摘要:

&NA;Recent repopularization of intrahepatic infusion chemotherapy has been made possible by the development of the implantable Infusaid®pump. Surgical placement of a catheter into the gastroduodenal artery with division of collaterals to the stomach, duodenum, and pancreas has reduced the incidence of gastroduodenal ulceration and pancreatitis. The risk of chemical cholecystitis similarly demands prevention. Anatomically, the cystic artery is a branch of the right hepatic, artery in over 95 percent of patients. As a result, even a normal gallbladder is subjected to high‐dose chemotherapy with the risk of development of drug‐induced cholecystitis. In our first six patients undergoing pump implantation who had normal appearing gallbadders at the time of surgery, two developed symptomatic cholecystitis, necessitating cholecystectomy after receiving intrahepatic chemotherapy. As a result, we recommend elective cholecystectomy at the time of arterial catheterization for intrahepatic chemotherapy.

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;A 62‐year‐old woman developed diffuse histiocytic lymphoma in the couse of chronic lymphocytic leukemia and manifested symptoms mimicking chronic ulcerative colitis. Chronic lymphocytic leukemia may be complicated by the development of lymphoma designated Richter's syndrome. These lymphomas may present in the gastrointestinal tract with signs and symptoms suggestive of chronic inflammatory bowel disease. Initial diagnostic studies, especially barium studies, may yield similar findings. However, histologic findings and clinical course are particularly important in differentiating the disorders.

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;Neutropenic enterocolitis, also known as typhlitis or ileocecal syndrome, is a recognized complication of the treatment of hematologic malignancies and usually is fatal. The pathologic findings consist of bowel‐wall ulcerations and necrosis with bacterial or fungal invasion. These findings are usually limited to the ileum, cecum, ascending colon, and appendix. The syndrome occurs in a select patient population who generally have 1) a hematologic malignancy, 2) neutropenia, 3) thrombocytopenia, 4) a recent course of chemotherapy, and 5) a recent course of antibiotics. This syndrome also can arise spontaneously in patients with aplastic anemia or cyclic neutropenia. The clinical presentation consists of a high fever and right‐sided abdominal pain with evidence of peritoneal irritation. Recommended therapy is right hemicolectomy. Experience and a critical review of the literature support this approach.

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;Whereas minor side effects of sulfasalazine are common, serious adverse reactions to this drug generally are considered rare. However, this report discusses three major complications of sulfasalazine that occurred within the past three years, one resulting in the death of a patient. As more patients with inflammatory bowel disease are being managed by physicians of various disciplines, it is important to become familiar with the potentially dangerous side effects of all medications prescribed. For this reason, a brief review of the pharmacology, clinical use, and toxicity of sulfasalazine is presented.

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;This study analyzes 400 cases of acute pseudo‐obstruction of the colon (Ogilvie's syndrome). Seven cases were reported at St. Elizabeth Hospital Medical Center between October 1982 and February 1985; 393 cases were reported in the literature from 1970‐1985. Ogilvie's syndrome is most commonly reported in patients in the sixth decade, and is more predominant in men. It is caused by an unknown disturbance to the autonomic innervation of the distal colon, and is associated with different conditions. Plain abdominal roentgenogram is the most useful diagnostic test. If the cecal diameter is 12 cm or greater, or conservative management is unsuccessful, colonoscopic or operative decompression is needed. The mode of treatment, age, cecal diameter, delay in decompression, and status of the bowel significantly influence the mortality rate, which is approximately 15 percent with early appropriate management, compared with 36 to 44 percent in perforated or ischemic bowel.

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;Preliminary experience with seven infants with Hirschsprung's disease has demonstrated the safety and reliability of performing a very low colorectal anastomosis using a disposable intraluminal stapler. A 21‐mm diameter stapler allows this procedure to be performed on patients with a mean body weight of approximately 10 kg.

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

摘要:

&NA;New operating proctoscopes have been designed that facilitate the passage of a stapling head without its anvil in rectal procedures which call for this technique to be used.

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1986

数据来源: OVID