Effect of fasting on coagulation factors in patients who undergo major abdominal surgery.

Major abdominal surgery without preoperative adequate oral intake with some cephalosporins may result in vitamin K deficiency and bleeding tendency. The aim of this study is to clarify the effect of preoperative fasting on postoperative coagulation factors. We prospectively examined 16 patients who underwent major abdominal surgery.

Severe anemia inducing preshock caused by sarcomatoid carcinoma of the small intestine.

A 55-year-old man consulted the outpatient department because of shortness of breath on effort and palpitation. Clinical examination showed severe anemia, a tumor with an ulcer on jejunography, with isodensity in contrast enhancement computed tomography, and a tumor stain on angiography, with middle intensity in T1- and T2-weighted images on magnetic resonance imaging. During laparotomy, we found jejunal tumors and lymph node swelling (TMN stage T3 N4 M1), and we performed a partial resection of the jejunum.

Usefulness of the 3-dimensionally reconstructed computed tomography imaging for diagnosis of the site of tracheal injury (3D-tracheography).

Computed tomography (CT) has not been considered useful for early diagnosis of traumatized patients who could hardly hold their breath, particularly patients with tracheal injuries. However, the recent development of spiral CT has made it possible to acquire contiguous patient data, which eliminates the respiratory misregistration. Air is easily differentiated from surrounding tissues by striking contrast, and the trachea can therefore be well displayed by three-dimensional (3D)-CT.