[Diagnostic image (238). A girl with abdominal pain after a play-fight].
A 15-year-old girl presenting with abdominal pain after a play-fight was diagnosed with a duodenal rupture, which was surgically repaired.
Biomedical subjects
Publications and source records attributed to A J Julius.
A 15-year-old girl presenting with abdominal pain after a play-fight was diagnosed with a duodenal rupture, which was surgically repaired.
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99mTc macroaggregated albumin lung perfusion scans were performed with assessment of pulmonary hemodynamics in 14 male patients with a centrally located lung tumor, subjected to pneumonectomy. In 7 patients perfusion of the affected lung was less than one third of total perfusion. However, all tumors were resectable. Results show that predictive value of the perfusion scan was significant (p less than 0.02) with regard to forced expiratory volume in the first second (FEV1, r = 0.80). A fair but not significant correlation existed in the prediction of vital capacity (VC, r = 0.64) and total lung capacity (TLC, r = 0.71). No correlation was found between perioperative change in mean pulmonary artery pressure (MPAP) and either relative radionuclide uptake of the affected lung or predicted FEV1. So, the lung perfusion scan cannot be used in preoperative estimation of postoperative MPAP.
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From 1968 to 1983 123 patients were admitted with a diagnosis of pancreatitis; in 28 patients a pseudocyst developed. To evaluate results of surgical therapy a study of the literature and a chart review were performed. From this study we conclude that asymptomatic patients with a pseudocyst of 4 cm or less in diameter can initially be treated expectantly. If the pseudocyst is larger than 4 cm in diameter and in those cases where the cyst shows no tendency to spontaneous resolution, operative intervention seems mandatory. If no complications occur, surgery is postponed until six weeks' observation to allow maturation of the cyst and facilitate cystenteric anastomosis. In pseudocysts related to blunt abdominal trauma, endoscopic retrograde cholangiopancreatography (ERCP) should be performed. If ERCP reveals a major duct lesion, resection should be considered.
Complete bilateral, simultaneous and spontaneous rupture of the quadriceps tendon is exceedingly rare; 17 cases have been reported, four with no predisposing cause. This report documents a fifth case, being the first in Dutch literature. Although diabetes, primary or secondary hyperparathyroidism, lupus erythematosus and gout are well-known predisposing factors, this case illustrates that the condition can occur in a previously healthy older patient.
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