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Biomedical subjects

A E Rajagopalan

Publications and source records attributed to A E Rajagopalan.

4 recordsLinked to original sources
PubMed1982

Biliary colic and functional gallbladder disease.

We carried out a review of 358 patients undergoing cholecystectomy during a seven-year period. Twenty-one patients were found to have classic biliary colic with a normal oral cholecystogram. All patients were female and had symptoms for three to 120 months (mean, 24 months). Cholecystosonography, upper gastrointestinal (GI) tract x-ray series, and infusion tomography of the gallbladder, when performed, were normal. Twelve patients underwent cholecystokinin (CCK) cholecystography. Failure of normal contraction of the gallbladder was noted in all 12. All 21 underwent cholecystectomy; three months postoperatively, all patients were relieved of their pain, and 15 of the 16 available for long-term follow-up (averaging 22 months) were completely cured of their symptoms. We conclude that the young woman with typical biliary colic and a normal oral cholecystogram, gallbladder ultrasound study, and upper GI tract x-ray series should undergo CCK cholecystography. If the results are positive, these patients can be reliably cured by cholecystectomy.

Adult↗
PubMed1982

Free perforation of the small intestine.

Surgeons operating on patients with an obscure peritonitis should be aware of the diverse etiologies of small intestinal perforation and the general principles of management of each. A series of 16 adult patients with free perforation of the small intestine and spreading peritonitis in the absence of bowel obstruction, incarcerated hernia, or trauma is reviewed. Etiologies were as follows: Crohn's disease, four patients; foreign body ingestion, two patients; jejunal diverticulosis, one patient; lymphoma, two patients; cancer chemotherapy, one patient, amyloidosis, one patient; idiopathic, five patients. Although all patient presented with diffuse peritonitis, the findings of fever and leukocytosis were inconstant. Free air was demonstrated on radiographs in only eight of 16 patients, and the correct preoperative diagnosis was not made except in the four patients with Crohn's disease. Resection and primary anastomosis were utilized successfully in ten patients, the remainder of the patients undergoing oversewing the the perforation. Four patients (25%) died.

Adult↗
PubMed1977

The value of the barium enema in the diagnosis of acute appendicitis.

Contrary to popular belief, the barium enema is a safe diagnostic tool in the management of acute appendicitis. This is a survey of our experience over three years with 489 cases of suspected acute appendicitis. Two hundred eighteen barium enema examinations were done. The barium enema has a high degree of pathological correlation (97.14%). It has reduced negative surgical exploration in women between 11 and 40 years of age. This group traditionally represents the greatest diagnostic challenge in appendicitis. As a result, our negative exploration rate has been reduced to a figure below the average for this disease. We recommend its performance in all patients who pose a diagnostic dilemma.

Acute Disease↗