摘要:

AbstractOne hundred and thirteen patients with missile injuries of the abdomen were seen over a 3‐year period at one hospital in Zimbabwe–Rhodesia. The details of these injuries and the results of their treatment are presented.Twenty‐four patients died (21 per cent). Twenty of these patients had sustained high velocity missile injuries, 18 had damaged colons and 3 died from major vascular injuries before surgery. Excluding these last 3 patients, the mortality rate for high velocity wounds of the colon was 52 per cent and that for all other patients was 6 per cent (P<0.01). More than half the postoperative deaths were due to septicaemia.The importance is stressed of early and effective resuscitation, including appropriate antibiotic therapy and rapid evacuation to facilities for major su

ISSN:0007-1323    

DOI:10.1002/bjs.1800670502

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractIn a prospective study of 108 intravenous infusions a significant decrease was noted in the incidence of both cannula‐related sepsis and cannula‐related phlebitis in those patients on low dose (1000 units/1000 ml infusate) heparin given intravenously. A signficant decrease in the incidence of cannula‐related phlebitis was also noted in patients receiving subcutaneous low dose heparin (5000 units 8‐hourly). This significant decrease may be due to inhibition of fibrin clot formation around the tip of the indwelling intravenous

ISSN:0007-1323    

DOI:10.1002/bjs.1800670503

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractA program to calculate the 24‐h intravenous requirements of water, nitrogen, energy and six electrolytes on a card‐programmable pocket calculator is described. Comparison of calculator‐generated requirements with intravenous feeding regimens prescribed by junior clinicians for 8 ill patients suggests that the clinicians provide too much water and too little nitrogen and energy. Certain program modifications are necessary to widen the useful clinical application of the calculator, but in general it is a useful bedside tool capable of further application to suitable medical

ISSN:0007-1323    

DOI:10.1002/bjs.1800670504

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractTwenty‐one patients with duodenal ulcer were treated with cimetidine. After 2 weeks they were submitted to an insulin test and the results were compared with a range of secretion previously established in untreated duodenal ulcer patients (1). The secretion of 13 patients fell within this range and so they were predicted to have a high risk of relapse. The patients whose secretion was below the range had a predicted low risk of relapse. After 4 weeks treatment repeat endoscopy showed that 4 ulcers had failed to heal. The secretion of 3 of the patients was within the range of the high risk group. The remaining 17 patients were followed up (range 20–23 months): 9 relapsed and 8 remained symptom‐free. Eight of the 9 were in the high risk group and 6 of the 8 symptom‐free patients were in the low risk group. In all, 11 out of 13 were correctly predicted in the high risk group and 6 out of 8 in the low risk group.The performance of the insulin test in predicting liability to relapse following cimetidine treatment was significant (P =

ISSN:0007-1323    

DOI:10.1002/bjs.1800670505

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractTwenty‐four patients presenting with primary malignant melanoma of the skin (stage 1) were submitted to wide excision of the tumour, followed by immediate split‐skin grafting. In 12 patients a CO2laser was used to excise the melanoma and only 1 of these patients had a 100 per cent skin graft take, while 9 out of 12 patients whose melanoma was excised with a conventional scalpel had a 100 per cent take. It is concluded that skin excision with the CO2laser impairs subsequent skin graft t

ISSN:0007-1323    

DOI:10.1002/bjs.1800670506

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractDamage of the biliary tract at the end of a period of hepatic preservation prior to liver transplantation has been observed in man. This damage may be important in the development of early biliary complications.A model of hepatic biliary ischaemia in the pig has been developed which permits comparison between the influences of warm and cold ischaemic damage on the biliary tract. The major damage to the biliary tract in the pig in this model appears to occur after prolonged cold preservation.

ISSN:0007-1323    

DOI:10.1002/bjs.1800670507

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

Abstract99Tcm‐labelled HIDA administered intravenously is promptly taken up by the liver and excreted into the bile duct and gallbladder. In this study the use of this agent in hepatoscintigraphy was evaluated. Thirty patients with a variety of hepatobiliary pathology were studied. After an overnight fast 2 mCi of99TcmHIDA were given intravenously and the patient was scanned continuously for 1 h. A rapid outline of the liver and biliary tract was usually obtained and the T1/2of the tracer in the blood stream was 20 min. In total obstructive jaundice, isotope was excreted through the renal tract without visualization of the liver. Hepatoscintigraphy was compared with conventional radiographs and ultrasonography in 19 patients presenting as emergencies with suspected hepatobiliary disease and was found to be comparable to the latter modes of investigation. In the jaundiced patients hepatoscinsigraphy was inferior to percutaneous transhepatic cholangiography and to ultrasonography. No adverse side effects have followed the use of the radiopharmaceutica

ISSN:0007-1323    

DOI:10.1002/bjs.1800670508

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractIn a prospective study of 73 patients undergoing hepatodochojejunostomy for benign bile duct stricture who were covered by antibacterial prophylaxis with gentamicin and cephalothin, bacteria were cultured from bile sampled at operation in 80 per cent of cases. Aerobic organisms were found in 50 cases (82 per cent) and anaerobic organisms in 11 cases (18 per cent). Seventy‐three per cent of the patients with postoperative septic complications had bile cultures positive for anaerobes at operation, and the same organisms were cultured from pus. All patients with anaerobes in the bile at some time in the perioperative period developed postoperative sepsis. Antibacterial prophylaxis with gentamicin and cephalothin, together with specfic therapy with drugs effective against anaerobes when indicated, are recommended in the management of these case

ISSN:0007-1323    

DOI:10.1002/bjs.1800670509

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractThe risk of delayed intracranial abscess formation following excision of an occipital dermal sinus or cyst is illustrated by three recent cases. Once suspected, posterior fossa epidermoid and dermoid cysts are readily diagnosed by CT scanning.

ISSN:0007-1323    

DOI:10.1002/bjs.1800670510

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY

摘要:

AbstractFifty incisional hernias were managed by excision of all scar tissue and approximation of the abdominal wall using continuous doubled nylon inserted with a generous suture length: wound length ratio. There were no major recurrences and only 4 minor ones. The method is theoretically sound and should be more widely used.

ISSN:0007-1323    

DOI:10.1002/bjs.1800670511

出版商:John Wiley&Sons, Ltd.    

年代:1980

数据来源: WILEY