摘要:

&NA;Thirty four patients with restorative proctocolectomy and ileoanal pelvic reservoirs were studied by “evacuation pouchography” to determine why only some patients could evacuate spontaneously. The 50 per cent who were able had a significantly shorter distal segment (P<0.02) of mean length (8±3 cm) that filled on straining, compared with those who had to use a catheter to empty the pouch, in whom the distal segment was longer (mean 11±4 cm) and often failed to fill on straining. The longer the distal segment, the more likely it was to be angulated, causing difficulty in passage of the catheter with possible ulceration and stenosis from minor trauma. Stricturing in the distal segment was associated with minor nocturnal leakage. A short distal segment is recommended to allow spontaneous evacuation and avoid the risks of repeated catheterization.

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;The progress of 139 patients operated upon for cure of colorectal carcinoma, was followed postoperatively with a standardized protocol. A CEA test was performed for comparison with other parameters. Median observation time was four years. When an upper limit for CEA of 7.5 &mgr;g/l was allowed, sensitivity was found to be 78 per cent, specificity 91 per cent, and predictive value of an elevated CEA concentration, 83 per cent. In general, CEA measurement traced, recurrence six months before clinical diagnosis. In only a few cases was recurrence first heralded by an abnormality in other blood chemistry test results. CEA may thus be used in postoperative screening for recurrence even though most recurrences, when detected, are not curable.

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;The vermiform appendix can be the site of development of diverticula which may suffer either inflammatory complications with or without appendicitis or may only be an incidental finding in an uninflamed appendix. This is a retrospective study of 10 of 575 cases of consecutive appendices removed and examined within a year, with single or multiple appendiceal diverticula with diverticulitis and peridiverticulitis. In six of the 10, the lumen of the appendix did not show any inflammatory changes. In conclusion, one could assume that inflammatory complications of the appendiceal diverticula, although they may mimic acute appendicitis, are quite distinct clinical entities. Acute appendicitis in the presence of appendiceal diverticula may carry an earlier and higher rate of perforation and appendiceal diverticula, as an incidental finding, may justify appendectomy on occasion

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;This paper reviews the clinical characteristics of a group of patients in whom unsuspected primary adenocarcinoma of the colon presented with signs and symptoms of a primary ovarian neoplasia. In most patients the ovaries were removed, the correct diagnosis was established at a later time, and a second surgery for resection of the primary adenocarcinoma of the colon was then performed. Preoperative use of colonoscopy or barium‐enema examination would have helped. We compared these patients to a group of patients with similar clinical characteristics, but in whom the ovarian metastases were clinically apparent months after the resection of a primary colorectal cancer. We found that, in both groups, age of the patients, anatomic distribution of the primary tumor, histologic differentiation, serosal or mesenteric lymph node tumor involvement, and timing of the oophorectomy in relationship to removal of the primary colorectal tumor did not affect the overall survival. Once ovarian metastases were documented, patients died regardless of treatment, approximately 16 1/2 months after the diagnosis.

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;A survey of anorectal diseases in parts of Western Nigeria was performed by examining 336 adults in various locations. It was concluded that anorectal diseases are more common among the population than is suggested in reviews of hospital cases—a fact largely due to poor health awareness and consequently poor hospital attendance. The fairly generally high prevalence of these diseases does, in fact, mirror holoendemic conditions such as schistosomiasis, amebiasis, and intestinal tuberculosis. In spite of known western influence on food preparation and dietary habits, particularly among the urban dwellers, it is probably too early to expect any impact on bowel habits and largebowel and anorectal diseases. In view of the significant association, the author suggests than any disturbance in bowel action should prompt a thorough investigation for anorectal diseases.

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;The unusual finding of an acute appendix located within the posterior wall of the cecum, beneath the serosa, and its surgical removal is described. In order to remove the appendix, the cecal wall had to be incided. The appendix had no serosal covering, and had the gross appearance of a peeled seedless grape. The anatomy and embryology of the vermiform appendix, including this aberration, are presented briefly. A discussion of the difficult‐to‐find appendix is presented. The possibility exists that some of the reported cases of agenesis of the appendix could have been an overlooked intracecal appendix.

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;We report a case of a left psoas abscess resulting from a perforating carcinoma of the sigmoid colon. The chief complaints were edema of the left leg and pain in the left thigh. Single and double contrast barium‐enema film demonstrated an extrinsic inflammatory mass distoring the sigmoid colon. A preoperative diagnosis of sigmoid carcinoma was not made on these examinations, nor on flexible colonoscopy. Carcinoma of the colon should be considered as a cause of an unexplained psoas abscess.

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;The increasing ratio of proximal to distal colorectal carcinomas was confirmed in this population‐based study of 668 new cases diagnosed among Rochester, Minnesota residents between 1940 and 1979. The change was due to a rise in the incidence of proximal lesions (from 15.1 per 100,000 person‐years in 1940‐59 to 17.3 per 100,000 in 1960‐79) and a simultaneous fall in the incidence of distal lesions (from 35.5 to 28.2 per 100,000 person‐years). Changes in definitions or referral patterns played no role in these observations, although improved diagnostic capabilities may have had an impact on the incidence of proximal lesions. These discrepant changes in incidence strongly suggest that proximal and distal colonic cancers are different diseases or have a different pathogenesis. The changing incidence rates were not associated with consistent differences in clinical characteristics at the time of initial diagnosis.

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID

摘要:

&NA;Extracolonic manifestations are often associated with familial polyposis coli, but the cysts and osteomas may be few and inconspicuous. Abnormal fibrous reactions may also occur and may be a cause of death. These manifestations act as “external markers” for the later appearances of adenomas. In any family, some individuals may manifest some extracolonic manifestations and other individuals may not. Other abnormalities, usually neoplastic, described in familial polyposis coli families, are probably fortuitous occurrences, but medulloblastoma has been found relatively frequently. Turcot's syndrome, described in a unique family, should be used more restrictively. Diagnosis depends on histology showing adenomas, but no particular number is required in an afflicted family member. Total reliance on sigmoidoscopy alone is potentially hazardous as the descending colon may be affected initially. Inherent problems regarding “isolated cases” are outlined.

ISSN:0012-3706    

出版商:OVID    

年代:1983

数据来源: OVID