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Query: UMLS:C0034065 (pulmonary embolism)
 14,979 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A patient is described, with a history of pain in the neck, followed by a slowly progressive loss of muscle strength in both arms, followed by tetraplegia. Medical history included laryngectomy with partial hypopharyngectomy preceded by radiotherapy, because of carcinoma. X-ray of the cervical spine was suggestive for metastases. The patient died as a consequence of massive pulmonary embolism and at autopsy the cause of the neurological deficit turned out to be vertebral osteomyelitis and epidural abscess due to mucormycosis.
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PMID:Vertebral osteomyelitis and epidural abcess due to mucormycosis, a case report. 22 96

Twelve iatrogene bile duct injuries are reported. Eleven occurred in operations of the bile system, and one in a gastric resection (B II). The injury should be diagnosed immediately, especially by intraoperative cholangiography. Operative treatment is discussed. Eleven patients survived, one died of pulmonary embolism (operative mortality, 8,3%). One patient had to be reoperated because of stenosis of the common bile duct. Choledochoduodenostomy was performed. The follow-up of 11 patients showed good results without any recurrence of jaundice or pain.
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PMID:[Intraoperative biliary tract injuries]. 35 May 17

48 patients with acute deep venous thrombosis of the lower limbs were treated with sodium heparin. In 23 patients heparin was injected subcutaneously (s.c.) twice a day and in 25 patients heparin was given by continuous intravenous perfusion (i.v.). Pain and edema disappeared after 8.7 days (s.c.) and 11.7 days (i.v.) respectively. One non fatal pulmonary embolism occurred in each group. A second venography was performed in 24 patients after 7 days of treatment and revealed no difference between the two groups. As judged by repeated thrombin time determination, anticoagulation was ineffective on at least one day in 39% of patients treated subcutaneously and in 60% of patients treated intravenously. The two pulmonary embolisms occurred in patients with ineffective anticoagulation. It is concluded that heparin may be used either intravenously or subcutaneously in the treatment of acute deep venous thrombosis. Thromboembolic complications occurred with both methods of treatment when anticoagulation was ineffective.
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PMID:[Heparin treatment. Comparison between intravenous and subcutaneous administration]. 50 73

A prospective analysis of 155 patients with pulmonary embolism was undertaken to describe the radiographic characteristics of associated pleural effusions and related abnormalities. Approximately one half of these patients had pleural effusions. Patients with other potential causes of effusion, such as heart failure, pneumonia, or cancer, were eliminated from further analysis. In the remaining 62 patients, radiographic evidence of pulmonary infarction accompanied pleural effusions in one half of the cases. One third of patients with parenchymal consolidation had no evidence of effusion. Atelectasis and other nonspecific radiographic abnormalities occurred in less than one fifth of the cases. Typically, pleural effusions were small and unilateral, appeared soon after symptoms of thromboembolism began, and tended to reach their maximal size very early in the course of the disorder. Pulmonary infarction was associated with larger effusions that cleared more slowly and were more often bloody in appearance on thoracentesis. Chest pain occurred in all but one patient and was a valuable diagnostic clue. Pain and pleural effusions were always ipsilateral and almost always unilateral, but neither correlated well with the presence or time course of infarction. Effusions that were delayed in onset or that enlarged late in the course were associated with recurrent pulmonary embolism or superinfection. These radiographic features may be helpful in the diagnosis and management of pulmonary embolism.
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PMID:Radiographic features of pleural effusions in pulmonary embolism. 65 89

To improve the surgical results of severe osteoarthritis of the hip, surface replacement of the hip using a double cup without cement was employed on 75 hips during the period from 1972 to 1977. The results of the procedures have been analyzed on 67 hips followed for more than 6 months. The most dramatic improvement following the procedure has been pain relief, observed in 58 of 67 hips (86%). Three reoperations were necessary. Failures were treated satisfactorily either by total hip replacement, or by arthrodesis and/or by placing a new cup on the head respectively. There was no operative death, pulmonary embolism, thrombophlebitis, nor deep infection. We do not think this procedure replaces more definitive surgery such as the Charnley-type total hip replacement, but it is a good adjunctive procedure particularly in patients younger than 60 years of age.
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PMID:Socket and cup surface replacement of the hip. 72 67

Pulmonary embolization from occult venous thrombosis in the lower extremities occurs in previously well individuals of all ages. Incomplete or hemorrhagic pulmonary infarction may result. The incomplete pulmonary infarction syndrome (IPIS) is characterized by sudden onset of pain in the lower chest, knife-like and stabbing in quality and accentuated by breathing, with pathognomonic abnormalities on chest x-rays. The physician should hospitalize the patient, begin heparinization and confirm the diagnosis with daily chest x-rays in multiple views. Failure to promptly diagnose and treat IPIS may lead to catastrophic, massive pulmonary embolism and death, or to recurrent embolism with pulmonary hypertension and chronic cor pulmonale, resulting in incapacitating dyspnea on exertion, and disability.
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PMID:Unsuspected pulmonary emboli in well persons: the incomplete pulmonary infarction syndrome. 83 54

We compared 41 patients with angiographic proof of pulmonary embolism and clinical signs of pulmonary infarction (as evidenced by an infiltrate on x-ray study and pleuritic pain in the area of the embolus) with 24 patients with pulmonary embolism but without infarction. Only 18 of the 41 patients with pulmonary infarction had associated heart disease. Pulmonary infarction was uncommon when emboli obstructed central arteries but frequent when distal arteries were occluded. Follow-up x-ray examination showed that the infiltrates resolved in the patients with pulmonary infarction without heart disease, but persisted when heart disease was present. We suggest that obstruction of distal arteries results in pulmonary hemorrhage owing to an influx of bronchial arterial blood at systemic pressure. Hemorrhage causes symptoms and x-ray changes usually attributed to pulmonary infarction. However, hemorrhage resolves without infarction in patients without, but progresses to infarction in those with, heart disease.
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PMID:Pulmonary embolism, pulmonary hemorrhage and pulmonary infarction. 86 13

In a patient receiving warfarin and heparin in the treatment of pulmonary embolism, a hematoma developed in the iliacus muscle, compressing the overlying femoral nerve. Femoral nerve paralysis ensued, causing inability to walk, pain and loss of sensation in the sensory distribution of the nerve. Surgical intervention and removal of the hematoma relieved the nerve compression and the condition gradually improved.
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PMID:Iliacus hematoma syndrome. 112 61

The usefulness of various modalities in evaluating pleuritic pain in young patients and in isolating cases of pulmonary embolism was assessed using likelihood ratios and the receiver operating characteristic (ROC) curve. History and physical, laboratory, and radiographic finding were used disjunctively to establish an ROC curve. The percentage of patients found to have pulmonary embolism increased monotonically with certain critical pieces of diagnostic data. For example, a history and physical examination alone detected 80% of patients with pulmonary embolism; a chest radiograph raised the percentage to 95%; and the addition of a lung scan increased the percentage to 100%. Thus, with proper interpretation of clinical and radiographic data, the lung scan has only a marginal impact upon the sensitivity with which pulmonary embolism is detected. Its major value is an increased specificity in the diagnosis of pulmonary embolism.
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PMID:Measures of clinical efficacy. III. The value of the lung scan in the evaluation of young patients with pleuritic chest pain. 124 24

450 successive celioscopic cholecystectomies (May, 1990-April, 1992) are reported for 312 cases of uncomplicated gallstone (69%) operated electively and 138 cases operated in emergency, including 120 cases of acute cholecystitis, 17 cases of biliary pancreatitis and 1 case of angiocholitis. Immediate conversion into laparotomy was required in 10 cases (2.2%) either for technical reasons (1.1%) or because of lithiasis of the common bile duct (1.1%). The stay in hospital lasted an average of 2.2% days for elective admission and 3.3 days for emergent admission. The average operating time was 65 minutes (75 minutes until May, 1991, and 55 minutes between May, 1991 and April, 1992). Preoperative retrograde cholangiography was performed in 67 cases and intraoperative cholangiography in 16 cases. Second surgery was required for suture in one case because of cholerrhagia in a secondary duct of the gallbladder bed. This cholerrhagia would not have been amenable to simple aspiration. One patient (0.2%) died of myocardial infarction at D + 10. Complications include 4 cases of pulmonary embolism, 3 cases of cystic biliary fistula without second surgery and 4 cases of umbilical hernia. A more peculiar case is that of a patient admitted 5 months after surgery for gangrenous acute cholecystitis. This patient was admitted for fever and epigrastric pain. He had a very low-flow duodenocutaneous fistula of uncertain origin. This patient was not operated again. This may not be a complication connected to celioscopic surgery. Celioscopic cholecystectomy is superseding conventional cholecystectomy. Surgeons' efforts should strive at eliminating operative errors, reducing postoperative morbidity, improving techniques and instruments, teaching celioscopic surgery and extending its indications to other intraabdominal operations.
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PMID:[Laparoscopic cholecystectomy. Apropos of 450 cases]. 134 88


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