摘要:

&NA;Protein‐calorie malnutrition, as determined by anthropometric measures and laboratory tests, was assssed in 17 preoperative patients with colorectal cancer and 47 control patients. The cancer patients had significant deficits in visceral protein and skeletal muscle and no deficit in fat stores. Greater attention should be given to preoperative nutritional assessment and to the correction of protein deficits.

ISSN:0012-3706    

出版商:OVID    

年代:1978

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;Colonoscopy, done to elucidate the cause of obscure rectal bleeding not diagnosable on the basis of previous proctoscopic and barium‐enema examinations, resulted in a 17 per cent diagnostic yield in this series. Eighteen of 105 patients were found to have lesions: three had carcinomas, six had polyps, eight had colitis, and one had proctitis.When bleeding had been demonstrated by the physician, there was a higher diagnostic yield (22.5 per cent) than when bleeding was reported only by the patient (5.9 per cent). Descriptions of the bleeding by the patients were found to be somewhat unreliable.Sixteen of the 18 lesions revealed by the colonoscope were in the left colon.It is suggested that the basic work‐up for undiagnosed rectal bleeding should include history, physical examination, sigmoidoscopy, and barium‐enema study. When no diagnosis is found, subsequent work‐up must be individualized. When bleeding has been demonstrated to originate from the colon, colonoscopic examination should be performed.

ISSN:0012-3706    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;The continent ileostomy has significantly improved the quality of life in selected patients. This procedure may be useful for patients who need total proctocolectomy for ulcerative colitis or familial polyposis or who have complications from conventional ileostomies. It should be performed only by experienced intestinal surgeons who are willing to accept the long‐term commitment of treating these patients and their numerous complications. It is recommended with cautious optimism for selected patients.

ISSN:0012-3706    

出版商:OVID    

年代:1978

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;Infarctions of the colon and rectum (incidences approximately 1 and 0.5 per cent, respectively) are caused by compromised collateral circulation to the colon and rectum, usually as a result of arteriosclerotic disease of the superior and inferior mesenteric arterial systems, as well as the hypogastric arteries Patients who have colorectal ischemia after operations for abdominal aortic aneurysms have diarrhea (sometimes bloody), abdominal pain, and distention. The diagnosis may be established by sigmoidoscopic examination. Treatment includes surgical removal of the compromised bowel and creation of a temporary or permanent end colostomy. Prevention of this complication is aided by preservation of primary and collateral circulation, avoidance of hypotension, and preoperative bowel preparation.

ISSN:0012-3706    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;Five (1 per cent) of 529 thermally injured patients experienced pseudo‐obstruction of the colon over a two‐year period. All patients had classic non‐painful abdominal distention. Infection was the most common associated problem and possible triggering mechanism in these patients. After confirmation of the colonic dilation on a plain abdominal roentgenogram, distal obstruction was ruled out by contrast enema. Occasionally, Gastrografin enema seemed to ameliorate the distention.Conservative medical management should be attempted initially. Colonoscopy should be employed at the earliest possible time. Exploratory laparotomy and tube cecostomy are usually adequate when surgical decompression is necessary.Patients who have accompanying small‐intestinal distention seemed to tolerate this condition better, possibly due to a decompressing effect of an incompetent ileocecal valve. “Hinge‐type” kinks, which occur in time at both hepatic and splenic flexures, become obstructing in themselves, and can be a barrier to conservative treatment.

ISSN:0012-3706    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;Two cases of nonspecific cecal ulceration are presented. The lesions tend to occur in the right colon, produce pain or bleeding, and generally are best managed surgically. Etiology of the ulcers is unknown, but a vascular theory of origin is favored.

ISSN:0012-3706    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;Three cases of inflammation of a solitary cecal diverticulum are described. The preoperative and peroperative difficulties in diagnosis are emphasized. It is suggested that the safest course of treatment is drainage of the inflamed area, with postoperative administration of antibiotics.

ISSN:0012-3706    

出版商:OVID    

年代:1978

数据来源: OVID

摘要:

&NA;While villous adenomas of the rectum are common, they rarely encompass the entire rectum to the dentate line. It is even more unusual to find a tumor of this size to be benign. Fluid and electrolyte deficits associated with this tumor add to the difficulty in management. The experienced surgeon should be aware of the various modes of treatment and be able safely to use the appropriate operation. It is as grave an injustice to the patient to treat a benign lesion as a malignancy as it is to remove the rectum for a benign villous adenoma.

ISSN:0012-3706    

出版商:OVID    

年代:1978

数据来源: OVID