ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1976.tb03209.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

A prospective study of the surgical management of 100 consecutive patients with benign, non‐variceal upper gastrointestinal bleeding is presented. The manner of presentation, precipitating factors, investigations and associated medical problems are discussed. Chronic duodenal ulceration was the most common cause of hemorrhage. Vagotomy and drainage with oversaving or excision of the bleeding ulcer was the surgical procedure performed in 71 of the patients in the series. The incidence of recurrent bleeding was 7%; no patient in this category required further operation. The mortality rate was 6%, and there were no deaths recorded in the patients who underwent vagotomy and drainage. The reasons for the relatively low surgical mortality are discusse

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1976.tb03210.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

The first 15 years' experience with vagotomy and drainage for duodenal ulcer at the Royal Prince Alfred Hospital, Sydney, is summarized in a retrospective study. Proved ulcer recurrence in 16% of patients, a mortality rate of 2–6%, and a postoperative complication rate of 32% suggest that vagotomy and drainage as the procedure of choice in all patients with chronic and complicated duodenal ulcer sjiould be reconsidered. The delay in recognition of ulcer recurrence and the increase in the number of patients with longer follow‐up show disturbing similarities to the recurrence of ulcer after gastroenterostomy al

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1976.tb03211.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

Postbulbar duodenal ulceration is not common, but when present is difficult to diagnose and treat. Between January 1965 and September 1971, 1,080 patients with duodenal ulcers were treated surgically at St James Hospital. Forty‐one ulcers were found at operation to lie distal to the duodenal bulb. Pain was the most common indication for surgery. In six patients it was clinically indistinguishable from biliary pain, giving rise to diagnostic difficulty. Twelve patients (29%) presented with hæmorrhage, a percentage similar to the 25% of bulbar ulcers presenting with this complication over the period of this study. This is contrary to the finding in most other series, that postbulbar ulceration is more frequently complicated by hemorrhage than is bulbar ulceration. Perforation and stenosis are uncommon complications. Postbulbar ulceration is easily overlooked in conventional barium studies. Only one‐third of the patients subjected to barium meal X‐ray examination had their ulcers identified in the first study. In a further third the presence of an ulcer was suspected, and the remainder required multiple investigations for undiagnosed symptoms before the condition was demonstrated. Duodenoscopy was not performed in a sufficient number of patients for its value to be assessed, but other reports indicate that it should be a valuable manæuvre. The technical difficulties and potential hazards of Pólya gastrectomy are discussed and special reference is made to the surgical management of bleeding postbulba

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1976.tb03212.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

A patient with well‐controlled and currently asymptomatic ulcerative colitis had n unusually large polypoid lesions in his colon demonstrated by barium enema X‐ray examination and colonoscopy. Previous histological descriptions of inflammatory polyps did not adequately describe their morphology, and the term “hyperplastic inflammatory polyp” is su

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1976.tb03213.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

A review is presented of seven patients who have undergone a continent type of ileostomy, as described by Professor Kock. There has been no mortality. Two of the early patients had considerable difficulty with the functioning of the valve and required re‐operation. No patient in the series now wears an external appliance. Six of the seven are fully continent; the seventh reports occasional leakage, but is satisfied with the operation. The operation is considered to be still under trial, but is regarded as having great potential and likely to be much more widely practised in the futur

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1976.tb03214.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

A retrospective review of no patients who had their colostomies closed during the period from 1963 to 1973 has been undertaken. Their average age was 64 years. Diverticular disease and colorectal cancer had been the most frequent indications for the colostomy. Wound infection occurred in 36‐4% and facal fistula in 7m3%. These complications occurred less frequently in patients who had antibiotic bowel preparation. The overall mortality rate was 4.5%. Measures to reduce the morbidity and mortality are discusse

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1976.tb03215.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

Small‐bowel infarction resulting from mesenteric venous thrombosis is a rare but life‐threatening complication to which young women taking oral contraceptives are liable. The patient characteristically presents with an “acute abdomen” after a variable prodromal period of vague abdominal pain. The correct diagnosis can be made from the macroscopic appearance at laparotomy, provided the surgeon is alert to the condition. An accurate diagnosis is important, as anticoagulation measures must be instituted early to counter the commonly associated thromboembolic ph

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1976.tb03216.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

Data on 13 patients, including two not previously reported, with carcinoid tumours of the biliary tract are reported. In ten of them the primary tumour was located in the gallbladder and in three in the biliary duct. No specific symptoms were recorded, and the carcinoid syndrome has not been reported in carcinoid tumours of the biliary tract. In five patients the tumour was first found at autopsy. Metastases were found in three patients at operation or autopsy. Cholecystography can show either a functioning or a non‐functioning gallbladder. Some patients had concretions in the gallbladder. The prognosis appears to be good, and one of the patients reported survived so years with metastase

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1976.tb03217.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

The closure of a pharyngocutaneous fistula by the use of a posteriorly based tongue flap is described. The use of such a flap for this purpose has not been previously recorded in the literature.

ISSN:0004-8682    

DOI:10.1111/j.1445-2197.1976.tb03218.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY