Robert Wolfson

Publications

• 2.63

  Impact points

  Delayed staple penetration of the heart: transthoracic migration with late tamponade.

  R H Wolfson, E E Moore, C W Van Way

  The Journal of trauma. 04/1986; 26(3):293-4.

  Most foreign bodies in the chest do their damage at the time of injury. While needle-like objects may migrate (6), delayed intrathoracic injury is rare. Delayed transthoracic penetration of the heart by a staple is reported, and is felt to be unique because acute hemopericardium resulted 30 days aft... [more] Most foreign bodies in the chest do their damage at the time of injury. While needle-like objects may migrate (6), delayed intrathoracic injury is rare. Delayed transthoracic penetration of the heart by a staple is reported, and is felt to be unique because acute hemopericardium resulted 30 days after the time of initial injury. The principles of recognition of pericardial tamponade, initial stabilization with periocardiocentesis, and immediate exploration are emphasized.
• 4.32

  Impact points

  Role of intra-arterial streptokinase in treatment of arterial thromboembolism.

  R H Wolfson, D A Kumpe, R B Rutherford

  Archives of surgery (Chicago, Ill. : 1960). 07/1984; 119(6):697-702.

  We treated 27 cases of arterial thromboembolism, including nine thrombosed grafts, with intra-arterial (IA) streptokinase. Complete lysis without significant residual lesions was achieved in eight (30%) of the cases, and partial lysis with sustained improvement was achieved in an additional six case... [more] We treated 27 cases of arterial thromboembolism, including nine thrombosed grafts, with intra-arterial (IA) streptokinase. Complete lysis without significant residual lesions was achieved in eight (30%) of the cases, and partial lysis with sustained improvement was achieved in an additional six cases (22%). Partial lysis revealing inaccessible residual disease in runoff vessels occurred in four (15%) of the cases, and nine (33%) were primary failures. Surgery was completely avoided in 11 (41%) of the patients, lesser amputations were possible in three (11%), and 18 (67%) avoided major amputation. Grafts lysed faster (35 v 62 hours) and more frequently (seven [78%] of nine v 11 [61%] of 18) than native vessels, but had a higher rethrombosis rate (four [71%] of seven v two [11%] of 11) and a lower late patency rate (two [22%] of nine v nine [50%] of 18). Significant bleeding occurred in one (3.7%) of the patients, and major thromboembolic complications occurred in four (13.8%). None occurred in those treated with concomitant heparin sodium. Better patency and fewer complications were also observed in limbs that were not acutely threatened, when IA streptokinase infusion was completed within 48 hours, and when the occluded segment and runoff vessels were rendered widely patent by IA streptokinase, with the aid of balloon angioplasty when necessary (five [36%] of 14).
• 1.27

  Impact points

  Free intraperitoneal cholelithiasis--a sign of traumatic perforation of the gallbladder.

  R H Wolfson, E E Moore, P C Murr

  The Journal of emergency medicine. 02/1984; 1(3):223-5.

  Traumatic perforation of the gallbladder is relatively infrequent and is rare as an isolated lesion. The unique aspect of this case is the diagnosis of traumatic gallbladder perforation based on plain abdominal roentgenographic evidence of free intraperitoneal cholelithiasis.... [more] Traumatic perforation of the gallbladder is relatively infrequent and is rare as an isolated lesion. The unique aspect of this case is the diagnosis of traumatic gallbladder perforation based on plain abdominal roentgenographic evidence of free intraperitoneal cholelithiasis.
• 2.23

  Impact points

  Massive pneumatosis intestinalis and subcutaneous emphysema: complication of needle catheter jejunostomy.

  T H Cogbill, R H Wolfson, E E Moore, C W VanWay, T N Jones, J D Strain, J C Rudikoff

  JPEN. Journal of parenteral and enteral nutrition. 7(2):171-5.

  The safety and efficacy of enteral feeding by needle catheter jejunostomy has prompted its use after many major gastrointestinal operations. Indeed, the technical complications of this procedure are infrequent. This report details the development of massive pneumatosis intestinalis associated with e... [more] The safety and efficacy of enteral feeding by needle catheter jejunostomy has prompted its use after many major gastrointestinal operations. Indeed, the technical complications of this procedure are infrequent. This report details the development of massive pneumatosis intestinalis associated with elemental feeding via jejunostomy. The proposed etiology includes excessive gas accumulation within the small intestine secondary to 1) inadequate nasogastric suction, 2) post-traumatic intestinal ileus, and 3) disaccharide fermentation; combined with a mucosal defect created by the catheter jejunostomy. Successful management consists of nasogastric suction and immediate termination of the enteral feeding.