SMJ // December 1979, Volume 72 - Issue 12
Editorial
CARE‐Medico
Editorial
POPULAR BARBARISMS REVISITED
Primary Article
Cutaneous Myiasis in Visitors to Central America
ABSTRACTSix cases of cutaneous myiasis occurred in three groups of visitors to Guatemala between February and May 1978. Attack rates ranged from 12% to 50%. Furuncular lesions were generally multiple and involved both exposed and usually unexposed areas of the body. Parasitic fly larvae recovered from two patients were identified…
Primary Article
Shelf Reconstruction for Hip Dysplasia
ABSTRACTShelf reconstruction of the hip has been successful in 12 patients, with an average of 14 years' follow-up. Revision has been done in two to again give relief of pain and continued stability. Average age at the time of operation was 20 years.
Primary Article
Aortoenteric Fistula A Mandatory Early Operative Diagnosis
ABSTRACTThe records of eight patients with aortoenteric fistulas from 1961 to 1976 were reviewed. The aortoenteric fistulas were primary in three patients and secondary in the remaining five. The most common symptom was gastrointestinal hemorrhage, seen in seven of eight patients. Four patients also had fever. Seventy percent of patients…
Primary Article
How and When to Use Barium for Diagnosis of Small Bowel Obstruction
ABSTRACTThe diagnosis of intestinal obstruction is readily made when a patient presents with typical history and signs, and when plain films of the abdomen display characteristic findings. Some patients, however, constitute diagnostic problems because abdominal roentgenograms are still equivocal, even after repetition in four hours. In the unclear case, use…
Primary Article
Problems Encountered With Hyperalimentation in Critically Ill Patients
ABSTRACTAn analysis of complications arising from hyperalimentation in 17 septic patients in an ICU is presented. All developed hypophosphatemia. Hyperglycemia necessitated intravenous insulin in 16 patients. Hypoalbuminemia persisted in all patients despite 134 gm of protein a day. Abnormal liver function and azotemia were common. Catheter complications occurred in three…
Primary Article
Management of Persimmon Bezoars (Diospyrobezoars)
ABSTRACTSince 1946, 20 men and one woman aged 40 to 76 years (average 57) were operated upon for complications of diospyrobezoars. Shortly after eating persimmons, 11 (52.4%) had severe abdominal cramping, nausea, vomiting, and pyrexia. Twelve of 17 (70.9%) with gastric bezoars had hematemesis or melena caused by an associated…
Primary Article
Results of Corrective Surgery for Alkaline Reflux Gastritis
ABSTRACTReflux alkaline gastritis and esophagitis have been incriminated as a source of symptoms in achlorhydric patients after operation for duodenal ulcer. Documentation of such pathologic findings has increased due to widespread use of fiberoptic endoscopy. As reported in the literature, results of remedial operations have ranged from encouraging to excellent,…
Primary Article
Intraoperative Gastrointestinal Endoscopy in the Management of Occult Gastrointestinal Bleeding
ABSTRACTIntraoperative gastrointestinal endoscopy has become an increasingly valuable diagnostic and therapeutic adjunct in the management of a variety of complicated problems in surgical patients. At the Medical College of Georgia, intraoperative gastrointestinal endoscopic technics have been successfully used to locate the site and cause of occult gastrointestinal bleeding; to diagnose,…
Primary Article
Pancreatic and Duodenal Injuries Morbidity and Mortality of Surgical Management
ABSTRACTA retrospective review of pancreatic injury is presented. Twenty-five cases in which the pancreatic injury was either the sole or major injury were selected from over 100 cases of pancreatic injury admitted during the period 1970 to 1977. Eight pancreatic injuries resulted from blunt trauma and 17 from penetrating trauma….
Primary Article
Brunner's Gland Adenomas Clinical Presentation and Surgical Management
ABSTRACTTumors of the Brunner's glands are rare, and the etiology remains obscure. Bleeding is the most common presenting symptom and may be occult or exsanguinating. Gastric outlet or duodenal obstruction may also occur. Often there is a history of preexisting nonspecific upper gastrointestinal symptoms, or the adenoma may be an…
Primary Article
Bacteriologic Considerations in Perforated Necrotizing Enterocolitis
ABSTRACTDuring a ten-year period, 61 infants with perforated necrotizing enterocolitis were managed by bowel resection, enterostomy, and intravenous antibiotics. Aerobic and anaerobic cultures were taken of venous blood, from the peritoneal cavity at operation, and of any subsequent wound and/or intraperitoneal infection. No significant differences between fatal and nonfatal cases…
Primary Article
Pelvic Recurrence of Cancer After Abdominoperineal Resection of the Rectum
ABSTRACTRecords of 122 patients with carcinoma of the rectum treated by abdominoperineal resection at M. D. Anderson Hospital and Tumor Institute between 1967 and 1972 were reviewed with regard to local pelvic recurrence and survival. Local recurrence rates for men were: stage IB, 14%; II, 23%; and III, 21%; and…
Primary Article
Small Cell Carcinoma of the Lung Results of Combination Chemotherapy and Radiation Therapy
ABSTRACTA retrospective study of 244 patients treated for small cell carcinoma of the lung from Jan 1, 1971 to Dec 31, 1976 revealed that 34% of patients with local-regional disease who received radiation alone survived one year (median survival, seven months), and 53% with local-regional disease survived one year (median…
Primary Article
Mini‐Laparotomy for Bilateral Tubal Ligation in Lithotomy Position
ABSTRACTTwo hundred consecutive cases of mini-laparotomy for nonpuerperal bilateral tubal ligation done by a single gynecologist with the patient in lithotomy position are presented here. Technical aspects of the procedure, some innovative and some old, are presented in an effort to demonstrate a simple, low-risk alternative to laparoscopic sterilization.
Primary Article
Comparison of Staphylococcal and Nonstaphylococcal Endocarditis in Narcotic Addicts
ABSTRACTIn a 54-month retrospective review, we compared the clinical features of 26 narcotic addicts with staphylococcal endocarditis (group 1) and ten other addicts with nonstaphylococcal endocarditis (group 2). The admission temperature and the respiratory rate of patients in group 1 were significantly higher (P < .05 and < .02 respectively)…
Primary Article
Colposcopy in Anorectal Disease
ABSTRACTThe colposcope was introduced into colon and rectal surgery for the evaluation of anal and perianal disease. The standard technics of gynecologic colposcopy were used. The indications included evaluations of pruritus ani, condyloma, mass lesions, unexplained bleeding or pain, and follow-up of patients previously treated for carcinoma of the anus…
Primary Article
Tuberculous Peritonitis
ABSTRACTTuberculous peritonitis is an uncommon disorder and is often not considered on initial evaluation of ascites. A negative 5-TU PPD test, a normal chest roentgenogram, or a low level of ascitic fluid protein may erroneously direct attention away from tuberculosis. Failure to thoroughly evaluate nonmalignant exudative ascites, especially in alcoholics,…
Primary Article
Lidocaine A Neglected Anticonvulsant?
ABSTRACTAn elderly man had focal motor status epilepticus secondary to a frontal lobe hematoma. Phenytoin, phenobarbital, and diazepam did not stop the seizures. Intravenous lidocaine by bolus injection and continuous infusion rapidly controlled the seizures.
Primary Article
Clearance of Lidocaine by Hemodialysis
ABSTRACTBecause little has been known regarding the dialyzability of lidocaine, we studied the clearance of this drug by hemodialysis. The dialysance of lidocaine was found to range between 10.6 to 21.3 ml/min. Lidocaine-urea extraction ratio averaged 11%. Because of the low therapeutic and even toxic plasma levels, the amount of…
Current Concepts
Evaluation and Treatment of Urinary Candidiasis
ABSTRACTThe incidence of genitourinary fungal infections is increasing, and because of their lethal potential, early diagnosis and treatment is mandatory. Candida is the most common urinary fungus and is manifest as renal involvement from systemic candidiasis, primary renal candidiasis, bezoar formation, cystitis, and as asymptomatic candiduria. The clinical status of…
Current Concepts
Polycystic Kidney Disease Diagnosis and Management
Our Medical Heritage
Blood Transfusion in the South Before the War Between the States
Article
Eponym Theodor Billroth
“The success of an unprepared, half accidental operation occasionally makes the operation itself famous as a curiosity, but cannot absolve the surgeon from the accusation of frivolity: the fact that he has been lucky does not mean that his methods should be imitated.”1
