Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0036690 (sepsis)
 59,461 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In spite of a systemically increased clotting tendency in progredient arteriosclerosis there are locally restricted haemorrhagic sequelae following arterial vasoreconstruction. Because of the fact that each bleeding simultaneously includes the risk of wound infection with subsequent sepsis the formation of a haematoma is to be avoided in the surgical procedure. The development of disseminated intravascular coagulation caused by sepsis and that caused by massive haemorrhage are represented as to their clinical importance. Finally, an internationally accepted substitution concept for severe bleeding sequelae, e.g. in case of the rupture of an aortic aneurysm, is submitted.
 ...
PMID:[Disorders of blood coagulation during and after arterial vascular reconstruction]. 663 15

Gallstones were detected in 42 of 865 patients with abdominal aortic aneurysm (4.9%). Eighteen patients underwent concomitant aneurysm resection and cholecystectomy. Eleven patients had aneurysmectomy without cholecystectomy. Thirteen patients underwent cholecystectomy alone. There were no significant increases in operative mortality, duration of operation, or length of hospital stay when cholecystectomy was added to aneurysm resection. However, there was one instance of prosthetic infection which occurred in a patient who did not have his graft retroperitonealized prior to cholecystectomy, and who also underwent gastrostomy and drainage of the liver bed. There have been no graft complications in the remaining 17 consecutive patients who had their graft retroperitonealized prior to cholecystectomy. Nine of 11 patients who underwent aneurysmectomy without cholecystectomy experienced an episode of acute cholecystitis during a mean follow-up period of 2.9 years. Two of these episodes occurred in the immediate postoperative period and one patient died of biliary sepsis. On the basis of these findings, concomitant aneurysmectomy and cholecystectomy is advised in those patients with cholelithiasis undergoing aortic aneurysm resection providing no contraindications exist.
 ...
PMID:Management of cholelithiasis in patients with abdominal aortic aneurysm. 663 76

Aortic aneurysms may become infected. This unusual complication carries a highly unfavorable prognosis. In any patient with sepsis and a known aneurysm, spread of the sepsis to the aneurysm should be suspected if no other source of infection can be found. A case report is presented, together with a brief review of the literature.
 ...
PMID:Infected aortic aneurysm. 724 Jun 14

There is a high mortality of bacterial aortitis particularly as it is usually not recognized before the stage of rupture. Therefore the disease should early be considered in obscure febrile conditions. Problems of diagnosis and therapy are discussed on two own cases. A 63-year old man had a rupture of a small infrarenal aortic aneurysm in the course of salmonella sepsis, a 79-year old woman had a pyogenic osteomyelitis of a lumbar vertebra that spread to the aorta and caused its rupture. In both cases surgical treatment consisted of bleeding control followed by in-situ reconstruction.
 ...
PMID:[Bacterial infections of the abdominal aorta]. 758 61

We recently have used retrograde cerebral perfusion via the superior vena cava in association with hypothermic circulatory arrest as an adjunct to cerebral protection during aortic arch operations. Between April 1993 and March 1994, 23 patients (14 male; 9 female; median age, 64 years; age range, 25 to 76 years; 14 emergency, 9 elective) underwent operation on the ascending aorta, aortic arch, or both for acute dissection (11) or aneurysm (12). Aortic root replacement was performed in 13 patients (7 with arch replacement), ascending aortic replacement in 7 (4 with arch replacement), isolated aortic arch replacement in 2, and repair of sinus of Valsalva aneurysm in 1. Coronary artery bypass grafting was performed in 4 patients. Hypothermic circulatory arrest (15 degrees C) and retrograde cerebral perfusion were implemented in all cases (median circulatory arrest time, 21 minutes; range, 13 to 51 minutes; median retrograde cerebral perfusion time, 20 minutes; range, 12 to 50 minutes). Three hospital deaths occurred (atheromatous embolic stroke, sepsis, rupture of infrarenal aortic aneurysm). The remaining patients had no neurologic damage (median intensive therapy unit stay, 1 day; range, 1 to 5 days). Retrograde cerebral perfusion is easy to establish and safe, and may improve brain protection during hypothermic circulatory arrest.
 ...
PMID:Retrograde cerebral perfusion: clinical experience in emergency and elective aortic operations. 784 54

Seventy patients, 18 women and 52 men of mean age 68 (range 52-81) years, with vascular disease were studied using the Community Periodontal Index of Treatment Needs (CPITN). Twenty-six were edentulous and 44 dentate; 32 dentate patients were wearing partial dentures. All had occlusive peripheral arterial disease (ankle:brachial pressure index less than 0.9) or aortic aneurysm. No significant periodontal pathology was found in edentulous patients. Of the dentate patients, 28 were in the significant pathology range (CPITN 4) and 12 were in the moderate pathology group (CPITN 3); only four had no significant pathology (CPITN 0-2). As a proportion of prosthetic vascular graft infections may be due to dental sepsis, surgeons should consider referral for dental assessment before elective bypass grafting and patients should be warned about the importance of dental care after operation.
 ...
PMID:Dental infection in vascular surgical patients. 795 35

From 1984 to 1993, 48 thoracoabdominal aortic aneurysm resections were performed. The patient age ranged from 21 to 79 years (mean: 65.5 years), and the extent of the aneurysms were as follows: type I (most of descending and upper abdominal), 17 cases; type II (most of descending and most of abdominal), 3 cases; type III (distal descending and upper abdominal), 20 cases; and type IV (most or the entire abdominal aorta), 8 cases. Ten patients presented with ruptured aneurysms, 1 with hemoptysis, 20 with pain, and 20 with no symptoms. Operation was performed using simple aortic cross-clamping in 18 patients, distal perfusion via Gott shunt in 6, and heparinless left-heart bypass (Biomedicus pump) in 24. Intercostal or lumbar vessels were reimplanted into the graft in 13 patients. Aortic cross-clamp time was 25 to 115 minutes (mean: 49.6 minutes). Four of 10 patients (40%) with ruptured aneurysms and 3 of 38 (8%) patients with non-ruptured aneurysms died. Serious complications included paraparesis in 2 patients (5%), renal failure requiring dialysis in 2 (5%), stroke in 1 (2%), bleeding in 5 (12%), intraoperative cardiac arrest in 3 (7%), sepsis in 1 (2%), prolonged ventilation (longer than 3 days) in 11 (27%), and wound dehiscence in 2 (5%). Thoracoabdominal aneurysm resection remains a challenging problem but can be performed with acceptable risk in selected patients. Distal heparinless perfusion without a heat exchanger may help reduce the risk of paraplegia and renal failure.
 ...
PMID:Experience with thoracoabdominal aortic aneurysm resection. 818 36

Chyloperitoneum is a rarely reported complication of abdominal aortic surgery. From 1981 to 1992, we treated 5 cases of chylous ascites after operations on the abdominal aorta and reviewed 22 previously published cases. There were 22 men and 5 women, with a mean age of 63.8 years (range: 27 to 93 years). Twenty cases (74.7%) occurred after abdominal aortic aneurysm resection, 5 (18.5%) after aorto-femoral bypass for occlusive disease, and 2 (6.8%) after resection of infected aortic grafts, 1 for occlusive disease and the other for infrarenal aortic aneurysm. Abdominal distention was the most common presenting symptom, occurring in 26 (96.3%) of 27 patients. The mean time from aortic operation to the development of symptoms was 18.5 days (range: 7 to 120 days). Diagnosis was confirmed by paracentesis, which yielded lipemic, sterile fluid in all patients. Therapeutic paracentesis was not successful when used alone, but, when combined with a medium-chain triglyceride (MCT) diet or total parenteral nutrition (TPN), it resulted in resolution of chyloperitoneum in 8 of 14 patients (57.2%). TPN alone or with paracenteses and/or diuretics was successful in 9 of 15 (60%) patients. Peritoneovenous shunts resolved chylous ascites in four of five patients not responding to diet and/or TPN but resulted in one death due to sepsis. Operative ligation of the injured lymphatic channel was successful in all five patients treated by laparotomy when nonoperative efforts failed. Chyloperitoneum resolved in all but two (7.7%) patients. There were five (18.5%) deaths, but only three (11.5%) were directly related to chylous ascites. Treatment with TPN resolved chyloperitoneum in all five of our own patients. We reached the following conclusions: (1) Chyloperitoneum is a rare complication of aortic surgery; (2) This disorder should be considered whenever persistent abdominal distention appears after aortic surgery; (3) The diagnosis is easily confirmed by paracentesis; and (4) Surgery to close the lymph fistula should be reserved for those patients in whom conservative therapy with MCT diets or TPN has failed.
 ...
PMID:Management of chyloperitoneum after abdominal aortic surgery. 835 15

Pseudoaneurysms of the abdominal aorta (PAAA) are late complications of aortic reconstruction that occur with an incidence varying from 4.8 to 6.3% associated with an operative mortality of 21 to 35%. Between 1987 and 1994, 16 patients with a PAAA (14 men and two women, with a mean age of 69.5 years, ranging from 55 to 82 years) were treated in our unit. An anastomotic rupture with a pseudoaneurysm diameter varying from 50 to 75 mm was present in five cases (group 1). The eleven other cases were aorto-enteric fistula, isolated in six cases (group 2) and associated with local and/or general sepsis signs in five cases (group 3). The mean interval from the time of the primary aortic graft, which was performed as treatment for aortic aneurysm in six cases and for aortoiliac occlusive disease in 10 cases, and the diagnosis of the PAAA, was 11.3 years. An in situ replacement of the aortic graft with an interposition of the greater omentum was performed in each patient of groups 1 and 2, associated with an enteric restoration in the latter. Group 3 patients were treated by removal of the infected graft with closure of the aortic stump and extra-anatomic bypass. During the post-operative period, five deaths (31%) and one limb amputation (6%) occurred, i.e. one death in group 1 (20%), one in group 2 (17%) and three in group 3 (60%) associated with a limb amputation (20%).(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Late complications of abdominal aortic prostheses: false aneurysms and aorta-digestive fistulas]. 854 96

A 55-year-old woman suffered an episode of massive hematemesis caused by an aortoesophageal fistula from an atherosclerotic thoracoabdominal aortic aneurysm. In situ grafting of the thoracic portion of the aneurysm was followed by sepsis and a sinus tract between the mid-esophagus and the aortic prosthesis. Graft removal, aortic closure, esophageal closure and axillobifemoral bypass allowed clearing of the sepsis and recovery. Severe hypertension followed aortic closure and extra-anatomic bypass and resulted in the eventual death of the patient 16 months later from dissection of the ascending aorta with pericardial tamponade. There are very few treated cases of aortoesophageal fistulas caused by atherosclerotic aneurysms reported in the literature. Furthermore, there are no reported cases where the aorta was closed at the level of the subclavian artery with extra-anatomic bypass to restore blood flow to the lower half of the body.
 ...
PMID:Primary aortoesophageal fistula caused by an atherosclerotic thoracoabdominal aortic aneurysm: a case report and review of the literature. 857 32


<< Previous 1 2 3 4 5 6 7 8 Next >>