摘要:

&NA;Peptic ulcer disease, lower abdominal colicky pain, increasing diarrhea, and ulcers of the colon and rectum developed in a patient more than one year after he had an extensive resection of the small bowel. Parenteral adinistration of cimetidine, with blood levels of 2.00 mg/ml, caused resolution of the colonic ulcerations and other symptoms, after orally administered cimetidine had failed to produce a measurable blood concentration level.

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;Mean segmental transit time of radiopaque markers through the right colon, left colon and rectosigmoid areas of adults and children has been calculated from their distribution on consecutive plain films of the abdomen. Overall mean transit does not differ significantly in the large bowel between adults and children. However, there are regional differences within the colon in relation to age. Mean transit time in the right colon is 13.8 hours in adults and 7.7 in children (p<0.01). Corresponding values in the left colon are 14.1 and 8.7 hours (p<0.02) and, in the rectum, 11 and 12.4 hours (p=NS). The percentage of the mean total large bowel transit time spent in the right colon, left colon and rectosigmoid area are respectively for adults and children 33±4 and 28±3 per cent (p=NS); 39±4 and 32±4 per cent (p=NS); and 28±4 and 41±4 per cent (p<0.05), indicating a relative stagnation in the rectosigmoid area of children. These physiologic differences may have implications in diseased states.

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;This is the first case report of gangrenous colon from volvulus of the splenic flexure. It is also the first reported treatment of splenic flexure volvulus by exteriorization of the splenic flexure as a loop colostomy. Splenic flexure volvulus has been a rare cause of mechanical obstruction, producing 1 per cent of colonic volvuluses. Fourteen detailed case reports of splenic flexure volvulus were reviewed. Patients averaged 53.2 years old. Eight of 14 were women. Previous abdominal surgery, anomalies of fixation, and constipation played important roles in the pathogenesis. Diagnosis was made before surgery in two‐thirds of the patients. Treatment varied. One patient died without treatment. In two, the volvulus reduced spontaneously. Eleven required emergency surgery. Three underwent operative detorsion, one exteriorization of the splenic flexure as a loop colostomy (the present report), and six partial colectomy. All treated patients survived without recurrence of volvulus. Thus, there was only one death in 14 cases, a seven per cent mortality rate. This low mortality rate was attributed to the rarity of gangrenous colon from splenic flexure volvulus.

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;Extramedullary plasmacytoma (EMP) of the small bowel is a rare entity previously reported as a cause of intestinal obstruction or bleeding. A case report of this disease entity presenting as an ileocolic fistula is reported. EMP is diagnosed by the following critiera: 1) absence of paraproteinemia; 2) absence of Bence Jones proteinuiria; 3) normal skeletal survey; and 4) normal bone marrow biopsy specimen. Gastrointestinal plasmacytoma often occurs as a manifestation of multiple myeloma. EMP of the gastrointestinal tract is a rare cases manifestation of the disease, accounting for 13 per cent of all cases of EMP. It is a slow‐spreading, radiosensitive tumor with a high tendency toward local recurrence. Surgical excision combined with radiotherapy is the treatment of choice for EMP of the gastrointestinal tract.

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;A 39‐year‐old man who survived 14 years following the diagnosis of advanced colonic carcinoma is reported. The presence of metastatic lesions had been well documented at the time of abdominal surgery on three different occasions and at autopsy. The possible mechanism for his unusually prolonged survival time is discussed.

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;Until recently, Crohn's disease has not been regarded as a premalignant lesion, but the increasing number of patients with Crohn's disease in whom adenocarcinoma of the gastrointestinal tract develops strongly suggests that these patients are indeed at a higher risk for carcinoma. These patients are usually young and tend to develop a malignancy in the bypassed ileum or right colon. Patients with such lesions usually have a poor prognosis. Adenocarcinoma arising in perineal fistulas secondary to Crohn's disease has not been reported in English medical literature except for one case published in 1975. In this article, the authors report a second, similar case of Crohn's disease with recurrent perineal fistulas. An infiltrating adenocarcinoma developed in these fistulas, in the anorectal region, and in the left labia. the risk of malignancy should be seriously considered in the management of Crohn's disease, especially in young patients. Because of the risk of adenocarcinoma in these patients, resection rather than bypass is recommended in the surgical management

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;Malignant obstruction of a Brooke ileostomy is a very uncommon occurrence. This situation was encountered in a patient with chronic ulcerative colitis who had undergone a proctocolectomy for carcinoma of the rectum. Such an occurrence has not been described before in the English medical literature

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID

摘要:

&NA;H. W. Maunsell was born in Dublin in 1847 and obtained his degree from the College of Surgeons in 1867. He went to Melbourne the following year and became resident medical officer at the Melbourne Hospital. Following this appoitment he took a similar post in Hokitika, New Zealand. After a short period of private practice he returned to Europe, receiving his M.D. degree at his old University in 1876. He returned to New Zealand, settling at Dunedin, and ultimately held the post of honorary surgeon to that hospital.In 1892 he reemigrated to the South Kensington section of London, devoting his efforts to writing, lecturing and illustrating. He was quite well known as a very fine artist and supplemented his surgical lectures with his own beautifully illustrated drawings.He was an innovative surgeon and is credited with original concepts in the technique of intra‐abdominal hysterectomy. He was elected to the fellowship of the British Gynecological Society in 1889, and was appointed a Councillor in 1893.The article which is reproduced in this Classics section represents one of the earliest descriptions of the abdomino‐anal pull‐through procedure for carcinoma of the rectum. It was said that “the Maunsell Method will be at least more frequently employed, if it does not eventually displace the other procedure,i.e., Murphy's operation for intestinal anastomosis”.Maunsell died on February 21, 1895, from bronchitis following influenza, at the age of 48.

ISSN:0012-3706    

出版商:OVID    

年代:1981

数据来源: OVID