Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0022672 (acute tubular necrosis)
 2,175 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

From October 1986 to March 1989, a total of 7 patients who had preoperative profound shock underwent surgical treatment at the National Taiwan University Hospital for a ruptured aorta or vena cava. All 7 patients were men. Their age ranged from 21 to 70 years with a mean of 45 years. Emergency operations were performed due to a ruptured abdominal aortic aneurysm in 2, a ruptured dissecting thoracic aneurysm in 1, a penetrating injury which transected the intrahepatic vena cava in 2, and blunt chest injury which resulted in acute traumatic aortic transection in 2. One of these 7 patients died of acute tubular necrosis, anoxic encephalopathy and secondary sepsis, in spite of successful restoration of circulation. Two patients had postoperative complications. One had a transient paraparesis after an aortic cross-clamp, and the other had a transient impairment of the hepatic function due to the penetrating hepatic injury and the hypoxic hepatic damage. All 6 survivors were restored to an excellent state of health and had minimal post-resuscitation sequelae. We emphasize the importance of aggressive surgical treatment for those patients with the threat of impending death due to massive hemorrhage from a ruptured great vessel.
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PMID:Emergency surgery of patients with ruptured great vessels and profound shock. 197 58

Emergency surgery is the only effective treatment of ruptured abdominal aortic aneurysms, even though morbidity and mortality rates remain high. We have studied the feasibility of left retroperitoneal aortic exposure in these cases in an effort to reduce postoperative complications. Over a 33 month period, 29 patients underwent emergency surgery for either a ruptured or symptomatic infrarenal abdominal aortic aneurysm. Of 13 patients with ruptured aneurysms, 4 underwent repair through a midline transperitoneal approach (3 deaths) whereas the remaining 9 were repaired through the retroperitoneal exposure (1 death). Supraceliac aortic clamping through the same incision prior to aneurysm exposure maintained hemodynamic integrity. The remaining 16 patients with symptomatic aneurysms were all treated through the retroperitoneal exposure (3 deaths). In the retroperitoneal groups, the cause of death was cardiac in two patients, hypertensive stroke in one, and necrotizing pancreatitis in one. Morbidity consisted of prolonged intubation, respiratory distress syndrome, and thrombophlebitis in one patient each and acute tubular necrosis in two patients. We believe that the left retroperitoneal approach is a useful option in the emergent treatment of abdominal aortic aneurysms.
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PMID:Selective use of retroperitoneal aortic exposure in the emergency treatment of ruptured and symptomatic abdominal aortic aneurysms. 340 Aug 6

Endovascular repair of abdominal aortic aneurysm (AAA) was attempted in ten patients over a 12-month period. Median age was 72 (range 61-82) years and median AAA diameter was 5.5 (range 5.2-6.0) cm. An aortoaortic (tube) graft was used in seven patients and a tapered aortoiliac reconstruction in three. There were two failures requiring conversion to open repair. Additional procedures included iliac artery angioplasty (two), coil embolization of an associated common iliac aneurysm (one) and femorodistal bypass (one). Median operating time was 162 (range 95-270) min and median blood loss was 1200 (range 800-2000) ml. Median hospital stay was 9 (range 5-21) days. Complications included death (one), reversible acute tubular necrosis (one) and prolonged ventilation (one). Postoperative evaluation with duplex ultrasonography and computed tomography demonstrated three perigraft leaks (two proximal and one distal). It is concluded that endovascular repair of AAA is feasible but is associated with significant complications and requires careful evaluation before widespread use.
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PMID:Endovascular repair of abdominal aortic aneurysm: an initial experience. 866 47

This retrospective review examines the open surgical repair of intact juxtarenal (JRAAs) and suprarenal (SRAAs) aortic aneurysms to estimate effects on survival and renal function. Patients undergoing open repair of JRAA and SRAA were identified. Preoperative medical comorbidities and perioperative and late outcomes were recorded. Primary end points were survival (perioperative and long-term survival) and changes in renal function (acute tubular necrosis [ATN], acute dialysis, and late functional decline). Associations between outcomes and clinical variables were examined using univariate and multivariate techniques. Between December 1996 and September 2006, 678 patients underwent open repair of aortic aneurysms, including 150 aneurysms involving the renal vessels (134 JRAAs, 16 SRAAs). Perioperative mortality was 3% and long-term survival was 69% at 5 years. Fourteen percent of patients experienced ATN, and 7% required acute in-hospital dialysis. Late renal function remained unchanged or improved in 75%. These results demonstrate a perioperative mortality and renal complication rate in keeping with previous reports of open abdominal aortic aneurysm repairs involving the renal vessels. Future implementation of branch and fenestrated aortic endografts to treat similar aneurysms should approximate these results prior to widespread acceptance.
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PMID:Open repair of aortic aneurysms involving the renal vessels. 1792 84