four patients with atypical mycobacterial skin infections. Two patients were infected with Mycobacterium smegmatis after self-injection with a veterinary-grade anabolic steroid. To our knowledge, this complication has not been previously described. The other patients had steroid-dependent asthma and lower extremity infections involving M. kansasii and M. chelonei after minor household trauma developed. Atypical mycobacterial skin infections may be seen as chronic ulcerations with violaceous edges, rolled margins, and significant subcutaneous necrosis. An indolent course and the clinical appearance may aid in diagnosis. In our experience, limited incision and drainage or dressing changes fail to eradicate these infections, even when accompanied by appropriate antibiotic therapy. Successful treatment requires aggressive debridement of all infected subcutaneous tissues and skin. Split-thickness skin grafting was successfully used to cover large wounds. Grafting did not appear to foster recurrent infection.

Anabolic Agents↗

PubMed1988

Peritoneal mesothelioma.

Peritoneal mesothelioma is a rare neoplasm often related to previous asbestos exposure. In 14 cases the diagnosis before surgery was virtually impossible, as patients presented with vague abdominal complaints and nonspecific physical examination findings. Laboratory testing (including computed tomography) was of no added diagnostic help. Widespread peritoneal neoplastic growth was the common finding at laparotomy. The tumor was grossly indistinguishable from other types of abdominal carcinomatosis. Electron microscopy proved to be the diagnostic tool of choice. Routine histologic techniques often gave nondiagnostic results. Intraperitoneal asbestos fibers were not observed. Treatment with radiation, chemotherapy, or both produced a 50% partial response rate, but survival was not affected. Malignant ascites was effectively palliated without complication in two of three patients with peritoneovenous shunting. An unusual case occurred in which histologic material from a second-look laparotomy documented complete response to a new regimen of intraperitoneal chemotherapy.

Adult↗

PubMed1988

Structural failure of a Greenfield filter.

A unique case is discussed in which a Greenfield filter failed structurally after less than 1 year in situ. In the absence of external trauma, two struts of the filter separated from the hub and migrated into the retroperitoneal tissues. A brief discussion of the complications of Greenfield filters concludes with a possible explanation of this particular problem.

Adult↗

PubMed1987

Retroperitoneal hemorrhage presenting as a ruptured ectopic pregnancy.

A young woman presented with acute abdominal pain, anemia, and a positive pregnancy test. At surgery a large retroperitoneal hematoma secondary to a ruptured right kidney was found. Pathological examination revealed a hematogenic necrosis of a choriocarcinoma of the kidney. The patient tolerated subsequent chemotherapy with no evidence of recurrent disease after ten months of follow-up care. The diagnosis of choriocarcinoma must always be entertained when a patient presents with a positive pregnancy test and normal pelvic examination.

Accidents, Traffic↗

PubMed1980

Clinical tear analysis using laser diffraction.

A diagnostic method has been developed to analyze tear specimens from patients with red eyes, using the technique of laser diffraction. After proper tear sample preparation, presence of a diffraction halo produced by the tear specimen indicates presence of an external ocular inflammation and helps rule out such conditions as glaucoma, iritis and episcleritis. Measurement of the size of the halo pattern may also be used to give information as to the concentration of cells in the tear sample.

Conjunctivitis↗

PubMedDate not supplied

Delayed pneumothorax after subclavian vein catheterization.

One hundred fourteen patients having 121 subclavian venipunctures were studied retrospectively. Eight pneumothoraces occurred (6.6%) and were most frequent after the insertion of large catheters, or when the subclavian area was distorted by previous venipuncture or radiation. Delayed pneumothorax occurred in five patients. This unusual diagnosis was made radiographically 8 to 96 hr postoperatively in response to the appearance of new pulmonary symptoms. Delayed pneumothorax required treatment with tube thoracostomy more frequently than immediate pneumothorax. This study establishes the approximate incidence of delayed pneumothorax for the first time. The relative frequency of this complication may challenge the cost effectiveness of pneumothorax diagnosis by chest films done within 1 or 2 hr of subclavian venipuncture. An alternative diagnostic protocol is considered.

Adolescent↗