Severe chronic intra-abdominal sepsis: a report of 3 cases and a review of patient management.

The management of three cases (one fatal) with extensive intraabdominal sepsis, is described. Management included metabolic and fluid control, intravenous nutrition (where feeding by the oral route is impossible because of multiple intestinal fistuli), maintenance and support of vital organ function, and infection control. Appropriate and timely surgical intervention may be life saving.

Addiction in anesthesiologists: drug access and patterns of substance abuse.

Impaired anesthesiologists (IAs) seen by the Medical Association of Georgia Impaired Physicians Program were compared to all other impaired physicians seen by the program. Anesthesiologists were the specialists most overrepresented in the program. When each IA was matched to a control with respect to age, sex, race, professional activity status, and year of admission to the program, the IAs were found to be more likely to abuse drugs than alcohol, to abuse narcotics, and to abuse drugs intravenously. The authors recommend tighter control of narcotics and surveillance of all anesthesia personnel in order to reduce the risks to patients associated with chemical dependence.

Rupture of subcapsular haematoma of the liver in a case of eclampsia.

A case of rupture of subcapsular haematoma of the liver in a patient suffering from eclampsia is reported in which the patient survived. Peritoneal tap provided important diagnostic information. Surgical intervention with control of the liver haemorrhage provides the only chance of survival.