char = S;code = 83 char = e;code = 101 char = v;code = 118 char = e;code = 101 char = r;code = 114 char = e;code = 101 char = ;code = 32 char = g;code = 103 char = a;code = 97 char = s;code = 115 char = t;code = 116 char = r;code = 114 char = o;code = 111 char = p;code = 112 char = a;code = 97 char = r;code = 114 char = e;code = 101 char = s;code = 115 char = i;code = 105 char = s;code = 115 char = ;code = 32 char = c;code = 99 char = a;code = 97 char = u;code = 117 char = s;code = 115 char = i;code = 105 char = n;code = 110 char = g;code = 103 char = ;code = 32 char = s;code = 115 char = p;code = 112 char = l;code = 108 char = e;code = 101 char = n;code = 110 char = i;code = 105 char = c;code = 99 char = ;code = 32 char = r;code = 114 char = u;code = 117 char = p;code = 112 char = t;code = 116 char = u;code = 117 char = r;code = 114 char = e;code = 101 char = :;code = 58 char = ;code = 32 char = a;code = 97 char = ;code = 32 char = u;code = 117 char = n;code = 110 char = i;code = 105 char = q;code = 113 char = u;code = 117 char = e;code = 101 char = ,;code = 44 char = ;code = 32 char = e;code = 101 char = a;code = 97 char = r;code = 114 char = l;code = 108 char = y;code = 121 char = ;code = 32 char = c;code = 99 char = o;code = 111 char = m;code = 109 char = p;code = 112 char = l;code = 108 char = i;code = 105 char = c;code = 99 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = ;code = 32 char = a;code = 97 char = f;code = 102 char = t;code = 116 char = e;code = 101 char = r;code = 114 char = ;code = 32 char = h;code = 104 char = e;code = 101 char = a;code = 97 char = r;code = 114 char = t;code = 116 char = -;code = 45 char = l;code = 108 char = u;code = 117 char = n;code = 110 char = g;code = 103 char = ;code = 32 char = t;code = 116 char = r;code = 114 char = a;code = 97 char = n;code = 110 char = s;code = 115 char = p;code = 112 char = l;code = 108 char = a;code = 97 char = n;code = 110 char = t;code = 116 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = .;code = 46 result sql = Severe gastroparesis causing splenic rupture: a unique, early complication after heart-lung transplantation.
Severe gastroparesis causing splenic rupture: a unique, early complication after heart-lung transplantation.char = S;code = 83 char = e;code = 101 char = v;code = 118 char = e;code = 101 char = r;code = 114 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = w;code = 119 char = e;code = 101 char = e;code = 101 char = k;code = 107 char = s;code = 115 char = ;code = 32 char = o;code = 111 char = r;code = 114 char = ;code = 32 char = e;code = 101 char = v;code = 118 char = e;code = 101 char = n;code = 110 char = ;code = 32 char = m;code = 109 char = o;code = 111 char = n;code = 110 char = t;code = 116 char = h;code = 104 char = s;code = 115 char = ;code = 32 char = a;code = 97 char = f;code = 102 char = t;code = 116 char = e;code = 101 char = r;code = 114 char = ;code = 32 char = h;code = 104 char = e;code = 101 char = a;code = 97 char = r;code = 114 char = t;code = 116 char = -;code = 45 char = l;code = 108 char = u;code = 117 char = n;code = 110 char = g;code = 103 char = ;code = 32 char = t;code = 116 char = r;code = 114 char = a;code = 97 char = n;code = 110 char = s;code = 115 char = p;code = 112 char = l;code = 108 char = a;code = 97 char = n;code = 110 char = t;code = 116 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = ,;code = 44 char = ;code = 32 char = g;code = 103 char = a;code = 97 char = s;code = 115 char = t;code = 116 char = r;code = 114 char = o;code = 111 char = p;code = 112 char = a;code = 97 char = r;code = 114 char = e;code = 101 char = s;code = 115 char = i;code = 105 char = s;code = 115 char = -;code = 45 char = o;code = 111 char = r;code = 114 char = ;code = 32 char = d;code = 100 char = e;code = 101 char = l;code = 108 char = a;code = 97 char = y;code = 121 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = g;code = 103 char = a;code = 97 char = s;code = 115 char = t;code = 116 char = r;code = 114 char = i;code = 105 char = c;code = 99 char = ;code = 32 char = e;code = 101 char = m;code = 109 char = p;code = 112 char = t;code = 116 char = y;code = 121 char = i;code = 105 char = n;code = 110 char = g;code = 103 char = -;code = 45 char = c;code = 99 char = o;code = 111 char = m;code = 109 char = m;code = 109 char = o;code = 111 char = n;code = 110 char = l;code = 108 char = y;code = 121 char = ;code = 32 char = p;code = 112 char = r;code = 114 char = e;code = 101 char = s;code = 115 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = s;code = 115 char = ;code = 32 char = w;code = 119 char = i;code = 105 char = t;code = 116 char = h;code = 104 char = ;code = 32 char = c;code = 99 char = o;code = 111 char = u;code = 117 char = g;code = 103 char = h;code = 104 char = ,;code = 44 char = ;code = 32 char = e;code = 101 char = a;code = 97 char = r;code = 114 char = l;code = 108 char = y;code = 121 char = ;code = 32 char = s;code = 115 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = e;code = 101 char = t;code = 116 char = y;code = 121 char = ,;code = 44 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = d;code = 100 char = ;code = 32 char = b;code = 98 char = l;code = 108 char = o;code = 111 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = n;code = 110 char = g;code = 103 char = .;code = 46 char = ;code = 32 char = A;code = 65 char = s;code = 115 char = ;code = 32 char = i;code = 105 char = t;code = 116 char = ;code = 32 char = p;code = 112 char = r;code = 114 char = o;code = 111 char = g;code = 103 char = r;code = 114 char = e;code = 101 char = s;code = 115 char = s;code = 115 char = e;code = 101 char = s;code = 115 char = ,;code = 44 char = ;code = 32 char = g;code = 103 char = a;code = 97 char = s;code = 115 char = t;code = 116 char = r;code = 114 char = o;code = 111 char = p;code = 112 char = a;code = 97 char = r;code = 114 char = e;code = 101 char = s;code = 115 char = i;code = 105 char = s;code = 115 char = ;code = 32 char = c;code = 99 char = a;code = 97 char = n;code = 110 char = ;code = 32 char = c;code = 99 char = a;code = 97 char = u;code = 117 char = s;code = 115 char = e;code = 101 char = ;code = 32 char = s;code = 115 char = u;code = 117 char = b;code = 98 char = s;code = 115 char = t;code = 116 char = a;code = 97 char = n;code = 110 char = t;code = 116 char = i;code = 105 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = m;code = 109 char = a;code = 97 char = l;code = 108 char = n;code = 110 char = u;code = 117 char = t;code = 116 char = r;code = 114 char = i;code = 105 char = t;code = 116 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = d;code = 100 char = ;code = 32 char = i;code = 105 char = m;code = 109 char = p;code = 112 char = a;code = 97 char = i;code = 105 char = r;code = 114 char = ;code = 32 char = d;code = 100 char = r;code = 114 char = u;code = 117 char = g;code = 103 char = ;code = 32 char = a;code = 97 char = b;code = 98 char = s;code = 115 char = o;code = 111 char = r;code = 114 char = p;code = 112 char = t;code = 116 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = .;code = 46 char = ;code = 32 char = G;code = 71 char = a;code = 97 char = s;code = 115 char = t;code = 116 char = r;code = 114 char = o;code = 111 char = p;code = 112 char = a;code = 97 char = r;code = 114 char = e;code = 101 char = s;code = 115 char = i;code = 105 char = s;code = 115 char = ;code = 32 char = a;code = 97 char = f;code = 102 char = t;code = 116 char = e;code = 101 char = r;code = 114 char = ;code = 32 char = h;code = 104 char = e;code = 101 char = a;code = 97 char = r;code = 114 char = t;code = 116 char = -;code = 45 char = l;code = 108 char = u;code = 117 char = n;code = 110 char = g;code = 103 char = ;code = 32 char = t;code = 116 char = r;code = 114 char = a;code = 97 char = n;code = 110 char = s;code = 115 char = p;code = 112 char = l;code = 108 char = a;code = 97 char = n;code = 110 char = t;code = 116 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = ;code = 32 char = c;code = 99 char = a;code = 97 char = n;code = 110 char = ;code = 32 char = b;code = 98 char = e;code = 101 char = ;code = 32 char = a;code = 97 char = t;code = 116 char = t;code = 116 char = r;code = 114 char = i;code = 105 char = b;code = 98 char = u;code = 117 char = t;code = 116 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = t;code = 116 char = o;code = 111 char = ;code = 32 char = b;code = 98 char = i;code = 105 char = l;code = 108 char = a;code = 97 char = t;code = 116 char = e;code = 101 char = r;code = 114 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = v;code = 118 char = a;code = 97 char = g;code = 103 char = u;code = 117 char = s;code = 115 char = ;code = 32 char = n;code = 110 char = e;code = 101 char = r;code = 114 char = v;code = 118 char = e;code = 101 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = j;code = 106 char = u;code = 117 char = r;code = 114 char = y;code = 121 char = ,;code = 44 char = ;code = 32 char = w;code = 119 char = h;code = 104 char = i;code = 105 char = c;code = 99 char = h;code = 104 char = ;code = 32 char = p;code = 112 char = r;code = 114 char = o;code = 111 char = b;code = 98 char = a;code = 97 char = b;code = 98 char = l;code = 108 char = y;code = 121 char = ;code = 32 char = o;code = 111 char = c;code = 99 char = c;code = 99 char = u;code = 117 char = r;code = 114 char = s;code = 115 char = ;code = 32 char = j;code = 106 char = u;code = 117 char = s;code = 115 char = t;code = 116 char = ;code = 32 char = a;code = 97 char = b;code = 98 char = o;code = 111 char = v;code = 118 char = e;code = 101 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = l;code = 108 char = e;code = 101 char = v;code = 118 char = e;code = 101 char = l;code = 108 char = ;code = 32 char = o;code = 111 char = f;code = 102 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = c;code = 99 char = a;code = 97 char = r;code = 114 char = i;code = 105 char = n;code = 110 char = a;code = 97 char = ,;code = 44 char = ;code = 32 char = w;code = 119 char = h;code = 104 char = e;code = 101 char = r;code = 114 char = e;code = 101 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = r;code = 114 char = e;code = 101 char = c;code = 99 char = i;code = 105 char = p;code = 112 char = i;code = 105 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = ';code = 39 char = s;code = 115 char = ;code = 32 char = t;code = 116 char = r;code = 114 char = a;code = 97 char = c;code = 99 char = h;code = 104 char = e;code = 101 char = a;code = 97 char = ;code = 32 char = i;code = 105 char = s;code = 115 char = ;code = 32 char = r;code = 114 char = e;code = 101 char = s;code = 115 char = e;code = 101 char = c;code = 99 char = t;code = 116 char = e;code = 101 char = d;code = 100 char = .;code = 46 char = ;code = 32 char = W;code = 87 char = e;code = 101 char = ;code = 32 char = r;code = 114 char = e;code = 101 char = p;code = 112 char = o;code = 111 char = r;code = 114 char = t;code = 116 char = ;code = 32 char = a;code = 97 char = ;code = 32 char = h;code = 104 char = i;code = 105 char = g;code = 103 char = h;code = 104 char = l;code = 108 char = y;code = 121 char = ;code = 32 char = u;code = 117 char = n;code = 110 char = u;code = 117 char = s;code = 115 char = u;code = 117 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = c;code = 99 char = a;code = 97 char = s;code = 115 char = e;code = 101 char = ;code = 32 char = w;code = 119 char = h;code = 104 char = e;code = 101 char = r;code = 114 char = e;code = 101 char = i;code = 105 char = n;code = 110 char = ;code = 32 char = g;code = 103 char = a;code = 97 char = s;code = 115 char = t;code = 116 char = r;code = 114 char = o;code = 111 char = p;code = 112 char = a;code = 97 char = r;code = 114 char = e;code = 101 char = s;code = 115 char = i;code = 105 char = s;code = 115 char = ;code = 32 char = p;code = 112 char = r;code = 114 char = e;code = 101 char = s;code = 115 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = e;code = 101 char = a;code = 97 char = r;code = 114 char = l;code = 108 char = y;code = 121 char = ;code = 32 char = a;code = 97 char = f;code = 102 char = t;code = 116 char = e;code = 101 char = r;code = 114 char = ;code = 32 char = h;code = 104 char = e;code = 101 char = a;code = 97 char = r;code = 114 char = t;code = 116 char = -;code = 45 char = l;code = 108 char = u;code = 117 char = n;code = 110 char = g;code = 103 char = ;code = 32 char = t;code = 116 char = r;code = 114 char = a;code = 97 char = n;code = 110 char = s;code = 115 char = p;code = 112 char = l;code = 108 char = a;code = 97 char = n;code = 110 char = t;code = 116 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = d;code = 100 char = ;code = 32 char = w;code = 119 char = a;code = 97 char = s;code = 115 char = ;code = 32 char = m;code = 109 char = a;code = 97 char = n;code = 110 char = a;code = 97 char = g;code = 103 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = c;code = 99 char = o;code = 111 char = n;code = 110 char = s;code = 115 char = e;code = 101 char = r;code = 114 char = v;code = 118 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = v;code = 118 char = e;code = 101 char = l;code = 108 char = y;code = 121 char = .;code = 46 char = ;code = 32 char = H;code = 72 char = o;code = 111 char = w;code = 119 char = e;code = 101 char = v;code = 118 char = e;code = 101 char = r;code = 114 char = ,;code = 44 char = ;code = 32 char = 1;code = 49 char = 9;code = 57 char = ;code = 32 char = d;code = 100 char = a;code = 97 char = y;code = 121 char = s;code = 115 char = ;code = 32 char = p;code = 112 char = o;code = 111 char = s;code = 115 char = t;code = 116 char = o;code = 111 char = p;code = 112 char = e;code = 101 char = r;code = 114 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = v;code = 118 char = e;code = 101 char = l;code = 108 char = y;code = 121 char = ,;code = 44 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = p;code = 112 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = ;code = 32 char = d;code = 100 char = e;code = 101 char = v;code = 118 char = e;code = 101 char = l;code = 108 char = o;code = 111 char = p;code = 112 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = a;code = 97 char = c;code = 99 char = u;code = 117 char = t;code = 116 char = e;code = 101 char = ;code = 32 char = a;code = 97 char = b;code = 98 char = d;code = 100 char = o;code = 111 char = m;code = 109 char = i;code = 105 char = n;code = 110 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = p;code = 112 char = a;code = 97 char = i;code = 105 char = n;code = 110 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = d;code = 100 char = ;code = 32 char = h;code = 104 char = y;code = 121 char = p;code = 112 char = o;code = 111 char = t;code = 116 char = e;code = 101 char = n;code = 110 char = s;code = 115 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = .;code = 46 char = ;code = 32 char = L;code = 76 char = a;code = 97 char = p;code = 112 char = a;code = 97 char = r;code = 114 char = o;code = 111 char = t;code = 116 char = o;code = 111 char = m;code = 109 char = y;code = 121 char = ;code = 32 char = r;code = 114 char = e;code = 101 char = v;code = 118 char = e;code = 101 char = a;code = 97 char = l;code = 108 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = a;code = 97 char = ;code = 32 char = m;code = 109 char = a;code = 97 char = s;code = 115 char = s;code = 115 char = i;code = 105 char = v;code = 118 char = e;code = 101 char = l;code = 108 char = y;code = 121 char = ;code = 32 char = d;code = 100 char = i;code = 105 char = l;code = 108 char = a;code = 97 char = t;code = 116 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = s;code = 115 char = t;code = 116 char = o;code = 111 char = m;code = 109 char = a;code = 97 char = c;code = 99 char = h;code = 104 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = d;code = 100 char = ;code = 32 char = t;code = 116 char = o;code = 111 char = t;code = 116 char = a;code = 97 char = l;code = 108 char = ;code = 32 char = a;code = 97 char = v;code = 118 char = u;code = 117 char = l;code = 108 char = s;code = 115 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = ;code = 32 char = o;code = 111 char = f;code = 102 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = s;code = 115 char = p;code = 112 char = l;code = 108 char = e;code = 101 char = n;code = 110 char = i;code = 105 char = c;code = 99 char = ;code = 32 char = c;code = 99 char = a;code = 97 char = p;code = 112 char = s;code = 115 char = u;code = 117 char = l;code = 108 char = e;code = 101 char = ;code = 32 char = w;code = 119 char = i;code = 105 char = t;code = 116 char = h;code = 104 char = ;code = 32 char = h;code = 104 char = e;code = 101 char = m;code = 109 char = o;code = 111 char = r;code = 114 char = r;code = 114 char = h;code = 104 char = a;code = 97 char = g;code = 103 char = e;code = 101 char = .;code = 46 char = ;code = 32 char = T;code = 84 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = p;code = 112 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = ;code = 32 char = w;code = 119 char = a;code = 97 char = s;code = 115 char = ;code = 32 char = f;code = 102 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = v;code = 118 char = i;code = 105 char = a;code = 97 char = ;code = 32 char = j;code = 106 char = e;code = 101 char = j;code = 106 char = u;code = 117 char = n;code = 110 char = o;code = 111 char = s;code = 115 char = t;code = 116 char = o;code = 111 char = m;code = 109 char = y;code = 121 char = ;code = 32 char = t;code = 116 char = u;code = 117 char = b;code = 98 char = e;code = 101 char = s;code = 115 char = ;code = 32 char = u;code = 117 char = n;code = 110 char = t;code = 116 char = i;code = 105 char = l;code = 108 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = g;code = 103 char = a;code = 97 char = s;code = 115 char = t;code = 116 char = r;code = 114 char = o;code = 111 char = p;code = 112 char = a;code = 97 char = r;code = 114 char = e;code = 101 char = s;code = 115 char = i;code = 105 char = s;code = 115 char = ;code = 32 char = r;code = 114 char = e;code = 101 char = s;code = 115 char = o;code = 111 char = l;code = 108 char = v;code = 118 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = s;code = 115 char = p;code = 112 char = o;code = 111 char = n;code = 110 char = t;code = 116 char = a;code = 97 char = n;code = 110 char = e;code = 101 char = o;code = 111 char = u;code = 117 char = s;code = 115 char = l;code = 108 char = y;code = 121 char = .;code = 46 char = ;code = 32 char = T;code = 84 char = h;code = 104 char = i;code = 105 char = s;code = 115 char = ;code = 32 char = c;code = 99 char = a;code = 97 char = s;code = 115 char = e;code = 101 char = ;code = 32 char = i;code = 105 char = l;code = 108 char = l;code = 108 char = u;code = 117 char = s;code = 115 char = t;code = 116 char = r;code = 114 char = a;code = 97 char = t;code = 116 char = e;code = 101 char = s;code = 115 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = ;code = 32 char = i;code = 105 char = m;code = 109 char = p;code = 112 char = o;code = 111 char = r;code = 114 char = t;code = 116 char = a;code = 97 char = n;code = 110 char = t;code = 116 char = ;code = 32 char = s;code = 115 char = e;code = 101 char = q;code = 113 char = u;code = 117 char = e;code = 101 char = l;code = 108 char = a;code = 97 char = ;code = 32 char = o;code = 111 char = f;code = 102 char = ;code = 32 char = h;code = 104 char = e;code = 101 char = a;code = 97 char = r;code = 114 char = t;code = 116 char = -;code = 45 char = l;code = 108 char = u;code = 117 char = n;code = 110 char = g;code = 103 char = ;code = 32 char = t;code = 116 char = r;code = 114 char = a;code = 97 char = n;code = 110 char = s;code = 115 char = p;code = 112 char = l;code = 108 char = a;code = 97 char = n;code = 110 char = t;code = 116 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = .;code = 46 char = ;code = 32 char = I;code = 73 char = n;code = 110 char = ;code = 32 char = o;code = 111 char = r;code = 114 char = d;code = 100 char = e;code = 101 char = r;code = 114 char = ;code = 32 char = t;code = 116 char = o;code = 111 char = ;code = 32 char = d;code = 100 char = e;code = 101 char = c;code = 99 char = r;code = 114 char = e;code = 101 char = a;code = 97 char = s;code = 115 char = e;code = 101 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = ;code = 32 char = m;code = 109 char = o;code = 111 char = r;code = 114 char = b;code = 98 char = i;code = 105 char = d;code = 100 char = i;code = 105 char = t;code = 116 char = y;code = 121 char = ;code = 32 char = f;code = 102 char = r;code = 114 char = o;code = 111 char = m;code = 109 char = ;code = 32 char = g;code = 103 char = a;code = 97 char = s;code = 115 char = t;code = 116 char = r;code = 114 char = o;code = 111 char = p;code = 112 char = a;code = 97 char = r;code = 114 char = e;code = 101 char = s;code = 115 char = i;code = 105 char = s;code = 115 char = ;code = 32 char = i;code = 105 char = n;code = 110 char = ;code = 32 char = t;code = 116 char = h;code = 104 char = e;code = 101 char = s;code = 115 char = e;code = 101 char = ;code = 32 char = f;code = 102 char = r;code = 114 char = a;code = 97 char = g;code = 103 char = i;code = 105 char = l;code = 108 char = e;code = 101 char = ;code = 32 char = p;code = 112 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = e;code = 101 char = n;code = 110 char = t;code = 116 char = s;code = 115 char = ,;code = 44 char = ;code = 32 char = a;code = 97 char = ;code = 32 char = d;code = 100 char = r;code = 114 char = a;code = 97 char = i;code = 105 char = n;code = 110 char = a;code = 97 char = g;code = 103 char = e;code = 101 char = ;code = 32 char = p;code = 112 char = r;code = 114 char = o;code = 111 char = c;code = 99 char = e;code = 101 char = d;code = 100 char = u;code = 117 char = r;code = 114 char = e;code = 101 char = ;code = 32 char = s;code = 115 char = h;code = 104 char = o;code = 111 char = u;code = 117 char = l;code = 108 char = d;code = 100 char = ;code = 32 char = b;code = 98 char = e;code = 101 char = ;code = 32 char = c;code = 99 char = o;code = 111 char = n;code = 110 char = s;code = 115 char = i;code = 105 char = d;code = 100 char = e;code = 101 char = r;code = 114 char = e;code = 101 char = d;code = 100 char = ;code = 32 char = a;code = 97 char = s;code = 115 char = ;code = 32 char = a;code = 97 char = n;code = 110 char = ;code = 32 char = a;code = 97 char = d;code = 100 char = j;code = 106 char = u;code = 117 char = n;code = 110 char = c;code = 99 char = t;code = 116 char = ;code = 32 char = t;code = 116 char = o;code = 111 char = ;code = 32 char = h;code = 104 char = e;code = 101 char = a;code = 97 char = r;code = 114 char = t;code = 116 char = -;code = 45 char = l;code = 108 char = u;code = 117 char = n;code = 110 char = g;code = 103 char = ;code = 32 char = t;code = 116 char = r;code = 114 char = a;code = 97 char = n;code = 110 char = s;code = 115 char = p;code = 112 char = l;code = 108 char = a;code = 97 char = n;code = 110 char = t;code = 116 char = a;code = 97 char = t;code = 116 char = i;code = 105 char = o;code = 111 char = n;code = 110 char = .;code = 46 char = <;code = 60 char = b;code = 98 char = r;code = 114 char = /;code = 47 char = >;code = 62 result sql = Several weeks or even months after heart-lung transplantation, gastroparesis-or delayed gastric emptying-commonly presents with cough, early satiety, and bloating. As it progresses, gastroparesis can cause substantial malnutrition and impair drug absorption. Gastroparesis after heart-lung transplantation can be attributed to bilateral vagus nerve injury, which probably occurs just above the level of the carina, where the recipient's trachea is resected. We report a highly unusual case wherein gastroparesis presented early after heart-lung transplantation and was managed conservatively. However, 19 days postoperatively, the patient developed acute abdominal pain and hypotension. Laparotomy revealed a massively dilated stomach and total avulsion of the splenic capsule with hemorrhage. The patient was fed via jejunostomy tubes until the gastroparesis resolved spontaneously. This case illustrates an important sequela of heart-lung transplantation. In order to decrease the morbidity from gastroparesis in these fragile patients, a drainage procedure should be considered as an adjunct to heart-lung transplantation.
Publication: Tex Heart Inst J 2006 ;33(4)::508-11.
Publication Date: 2006
Study Author(s): Naik-Mathuria, Bindi;Jamous, Fady;Noon, George P;Loebe, Mattias;Seethamraju, Harish;Bag, Remzi;
Institution: Division of Transplant and Assist Devices, Michael E. DeBakey Department of Surgery, Baylor College of Medicine, Houston, Texas 77030, USA.
[email protected]
Shortcut link to this study:
Several weeks or even months after heart-lung transplantation, gastroparesis-or delayed gastric emptying-commonly presents with cough, early satiety, and bloating. As it progresses, gastroparesis can cause substantial malnutrition and impair drug absorption. Gastroparesis after heart-lung transplantation can be attributed to bilateral vagus nerve injury, which probably occurs just above the level of the carina, where the recipient's trachea is resected. We report a highly unusual case wherein gastroparesis presented early after heart-lung transplantation and was managed conservatively. However, 19 days postoperatively, the patient developed acute abdominal pain and hypotension. Laparotomy revealed a massively dilated stomach and total avulsion of the splenic capsule with hemorrhage. The patient was fed via jejunostomy tubes until the gastroparesis resolved spontaneously. This case illustrates an important sequela of heart-lung transplantation. In order to decrease the morbidity from gastroparesis in these fragile patients, a drainage procedure should be considered as an adjunct to heart-lung transplantation.
PMID: 17215983