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Biomedical subjects

B A Scobie

Publications and source records attributed to B A Scobie.

At least 19 recordsLinked to original sources
PubMed1998

Gastrointestinal emergencies with marathon-type running: omental infarction with pancreatitis and liver failure with portal vein thrombosis.

This paper reports two patients with catastrophic complications after marathon-type running not hitherto documented. The first, who collapsed with acute abdominal pains, was found at surgery to have infarction of the omentum and later, after a second laparotomy, acute oedematous pancreatitis. The second patient, who collapsed semi-comatose with hyperthermia, developed disseminated intravascular coagulation, rhabdomyolysis, renal shutdown and progressive hepatic failure. With regular dialysis, his condition stabilised but liver function continued to decline, associated with thrombosis of the portal vein. The spectrum of potentially life threatening disorders includes upper gastrointestinal bleeding, haemorrhagic colitis and rarely infarction of the bowel. The present two cases provide further support for ischaemia being a major contributor to the gastrointestinal catastrophes of marathon-type running.

Acute Disease↗
PubMed1988

Endoscopy in peptic diseases and bleeding: a community survey of 1635 patients.

Panendoscopy was analysed prospectively on 1635 patients in a personal series for the years 1976 to 1979, under standard conditions, including for emergency bleeding. 48% of males showed lesions, compared with 38% of females. Important diseases were uncommon under 40 years of age, except for reflux disease of the oesophagus. Duodenal ulcer craters exceeded gastric ulcers in the ratio of 1.6 to 1.0. The 103 chronic gastric ulcers were analysed according to gender (male to female ratio 1.6 to 1.0), age (only 4% were seen under the age of 40), diameter and location (larger ulcers were more common in the body of the stomach than the antrum). Multiple gastric ulcers occurred in 9 patients, while pyloroduodenal ulcers coexisted with gastric ulcer in 7. Duodenal ulcers seen in 164 patients were multiple in 12; only 4% occurred under 30 years of age. The duodenal ulcer male to female ratio for Europeans was 2.5 to 1.0. Cancer of the stomach was uncommon (36 patients). Reflux oesophageal disease (182 patients) was the most common disorder diagnosed endoscopically. The commonest lesions found in acute bleeding (174 patients) were duodenal ulcer in 19%, gastric ulcer in 11%, oesophageal erosions 17% and gastroduodenal erosions in 17%.

Adult↗
PubMed1987

Peptic diseases compared endoscopically in indigenous Fijians and Indians.

Analysis was undertaken of 693 endoscopies performed in Suva, from July 1984 to June 1986. Although Indians presented more often in the ratio of 5:2, Fijians had a higher percentage of abnormalities. Gastric ulcer and carcinoma were more common in Fijians, whereas duodenal ulcer dominated in Indians. Gastric ulcer size and location showed no racial differences. Erosive disease of the oesophagus, stomach or duodenal bulb was uncommon in both races. Fijians were much more likely to present with bleeding, most commonly from gastric or duodenal ulcer (equal numbers).

Adult↗
PubMed1983

Recurrent vomiting in adults. A syndrome?

Recurrent vomiting in adults is characterized by episodes of forceful vomiting which last several hours and recur at inconstant intervals; patients are free from symptoms between episodes. The series comprised 17 male and 14 female patients whose ages ranged from 14 to 69 years. In 10 patients, the vomiting attacks were accompanied by diarrhoea, and in 10 by abdominal pain. Eight patients suffered from bilious vomiting in childhood, and 11 patients had migraine. Five patients gave a family history of recurrent vomiting. Management necessitated a sympathetic approach and balanced investigation. Prochlorperazine administered by injection was helpful in the alleviation of an acute attack, but the possible value of more specific antimigraine therapy remains to be established. Evidence supports a link with migraine, which has an association with other gastrointestinal disorders such as irritable bowel and oesophageal reflux. In cases in which pain is prominent, cholelithiasis should be carefully excluded, but cholecystectomy did not always cure vomiting attacks.

Adolescent↗
PubMed1982

Large bowel diseases in New Zealand based on 1118 air contrast enemas.

Colorectal disorders were analysed from a radiology practice, where specific data were indexed at the time of each examination. Among 1118 consecutive adults examined by air contrast barium enema, 49 were found to have colorectal cancer, 49 polyps, 35 inflammatory bowel disease and 395 diverticular disease. The 267 patients under the age of 40 showed no carcinoma, two with polyps, 18 with inflammatory bowel disease and 16 with one or more diverticula. Carcinoma, polyp, and inflammatory bowel disease were detected no more frequently in patients with diverticular disease than without. Complicated diverticular disease was rare. An analysis of specific symptoms with uncomplicated diverticular disease showed patterns of bowel habit, pain or bleeding, no different from patients with negative barium enemas. Of the 44 colon carcinomas, 28 were located in the sigmoid; bleeding was the major presenting symptom in 11, while two others were anaemic. The importance of sigmoidoscopy in assessing abdominal symptoms and rectal bleeding is stressed, along with the need for radiology in patients over, rather than under, 40 years of age.

Adolescent↗
PubMed1982

Staphylococcal toxic shock: two fulminant cases with recovery.

Two young women with toxic shock syndrome are reported and compared with three previous New Zealand cases. Both presented with fulminant diarrhoea, confusion, collapse and an erythematous desquamating rash. One, complicated by disseminated intravascular coagulation, rhabdomyolysis, myoglobinuria and renal failure, recovered following peritoneal dialysis. At the onset of their illnesses both were menstruating and using tampons. Light growths of Staphylococcus aureus were cultured from the vagina in one case and the faeces in the other. Successful treatment depended on a vigorous intensive care regime.

Acute Kidney Injury↗
PubMed1981

Acute oesophagitis due to emepronium bromide.

Six cases of endoscopically documented acute oesophagitis during therapy with emepronium bromide (Cetiprin) for urinary symptoms are described. The oesophagitis was associated with acute severe retrosternal pain and dysphagia which resolved spontaneously on stopping medication. The potential of this drug to induce severe oesophageal inflammation and ulceration should be emphasised.

Acute Disease↗
PubMed1980

Pseudomembranous colitis in a patient on rifampicin and ethambutol.

A fifty-seven year old male with renal tuberculosis developed pseudomembranous colitis on rifampicin and ethambutol. Diarrhoea occurred within a week, and six weeks after commencing these antituberculous agents he developed typical sigmoidoscopic and biopsy findings. Withdrawal of the drugs led to rapid recovery. Repeated challenge testing indicated that the symptoms were worse when rifampicin was given, but a test dose of ethambutol also produced temporary aggravation of the diarrhoea.

Biopsy↗
PubMed1979

Prognosis of completely healed gastric ulcer.

Eighty patients with chronic gastric ulcer, shown to have complete healing by gastric photography, were followed for 18 months to nine years. Ulceration recurred in 24, always at the site of the original ulcer, the majority (14) of relapses occurring within 12 months. Those with recurrent ulcers were more likely to show delayed healing of their initial ulcer, than the ulcers not shown to recur. At two months, this was statistically significant (P = 0.004) and even more so at three months (P = 0.004). Recurrences were more frequent in males (P = 0.09). There were no differences in ulcer site or size compared with those ulcers not known to have occurred. The appearance of complications such as perforation, haemorrhage, or malignancy was rare after complete healing.

Adult↗
PubMed1979

High gastric ulcer after Nissen fundoplication.

Three of 100 patients who underwent Nissen fundoplication developed gastric ulcers, all high on the lesser curve. Two patients presented one year after, and the third seven years after fundoplication. All healed with medical therapy, but a relapse in one patient necessitated partial gastrectomy. The pathogenesis, is not known, but vascular factors may be relevant. Patients complaining of epigastric pain after fundoplication require careful endoscopic examination for ulcer, especially near the cardia, since this may be a site of predilection.

Adult↗
PubMed1979

Co-existing coeliac and inflammatory bowel disease in a patient with Turner's syndrome.

A patient, aged 20, with Turner's syndrome was found to have both coeliac disease and chronic ulcerative colitis. Although a gluten-free diet restored to normal the jejunal biopsy, persisting diarrhoea was found to be due to coexisting left-sided ulcerative colitis. A search of the literature revealed only three detailed reports of chronic inflammatory bowel disease in coeliac patients, one of coeliac disease in Turner's syndrome and three of inflammatory bowel disease in Turner's syndrome. Growth failure with coeliac or inflammatory bowel disease in females, may call for a chromosomal study, even in the absence of webbing of the neck. The reason for three uncommon disorders occurring in this patient remains obscure.

Adult↗
PubMed1976

Hepatic cirrhosis, alcohol and haemorrhage.

Fifty consecutive patients with cirrhosis of the liver were investigated, including 29 with gastrointestinal haemorrhage. Over two-thirds of these patients gave a history of heavy alcohol intake. The necessity for fibre-endoscopy is stressed in that barium studies alone showed oesophageal varices in only 40 percent of patients and erosive lesions were often present. Gastric varices, demonstrated by gastrophotography in 25 percent of patients with portal hypertension, were not readily detectable by standard barium meal or endoscopy. Radio-isotope scanning of the liver and spleen was invaluable in supporting not only the diagnosis of cirrhosis, but also the presence of portal hypertension, since the spleen was palpable in only 50 percent of such patients.

Alcoholism↗
PubMed1976

Successful bismuth (De-Nol) therapy for gastric ulcer.

Fourteen patients with chronic gastric ulcer were treated with a bismuth preparation (De-Nol) on an outpatient basis. The healing rates were good as with hospital admission and better than a control group of outpatients.

Bismuth↗
PubMed1976

Endoscopically controlled trial of alginate and antacid in reflux oesophagitis.

A double-blind crossover trial of Gaviscon (alginate/alginic acid plus antacid) versus standard antacid is reported in 20 patients with symptomatic hiatus hernia. Gaviscon was well tolerated but clinical improvement was equally good with antacid in this short-term (six-week study). At the beginning, endoscopic evidence of erosions or "oesophagitis" was common (in 12 of the 20 subjects). Oesophagoscopic evidence of improvement was seen in 50% of patients with both types of medication over a three-week period, compared with subjective improvement in 84%. Long-term studies are necessary to establish the natural history of peptic lesions of the oesophagus and their treatment, whether conservative or surgical.

Adult↗