Heterotopic gastric mucosa presenting as small-bowel obstruction.
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Biomedical subjects
Publications and source records attributed to A H Chapman.
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As embolism of small bowel arteries carries the risk of bowel infarction, the technique is usually reserved for situations where a vasopressin infusion has failed to control bleeding. We report three cases in which embolisation was used as the primary treatment to control small bowel haemorrhage without the complication of bowel infarction.
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A case of massive lower gastrointestinal bleeding from Crohn's disease is reported. This is an uncommon complication of the disease and the literature is reviewed. Successful control of gastrointestinal bleeding by intra-arterial vasopressin infusion has not previously been reported in Crohn's disease. We suggest that this technique may be used in an attempt to avoid surgery.
One of the major contributions of the American psychiatrist Harry Stack Sullivan (1892-1949) was the elimination of the concept of the mind from his system of psychiatric thought. He based all his concepts of personality development, and the nature of those psychiatric illnesses which are caused by emotional factors, on interpersonal relationships. Interpersonal relationships, in contrast to the functions of the mind, can be directly observed, and any principles based on interpersonal relationships can be submitted to experiments which can be proved or disproved by psychiatric investigators. The works of Sullivan thus furnish a path by which psychology and psychiatry can in time develop into truly scientific specialities.
We have found that Tc-99m methylene diphosphonate imaging of the heel is of diagnostic value in the "painful heel syndrome," permitting positive identification of the site of inflammation in cases where radiography is unhelpful. With this technique, tracer uptake in the heel is susceptible to quantification, allowing a serial and objective assessment of response to therapy.
The plain chest X-ray of 12 patients with hypertrophic cardiomyopathy were found to be grossly abnormal and atypical of this disease. Four patients presented with enlarged globular shaped hearts suggesting dilatation of all cardiac chambers. In a further four this appearance was seen to develop over a period of years and four patients were found with marked left atrial enlargement. On reviewing the echocardiographic, angiographic and necropsy data it was noted that the cardiac enlargement was produced by dilation of the atria and the right ventricle but not the left ventricle.
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