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Preoperative and Postoperative Management of Patients

BROCK E. BRUSH, M.D.; RAYMOND W. MONTO, M.D.; JOSEPH ABRAHAM, M.D.; E. J. GORDON, M.D.; J. RALPH CALDER, M.D.

AMA Arch Surg. 1954;68(6):787-793.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

OF THE many noted physiological effects of adrenocorticotropin (ACTH) and cortisone, perhaps their ability to produce variable degrees of remission in thrombocytopenic states may prove to be one of the most practicable. While splenectomy has been widely used in the treatment of idiopathic thrombocytopenic purpura for over 35 years, the results have not been entirely satisfactory. Welch and Dameshek¹ reported that in a series of 92 patients splenectomized for idiopathic thrombocytopenic purpura, 61% showed complete and sustained therapeutic response and an additional 19% showed a partial response with a great reduction in the bleeding tendency. Most of the mortality associated with splenectomy for this condition has occurred in those instances when it became necessary to operate during an acute fulminating crisis. It is in these hazardous cases that sufficient search may not be made for accessory spleens and also where the splenic capsule may be torn and thus small . . . [Full Text PDF of this Article]

Author Affiliations
DETROIT

From the Departments of General Surgery and Hematology, Henry Ford Hospital.

Footnotes
Read at the Sixty-First Annual Meeting of the Western Surgical Association, Chicago, Dec. 4, 1953.

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