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A Hatfield

Publications and source records attributed to A Hatfield.

22 records · Page 2Linked to original sources

Cholangiopancreatography and pancreatic cytology in carcinoma of the pancreas.

Twenty-three histologically proved cases of carcinoma of the pancreas were investigated preoperatively with endoscopic retrograde cholangiopancreatography and cytologic examination of pure pancreatic juice collected after secretin stimulation. In 12 cases in which radiology was highly suggestive of carcinoma, cytology confirmed the result in seven. When radiologic findings were equivocal, cytology was helpful in two of six cases. Cytology was most helpful in the patients in whom no diagnosis could be reached radiologically due to tumor invasion of the structures adjacent to the papilla. Malignant cells were found in all cases.

Carcinoma↗

Upper intestinal surveillance in familial adenomatous polyposis.

Our understanding of the natural history of upper gastrointestinal (GI) involvement in familial adenomatous polyposis (FAP) is still evolving, although we know that the main cause of death after colectomy in FAP is upper GI malignancy, affecting 5% of patients. The aim of duodenal surveillance is to target high risk individuals and identify cancers early. We have screened 200 patients prospectively and have observed that duodenal polyposis progresses slowly, but there are some young people who have severe disease who merit close observation. We pay particular attention to endoscopic technique and histological detail, and use a duodenal staging system. Patients are offered randomisation to studies of chemopreventive agents, and those with advanced disease are considered for surgery. Successful management is inhibited by our deficient knowledge of the natural history of upper gastrointestinal polyposis, and by our inability to identify high risk individuals with histological markers rather than because of any technological deficiencies in endoscopic equipment.

Adenomatous Polyposis Coli↗