КАРТОЧКА-ЗАДАНИЕ НА ТЕМУ
«MEDICAL WRITING: CASE ABSTRACT_445»
Warm-up
· What is a medical case report?
· What parts does it include?
· What is an abstract?
Read the abstract of the medical case report:
Hepatic artery aneurysm repair: a case report
Abstract
Introduction
Hepatic artery aneurysms remain a clinically significant entity. Their incidence continues to rise slowly and mortality from spontaneous rupture is high. Repair is recommended in those aneurysms greater than 2 cm in diameter. It is not surprising that vascular comorbidities, such as ischaemic heart disease, are common in surgical patients, particularly those with arterial aneurysms such as these. The decision of when to operate on patients who require urgent surgery despite having recently suffered an acute coronary syndrome remains somewhat of a grey and controversial area. We discuss the role of delayed surgery and postoperative followup of this vascular problem.
Case presentation
A 58-year-old man was admitted with a 5.5 cm hepatic artery aneurysm. The aneurysm was asymptomatic and was an incidental finding as a result of an abdominal computed tomography scan to investigate an episode of haemoptysis. Three weeks prior to admission, the patient had suffered a large inferior myocardial infarction and was treated by thrombolysis and primary coronary angioplasty. Angiographic assessment revealed a large aneurysm of the common hepatic artery involving the origins of the hepatic, gastroduodenal, left and right gastric arteries and the splenic artery. Endovascular treatment was not considered feasible and immediate surgery was too high-risk in the early post-infarction period. Therefore, surgery was delayed for 3 months when aneurysm repair with reconstruction of the hepatic artery was successfully performed. Graft patency was confirmed with the aid of an abdominal arterial duplex. Plasma levels of conventional liver function enzymes and of alpha-glutathione-S-transferase were within normal limits. This was used to assess the extent of any hepatocellular damage perioperatively. The patient made a good recovery and was well at his routine outpatient check-ups.
Conclusion
There is no significant difference in cardiac risk in patients who have undergone vascular surgery within 6 months of a myocardial infarction compared with those who have had the operation in the 6 to12 month time frame. Use of alpha-glutathione-S-transferase gives an indication of the immediate state of hepatic function and should be used in addition to traditional liver function tests to monitor hepatic function postoperatively.
Find in the abstract:
· Background
· Why is it important
· Needs to be reported
Answer the questions:
1. Is this the first report of this kind in the literature?
2. What are brief details of what the patient(s) presented with?
3. What the reader should learn from the case report?
4. What the clinical impact will be?
5. Is it an original case report of interest to a particular clinical specialty of medicine?
6. Will it have a broader clinical impact across medicine?
7. Are any teaching points identified?
Follow-up
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· What are basics of abstract writing?
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