Network


Latest external collaboration on country level. Dive into details by clicking on the dots.

Hotspot


Dive into the research topics where William P. Mikkelsen is active.

Publication


Featured researches published by William P. Mikkelsen.


American Journal of Surgery | 1957

Intestinal angina: its surgical significance.

William P. Mikkelsen

Abstract The term intestinal angina most closely identifies the syndrome that may, for a period of months to years, precede complete mesenteric arterial occlusion. This syndrome is characterized by postcibal, cramping abdominal pain and is produced by intestinal ischemia. The frequency with which this syndrome occurs and its pathophysiology are discussed. Evidence is presented suggesting that complete occlusion of the celiac axis must be present before narrowing of the ostium of the superior mesenteric artery will be productive of intestinal angina. Two typical case reports are presented. In one patient an objective diagnosis could be made by means of aortography. Of noteworthy significance has been the observation that whereas medical measures were of no benefit in preventing the unrelenting progression of this disease, the potential for surgical correction does exist. The potential surgical technics are indicated.


American Journal of Surgery | 1967

Tetracycline-induced fatty liver in nonpregnant patients: A report of six cases

Robert L. Peters; Hugh A. Edmondson; William P. Mikkelsen; Dorothy Tatter

Abstract Six patients are reported on to show that the fatty liver response to intravenous administration of large quantities of tetracycline is not restricted to pregnant women. The histologic changes were the same as those found in pregnant women with tetracycline-induced fatty liver. It was concluded that four of the patients died from the effects of tetracycline.


American Journal of Surgery | 1966

Extrahepatic portal hypertension in children.

William P. Mikkelsen

Summary The details of eighteen children with extrahepatic portal hypertension seen during the last twenty years at the Childrens Hospital of Los Angeles are presented. All had bleeding from esophagogastric varices, but in several this was not the presenting symptom or finding. Three initially presented with splenomegaly and five with ascites. Eleven of the patients manifested ascites at some stage of their disease, more commonly during infancy or early childhood. Three older patients currently have ascites which has persisted for two, six, and seven years, respectively. An etiologic mechanism such as that usually ascribed to the development of occlusion of the portal vein was observed in only three of the eighteen children. It is suggested that neonatal omphalitis or peritonitis is an unlikely cause and that the etiologic mechanism is, in fact, unknown. Fever, usually due to a respiratory infection, preceded varical hemorrhage in a number of patients. The implication of this feature is discussed. The results of operative management were disappointing. The ineffectiveness of shunt procedures in eliminating recurrent varical hemorrhage was probably due in large part to the young age of the patients at the time of operation. Of great interest was the observation that in four children varical hemorrhage ceased spontaneously. In two of them, varices are no longer demonstrable on roentgenogram. In the other two, this examination had not been carried out. Six of the eighteen patients are currently over the age of twenty years; only one still has bleeding. These features are consonant with the rarity with which an adult with extrahepatic portal hypertension provides a history of bleeding episodes extending from childhood.


American Journal of Surgery | 1958

Emergency portacaval shunt

William P. Mikkelsen; Arthur C. Pattison

Abstract Eleven cirrhotic patients had portacaval shunt performed during acute bleeding from esophagogastric varices. Four died in the postoperative period and two died at a later date. Five remain alive and have not bled again. Only one patient bled after surgery in spite of the fact that balloon tamponade was not employed postoperatively in any. The bleeding in this one patient was minor in degree. The conclusion that portal decompression as accomplished by end-to-side portacaval shunt, will in almost all cases immediately terminate bleeding seems warranted. Preoperative jaundice was an ominous sign with regard to survival. Comparison of our results with those utilizing emergency temporizing procedures suggests that the operative mortality is little different and that effective control of bleeding is more likely to be obtained by portacaval shunt. It still remains doubtful that any of the emergency operations currently in use will significantly improve the total mortality for these cirrhotic patients with severe varical bleeding.


American Journal of Surgery | 1961

Gallstones and diabetes: An ominous association

Fred L. Turrill; Margaret M. McCarron; William P. Mikkelsen

Abstract The data supplied by eighty-six diabetic and 395 nondiabetic patients admitted to the Los Angeles County Hospital for the management of cholelithiasis and its complications have been evaluated. Gross mortality was fivefold greater in the diabetic group. Deaths, almost exclusively, resulted in patients admitted for emergency treatment of complications of cholelithiasis. In the “sensitive” age group, fifty-one to sixty-five years, the mortality among the diabetics was almost twentyfold greater than that of the nondiabetics. As a result of the analysis of this data, two policies are recommended for diabetic patients with cholelithiasis. First, early cholecystostomy should be employed more often for acute cholecystitis. Second, prophylactic cholecystectomy should be performed on most diabetics before they attain older age.


American Journal of Surgery | 1962

Portacaval shunt in cirrhosis of the liver: Clinical and hemodynamic aspects☆

William P. Mikkelsen; Fred L. Turrill; Arthur C. Pattison

Abstract The clinical details of 230 patients with cirrhosis of the liver upon whom a portacaval shunt was performed during the years 1947 to 1962 are recorded. Operative mortality was 14 per cent for the entire series; 12 per cent followed elective surgery and 32 per cent followed emergency surgery; there were no deaths after prophylactic surgery. Postshunt encephalopathy developed in 11 per cent, peptic-ulcer in 7 per cent and late bleeding in 7 per cent of those that survived surgery. Of the 128 patients available for analysis of five year survival, 56 per cent survived for this or a longer period. Analysis of patients over the age of fifty years, revealed little difference from those of the entire group. Emergency portacaval shunt is endorsed with the recommendation that patients with acute varical bleeding be managed similar to those with acute peptic ulcer bleeding. From the data presented, continuation of a policy for prophylactic portacaval shunt, as outlined, is recommended. On the basis of operative facility, hemodynamic data obtained during and after surgery, and a clinical comparison of two similar groups, it is concluded that the preferable portacaval anastomosis is the end to side.


American Journal of Surgery | 1968

Acute hyaline necrosis of the liver: A surgical trap☆

William P. Mikkelsen; Fred L. Turrill; William H. Kern

Abstract Acute hyaline necrosis of the liver is an acute inflammatory and necrotizing process associated with alcoholism. The clinical picture presented frequently mimics a surgical hepatobiliary lesion as it did in sixteen of twentythree patients not having a portacaval shunt. An operation was performed on ten of these patients and importantly contributed to the death of four of them. A second group of twenty-three patients with acute hyaline necrosis was included among a total of fifty-four patients upon whom portacaval shunting was performed for cirrhosis and bleeding varices. There were fifteen immediate postoperative deaths and four late deaths, leaving only four patients alive one to seven years later among the twenty-three patients with hyaline necrosis. In contrast, among the thirty-one cirrhotic patients without hyaline necrosis there were only two postoperative and five late deaths, leaving twenty-four patients alive one to seven years postoperatively. Although the disease may be suspected clinically, especially if liver tenderness is present, conclusive diagnosis requires histologic examination of the liver biopsy specimen. The usual criteria for evaluating surgical risk among the patients having a portacaval shunting procedure, such as serum bilirubin, albumin, prothrombin, and presence of ascites and encephalopathy, were of no value in identifying those with acute hyaline necrosis. It is recommended that needle biopsy of the liver precede consideration for emergency or urgent operative control of bleeding varices in the patient with cirrhosis.


American Journal of Surgery | 1955

Cardiac arrest; problems in its control.

Clarence J. Berne; J.S. Denson; William P. Mikkelsen

Abstract 1. 1. Anesthetic death usually represents unrecognized and untreated cardiac arrest occurring in a good risk patient. 2. 2. Uncorrected physiologic disturbances in severely ill patients are often similar to those resulting from imperfect anesthesia or unduly traumatic, bloody surgery. 3. 3. Cardiac arrest is more likely to occur in severely ill than relatively well patients. 4. 4. Operating room deaths occurring in severely ill patients often are attributed to the primary disease. All such deaths should be included and analyzed when the incidence of cardiac arrest is reported from any series of surgical operations. 5. 5. In our cases of cardiac arrest the etiologic factors in order of importance were: asphyxia, relative overdose of anesthetic, operative hemorrhage, inadequate preoperative preparation and hypoxia. 6. 6. When the predominant etiologic factor was anesthetic rather than surgical, resuscitative measures were much more effective. 7. 7. Control of the problem of cardiac arrest is basically a problem in education. The joint program of the Los Angeles County Heart Association and the University of Southern California School of Medicine is described. 8. 8. Proficiency in the treatment of cardiac arrest can be attained best by practical experience in the laboratory.


Annals of Surgery | 1965

Extra- and intrahepatic portal hypertension without cirrhosis (hepatoportal sclerosis).

William P. Mikkelsen; H A Edmondson; R L Peters; Allan G. Redeker; Telfer B. Reynolds


Surgery | 1969

Systemic-portal arteriovenous fistulas: pathological and hemodynamic observations in two patients.

Donovan Aj; Reynolds Tb; William P. Mikkelsen; Robert L. Peters

Collaboration


Dive into the William P. Mikkelsen's collaboration.

Top Co-Authors

Avatar

Allan G. Redeker

University of Southern California

View shared research outputs
Top Co-Authors

Avatar

Arthur C. Pattison

University of Southern California

View shared research outputs
Top Co-Authors

Avatar

Telfer B. Reynolds

University of Southern California

View shared research outputs
Top Co-Authors

Avatar

Clarence J. Berne

University of Southern California

View shared research outputs
Top Co-Authors

Avatar

Robert L. Peters

University of Southern California

View shared research outputs
Top Co-Authors

Avatar

William H. Kern

Good Samaritan Medical Center

View shared research outputs
Top Co-Authors

Avatar

Dorothy Tatter

University of Southern California

View shared research outputs
Top Co-Authors

Avatar

Gregor Wilkinson

University of Southern California

View shared research outputs
Top Co-Authors

Avatar

Hugh A. Edmondson

University of Southern California

View shared research outputs
Top Co-Authors

Avatar
Researchain Logo
Decentralizing Knowledge