Elliott S. Hurwitt

A new surgical absorbable hemostatic agent: Experimental and clinical evaluation

Abstract Experimental and clinical observations confirm the preliminary impressions that oxidized regenerated cellulose (Surgicel) is a safe and effective absorbable hemostatic material, which is useful in a very wide variety of surgical situations. Clinical experience with over 300 consecutive cases to date (July 15, 1960) confirms the earlier impressions of applicability and freedom from complications. Its effectiveness in the control of bleeding from fabric grafts in vascular surgery and from retropleural and retroperitoneal surfaces has been outstanding in this series of 100 consecutive general surgical operations.

Recurrent diverticulitis in a defunctionalized colonic loop

Abstract 1. 1. A unique case is presented of free perforation secondary to recurrent diverticulitis in a defunctionalized colonic loop established seven and a half years previously. 2. 2. A mechanism for the development of this surgical complication is described. 3. 3. The morbidity and mortality associated with recurrent disease in long-term defunctionalized colonic loops may possibly be averted by periodic examinations and prompt institution of appropriate therapy.

Thrombotic Occlusion of Abdominal Aortic Aneurysm Following Distal Embolization

The second successfully treated case of sudden complete occlusion of an abdominal aortic aneurysm is presented. The thrombosis was caused by impaired run-off following an embolic occlusion of the right iliac artery. This complication is extremely rare in abdominal aortic aneurysms.

Granular cell myoblastoma of the breast

Summary A case of granular cell myoblastoma of the breast is reported and the literature reviewed. The ability of this generally benign lesion to imitate carcinoma clinically and by frozen section examination is emphasized. Awareness of its existence, common location, and gross appearance is essential if unnecessarily radical surgery is to be avoided.

THE NONOPERATIVE MANAGEMENT OF TWO CASES OF CATHETER PERFORATION OF THE AORTA.

I N THIS ERA of surgical tours de force the nonoperative management of perforations of the aorta may seem as heresy. The current literature abounds with reports of successful operations after blunt or perforating injuries to the thoracic aorta, predominantly just distal to the origin of the left subclavian artery. Undoubtedly most of these operations were indicated, and in the main life-saving. A similar attitude prevails regarding the abdominal aorta. That surgery need not categorically be mandatory for salvage under such circumstances, however, is illustrated by the following cases. heard in the neck and all pulsations above the diaphragm were normal. The heart and lungs were normal. The abdomen was protruberant and exhibited numerous striae as well as a firmly healed right subcostal incision. Aortic pulsations were felt to about 1 inch above the umbilicus, and a sharp bruit could be heard at the umbilicus, No pulsations or bruits could be elicited distal to this level in the abdomen, groins, legs, or feet. Both feet and ankles were cool, without edema, trophic changes, or varicosities. Pertinent laboratory data included a fasting blood sugar of 136, uric acid 2.9, and cholesterol of 359 mg. per 100 ml. The electrocardiogram and chest roentgenogram showed no significant abnormalities.

Fate of enzyme-digested bovine arterial heterografts in low pressure systems

Abstract Enzyme-digested bovine arterial heterografts were implanted in the pulmonary artery and vena cava of dogs. Results were noted up to sixteen months after implantation. Almost all of the long segment pulmonary artery grafts were patent on long-term follow-up study, but 50 per cent of the short segment grafts became occluded. The graft material did not fare well in the inferior vena cava, and while some good results were obtained in the superior vena cava, the study was rendered inconclusive by a high incidence of postoperative empyema. Results of gross and microscopic examination of implanted grafts are described and discussed, and conclusions are drawn regarding the nature of host graft reaction, factors affecting success of graft procedures, and possible improvement of results.