摘要:

&NA;4‐Aminosalicyclic acid was applied topically in a daily dose of 1.4 gm for two weeks in ten patients with ulcerative colitis. After favorable results, the therapeutic effects of 4‐aminosalicylic acid and salazopyrin enemas were compared in a two‐week cross‐over open trial, in 20 patients suffering from recurrent ulcerative colitis involving the rectum and rectosigmoid. No significant difference was found in the changes of the endoscopic picture of the mucosa. The results did not show a significant difference between 4‐aminosalicylic acid and salazopyrin enemas, either in the clinical activity or in the histologic picture. 4‐Aminosalicylic acid seems to be a suitable drug for improving the clinical symptoms of ulcerative proctitis.

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;During a 20‐year period (1965 to 1985), 4673 patients with rectal cancer underwent surgical treatment, with 3500 of them being subjected to radical surgery. Postoperative mortality was 6.1 percent. During the last five years, the mortality rate decreased dramatically down to 4.9 percent, despite an increase in the group of elderly patients (35.7 percent) and performance of a considerable percentage of simultaneous, extensive, and combined operations (33.7 percent). The trend of employing sphincter‐saving operations (in more than 60 percent of patients, the anterior resection and abdominoanal resection with a pull‐through were performed) accounts for the favorable five‐year survival rate (62 to 69 percent) and results in a good functional outcome in 80 percent of patients. The use of a combination of conservative and operative methods of rehabilitation contributes to the professional readaptation of 75 to 80 percent of patients after surgery with construction of a stoma. In 223 cases, a Soviet magnetic occlusive device was implanted, while in 67 patients an artificial sphincter mechanism was constructed from the flap of the adductor longus femoris muscle. It should be emphasized that surgical methods of rehabilitation are used both in primary and reconstructive operations. The experience with management of 124 patients with recurrent cancer after resection and extirpation of the rectum shows that local excision or repeated resections of the rectum cure 20 to 29 percent of those operated on.

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;A case of extensive gangrene of the colon secondary to fecal impaction is reported. The role of ischemia in the management of colonic obstruction and the pathogenesis and treatment of colonic gangrene are discussed.

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;The case of a 60‐year‐old man with massive lower intestinal bleeding, secondary to erosion of an abnormally large submucosal muscular artery in the ascending colon, is reported The bleeding site was localized by angiography. The clinicopathologic presentation of this case is identical to Dieulafoy's disease, which occurs almost exclusively in the stomach. Three similar patients with lesions also located in the ascending colon have been reported in the English medical literature.

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;Squamous‐cell carcinoma arising from a pilonidal sinus tract is an unusual complication of a common condition. Approximately 36 cases of carcinoma related to pilonidal disease have been reported in the literature. Wide excision with tumor‐free margins has yielded five‐year disease‐free states in 55 percent of patients. Recurrence rates have been 44 percent to 50 percent in several large series. Regional (inguinal) nodal metastasis occurs in 14 percent of patients, heralding a dismal prognosis. Radiation and chemotherapy are of minimal palliative value. Reconstruction of these patients has consisted of split‐thickness skin grafts or local cutaneous and myocutaneous flaps. Some authors have allowed healing by secondary intention. A case of squamous‐cell carcinoma arising in a chronic pilonidal sinus tract is reported. Local recurrence required an extensive resection resulting in a large sacral/perineal defect. A single‐stage reconstruction of this defect with multiple muscle and musculocutaneous flaps is described.

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;Heterotopic gastric mucosa in the rectum is particularly uncommon; only 23 cases have been reported to date. Moreover, no studies have been done on the neuroendocrine apparatus and glycoprotein production of the heterotopic mucosa. This study reports on a 13‐year‐old boy, admitted with rectal bleeding and persistent tenesmus. An ulcerative lesion was found on colonoscopy; biopsies revealed a fundic‐type gastric tissue. Medical therapy (H2‐blockers) promptly healed the rectal ulcer; surgical excision of the heterotopia was performed with complete and permanent relief of symptoms (3‐year follow‐up). Immunocytochemistry (PAP) revealed 5‐Ht and somatostatin cells in the gastric‐type mucosa, as in the normal human stomach. These cells also were present in the surrounding rectal epithelium where PYY‐entero‐glucagon cells were detected, which were absent in the heterotopic tissue. Mucin histochemistry showed PAS‐positive cells also strongly stained by LA lectin in the heterotopic tissue, differentiating the rectal epithelium that remained unstained. Therefore, the morphofunctional status (endocrine cells and mucins) of the gastric heterotopia was almost identical to its orthotopic counterpart confirming the hypothesis that endocrine cells and mucin‐producing cells differentiate their metabolic products according to the anatomic and functional activity of the epithelium where they grow.

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;A case of colopleural fistula, resulting from strangulation and perforation of a diaphragmatic hernia and presenting as tension pneumothorax, is reported. The hernia was most likely a consequence of a stab wound to the left side of the chest four years before admittance. Colopleural fistula as a cause of tension pneumothorax is an extremely rare entity, reported only once in past English medical literature.

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

摘要:

&NA;The thoracoabdominal incision is not a common incision in colonic surgery. However, it may be of unique benefit in tumors of the splenic flexure in which adequate mobilization and adequate lateral resection margins may otherwise be difficult to achieve. These tumors are believed to carry a poorer prognosis in part because of reduced accessibility. Specifically, exposure in short, obese patients with locally advanced lesions may be improved significantly with a thoracoabdominal incision. This report presents a patient with a tumor of the splenic flexure invading the diaphragm, greater curvature of the stomach, splenic hilum, and tail of the pancreas. The exposure provided by this incision made a radical cancer operation possible, which would not have been possible with an abdominal incision.

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1989

数据来源: OVID