Articles: tampons.
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A silastic tissue expander has been used to tamponade severe presacral hemorrhage in a patient undergoing abdominoperineal resection for rectal carcinoma. This technique may be applicable in similar cases when tamponade is required for uncontrolled venous hemorrhage. The presence of an expandable pelvic prosthesis may be of use postoperatively in avoiding radiation-associated small bowel injury.
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Comparative Study
Abdominal packing for surgically uncontrollable hemorrhage.
Planned intra-abdominal packing for surgically uncontrollable hemorrhage from liver and retroperitoneal injuries exacerbated by hypothermia, acidosis, and coagulopathy regained popularity over the past decade. The authors reviewed 39 patients injured between August 1985 and September 1990; 31 packed for liver injuries, eight for nonliver injuries. The overall mortality rate was 44% (17/39); 9 (23%) exsanguinated, 3 (8%) died of head injuries, 3 (8%) of multisystem organ failure, 2 (5%) of late complications. ⋯ Intra-abdominal packing will not stop all bleeding; 23% of the patients exsanguinated. In 77%, packing helped achieve hemostasis we believed was not otherwise possible. Packing may be done to prevent the development of acidosis, hypothermia, and coagulopathy or may be done early in the treatment of cold, acidotic patients rather than massive transfusion in the face of surgically uncorrectable bleeding.
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Am. J. Gastroenterol. · Aug 1985
Case ReportsAn unusual complication of balloon tamponade in the treatment of esophageal varices: a case report and brief review of the literature.
A Sengstaken-Blakemore tube was unable to be withdrawn 14 h after its initial insertion. Despite a number of recognized maneuvers, both gastric and esophageal balloons remained inflated leading to impaction of the tube. This uncommon complication along with other complications peculiar to the Sengstaken-Blakemore tube are described.
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In 205 patients undergoing surgery of the nose, throat of dental surgery, a gauze pack was used fixed into the tracheal tube, remaining during surgery above the vocal cords. Advantages in adults as well as children are discussed: laryngoscopy has to be performed only once, a free operating field is secured for the surgeon in that throat, the tube cannot be inserted too far into the trachea and the pack cannot be forgotten in the pharynx. The only disadvantage noticed so far was that in about 10% of the patients intubation was somewhat more difficult for the less experience anaesthetist.