摘要:

AbstractOpinion is divided as to the necessary extent of parathyroid resection in primary hyperparathyroidism. Some surgeons urge that subtotal parathyroidectomy be performed routinely, while others reserve subtotal resections for patients with parathyroid hyperplasia.In a review of 102 patients treated by parathyroidectomy for primary hyperparathyroidism and subsequently followed up for an average of 6 years, there were 73 patients with parathyroid adenoma, 26 with hyperplasia and 3 with carcinoma. The adenoma was not found at the first operation in only 3 cases; in the other 70 after removal of the adenoma no further hypercalcaemia was observed during the follow‐up period. Persistent or recurrent hypercalcaemia was a problem in 9 out of the 26 patients with primary hyperplasia who had inadequate resection at the first operation, and also in the 3 patients with carcinoma.Experience shows that peroperative biopsy with frozen section of all the parathyroids is useful in confirming their identity and can be a guide to the type of disease present and the appropriate extent of resectio

ISSN:0007-1323    

DOI:10.1002/bjs.1800640302

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractThis paper reports the resection of a benign non‐toxic goitre measuring 75 × 60 × 45 cm in a patient aged 48 who was unable to walk or sit because of the size of the goitre. The tumour proved to arise from the right half of the thyroid. A right‐sided hemistrumectomy was performed under local anaesthesia with the patient prone. A temporary tracheostomy was established. The postoperative course was uneventful apart from slight necrosis of the wound edge. The patient was discharged in good health on the twentieth postoperativ

ISSN:0007-1323    

DOI:10.1002/bjs.1800640303

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractOne hundred and eighty‐one patients with carcinoma of the upper thoracic oesophagus were intubated perorally using a Procter Livingstone tube. The mortality was 16·6 per cent but, in the patients who survived, the palliation achieved, as judged by improved swallowing, was considered satisfactory. Factors influencing the success of intubation are also consider

ISSN:0007-1323    

DOI:10.1002/bjs.1800640304

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractThis paper reviews evidence and ideas on closed accidental rupture of the aorta, and refers to an analysis of 37 subjects in whom traumatic aortic ruptures were found at necropsy. The mechanisms of rupture of the ascending aorta and the proximal and distal parts of the descending aorta are discussed.Aortic rupture is one of the major causes of rapid death after traffic accidents, especially in occupants of motor vehicles. However, about 20 per cent of subjects survive for hours, days or longer after the accident, allowing time for surgical repair in some cases.

ISSN:0007-1323    

DOI:10.1002/bjs.1800640305

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractEight aneurysms of the femoral artery out of a total of 27 in 16 patients developed symptoms requiring surgery. The operation of choice was Dacron prosthetic replacement of the aneurysm with preservation of profunda femoris perfusion. The incidence of complications of aneurysms was 30 per cent. The asymptomatic aneurysms were untreated and did not cause the patients any inconvenience as observed at their follow‐up. Hence, surgery is advocated only for patients who develop symptoms provided that adequate follow‐up and community medicine facilities ex

ISSN:0007-1323    

DOI:10.1002/bjs.1800640306

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractTwo clinical variants of jejunogastric intussusception are described. In one, self‐reduction is the rule, whilst in the other strangulation occurs and emergency surgery is mandatory. A case illustrating each variant is presented and its diagnosis and treatment are discusse

ISSN:0007-1323    

DOI:10.1002/bjs.1800640307

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractCarbohydrate tolerance was studied in 8 dogs with pancreatic venous drainage to the hepatic portal vein and 6 dogs with pancreatic venous drainage to the systemic veins. While systemic venous drainage of the pancreas was associated with higher fasting plasma insulin and lower fasting plasma glucose levels, no significant differences in either glucose clearance or insulin response to glucose were detectable. Therefore, in the maintenance of plasma glucose homeostasis, administration of insulin into the portal vein offers no significant advantages over the easier systemic route.

ISSN:0007-1323    

DOI:10.1002/bjs.1800640308

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractA case of portal hypertension is presented in which because of the presence of multiple thromboses of the main portal branches one of the usual portasystemic shunts could not be performed. An anastomosis between an enlarged left gastro‐epiploic vein and the left renal vein was successfully carried out. Six months after surgery the patient was well and no further haemorrhage had occurre

ISSN:0007-1323    

DOI:10.1002/bjs.1800640309

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractSevere arterial hypoxia while breathing ambient air (Pao2<60 mm Hg) was recorded in 38 (45 per cent) of a group of 84 patients with acute pancreatitis when arterial blood gas monitoring was performed during the first week of illness. This contrasted with an incidence of 19 per cent severe hypoxia in a heterogeneous group of 68 patients with acute abdominal pain admitted as surgical emergencies. Clinical evidence of respiratory embarrassment was rarely present in either the patients with acute pancreatitis or the other patients. Arterial hypoxia was related to the prognosis in both groups.It is recommended that all patients with acute pancreatitis have routine arterial blood gas monitoring performed during the first 5 days of illness. Furthermore, all older patients (over 60 years) and younger patients with moderate hypoxia (Pao2<70 mm Hg) should be given supplementary humidified oxygen. An awareness of occult respiratory insufficiency in surgical emergency admissions, and especially in acute pancreatitis, is of importance.

ISSN:0007-1323    

DOI:10.1002/bjs.1800640310

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY

摘要:

AbstractOne hundred and twenty‐two patients have been studied in order to evaluate the usefulness of the amylase creatinine clearance ratio (ACCR) as a simple diagnostic test for acute pancreatitis. Sixteen out of 17 patients with acute pancreatitis had significant elevations in ACCR; in only 10 of these 17 cases was the serum amylase greater than 1200 iu|l. The mean ACCR was within the normal range in control patients, in patients with chronic gastro‐intestinal disease and in patients with acute abdominal conditions excluding pancreatitis; however, the mean serum amylase was significantly greater in patients with acute abdominal conditions than in the control group (P<0·05). The ACCR remained significantly elevated in patients with acute pancreatitis for longer than either serum or urine amylase values. The findings of the study suggest that the amylase creatinine clearance ratio is a simple yet reliable diagnostic test which could be used when screening patients suspected of having acute pancreat

ISSN:0007-1323    

DOI:10.1002/bjs.1800640311

出版商:John Wiley&Sons, Ltd.    

年代:1977

数据来源: WILEY