摘要:

AbstractForty‐two patients with idiopathic megacolon who were seen at St Mark's Hospital over an 18‐year period are reviewed with regard to presentation, investigation and management. The differential diagnosis is discussed with particular reference to Hirschsprung's disease. The important aspects of medical treatment are outlined and the possible reasons for failure in more than one‐half of the patients are discussed. The indications for surgical intervention in 14 patients are reviewed. The results following subtotal colectomy were better than following a localized sigmoid rese

ISSN:0007-1323    

DOI:10.1002/bjs.1800640502

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractHirschprung's disease (aganglionosis) in the adult is a rare condition but needs to be considered as a diagnosis in any case of intractable constipation. A series of 35 cases of probable aganglionosis seen at St Mark's Hospital since 1954 is reviewed. Diagnosis is discussed and operative management evaluated.

ISSN:0007-1323    

DOI:10.1002/bjs.1800640503

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractFour cases of non‐Hirschsprung megacolon in adults are presented. The histology of the myenteric plexus suggests that this may be an anomaly of developmen

ISSN:0007-1323    

DOI:10.1002/bjs.1800640504

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractAfter gastro‐intestinal operations wound infection is usually caused by the inoculation of bacteria present within the intestinal tract into the incision during the surgical procedure. In theory, wound sepsis may be minimized by the following methods: (a) avoiding intestinal contamination of the incision; (b) altering the normal flora of the intestinal tract by adding oral antimicrobials to bowel preparation; (c) using topical or systemic prophylactic antibiotic administration for certain high‐risk patients. The relative importance of these methods of prophylaxis is descri

ISSN:0007-1323    

DOI:10.1002/bjs.1800640505

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractIn a series of 410 consecutive potentially contaminated operations, we have compared the relative efficacy of intra‐incisional cephaloridine and ampieillin in single doses of 1 g in 2 ml of water. In high risk operations (ileocolorectal surgery, perforated appendicitis, or when the patient has 2·5 cm or more of subcutaneous fat at the site of the incision) cephaloridine prophylaxis resulted in a primary sepsis rate of 14 per cent compared with 36 per cent for ampicillin. In all other patients the two antibiotics were equally effective. Secondary sepsis, following discharge from the wound of a substance other than pus, was equally common in the two grou

ISSN:0007-1323    

DOI:10.1002/bjs.1800640506

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractTwo methods of obtaining a preoperative diagnosis of breast lumps have been evaluated by simultaneous use on 131 patients. Tru‐Cut needle biopsies gave a reliable diagnosis in 75 per cent of those suffering from primary carcinoma of the breast. No cases of benign disease were wrongly reported as carcinoma by this method. Fineneedle aspiration cytology gave no helpful information in one‐half of the patients with malignant disease and in addition 5 cases of benign disease were falsely reported as carcinoma. Tru‐Cut needle biopsy is a valuable preoperative investigation in patients with primary carcinoma of the b

ISSN:0007-1323    

DOI:10.1002/bjs.1800640507

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractThrombosis and occlusion of major veins have been described following the use of transvenous pacing electrodes for the establishment of permanent cardiac pacing. The frequency of such complications is, however, not well known. A series of 125 patients was therefore reviewed, all of whom had been paced with permanent transvenous electrodes through a cephalic vein. There was clinical and venographic evidence of subclavian vein occlusion in only 3 of these patients. A further 20 of these patients were also subjected to venography and showed no radiographic evidence of venous occlusion although minor thrombosis associated with the pacemaker electrode was found in one patient. It is concluded that the convenience of using the cephalic vein as a route for the insertion of transvenous pacing electrodes outweighs the small risk of major venous occlusion.

ISSN:0007-1323    

DOI:10.1002/bjs.1800640508

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractFor the successful treatment of recurrent peptic ulceration confirmation of the presence of the ulcer by fibreoptic endoscopy is essential. Further investigation by barium meal and gastric acid secretion studies allows a rational surgical approach to be formulated. This process is illustrated by discussion of the investigative findings and the results of treatment in a series of 20 patients with recurrent peptic ulcer over a 5‐year period. In onehalf of these patients a second abdominal operation was necessary, but in the other half a transthoracic vagotomy alone gave equally good result

ISSN:0007-1323    

DOI:10.1002/bjs.1800640509

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractThe relative risk of stump cancer following partial gastrectomy for a benign gastroduodenal condition was estimated using an individually matched retrospective study design based on autopsy material. Data on all patients dying with gastric cancer and autopsied at the Central Laboratory of Pathology, University Central Hospital, Helsinki, during 1961–75 were collected. Matched pairs of the same sex and age were used as controls. Of the 464 patients dying with gastric cancer, 9 had undergone previous partial gastrectomy, while the respective number among the controls was 5. This result suggests that the risk of cancer in the gastric stump was not significantly increased as compared to the normal unoperated populatio

ISSN:0007-1323    

DOI:10.1002/bjs.1800640510

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractThe authors report the development of an extensive right chylothorax several days after Dwyer's anterior instrumentation in a 6‐year‐old girl with a severe progressing infantile scoliosis. Instrumentation extended from T11 to L4 with removal of the tenth rib and with splitting of the diaphragm. The postoperative course was initially without any problems. However, respiratory distress on the tenth day after surgery was accompanied by mediastinal shift and the symptoms were relieved with aspiration of 600 ml of chyle from the right pleural cavity.The literature on this complication of chylothorax is reviewed; it has been observed in cardiothoracic surgery. The management of the case is reported in detail and methods of detection and treatment are discus

ISSN:0007-1323    

DOI:10.1002/bjs.1800640511

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY