PubMed Health⌕ Search

Biomedical subjects

B M Thomas

Publications and source records attributed to B M Thomas.

At least 37 records · Page 2Linked to original sources

Morbidity study of submandibular gland excision.

Submandibular gland excision is an operation frequently performed by many different surgical specialists. It is often associated with a variety of postoperative complications, the commonest being neurological deficits related to damage to the marginal mandibular, lingual or hypoglossal nerves. Other patients develop further problems at a later date due to the development of calculi from gravel retained in the duct remnant. This study aims to discuss how these complications can be avoided.

Adolescent↗

Towards a radiologic definition of idiopathic megacolon.

Measurements of bowel width and rectal area were used to define normal limits of size in 50 double-contrast barium enema films. Two types of patient with constipation were defined by comparison with these results. In 18 women with prolonged whole-gut transit time, the measurements were within the normal range. Of 11 men and 9 women with a previous radiologic diagnosis of idiopathic megacolon, all had an enlarged rectum and the abnormal width extended proximally to involve the colon for a variable distance. A width of 6.5 cm at the pelvic brim provides a convenient and discriminating separation of normal from abnormal.

Chronic Disease↗

The balloon proctogram.

A balloon filled with barium has been used to simulate a soft stool for the radiological study of disorders of defaecation. Lateral radiographs demonstrate the level of the pelvic floor in relation to the pubococcygeal line, the change in the anorectal angle and the behaviour of the anal sphincters. In 12 patients with faecal incontinence, successfully treated surgically by postanal sphincter repair, the anorectal angle was reduced from 135 degrees +/- 4.4 degrees (s.e.m.) to 103 degrees +/- 4.1 degrees and the anorectal junction rose by 1.5 +/- 0.4 cm. In 10 patients with slow-transit constipation there was no pelvic descent and no change in the anorectal angle on straining. These patients were unable to expel the balloon and the results suggest that the pelvic floor does not relax normally.

Constipation↗

Diagnosis of carcinoma of the colon by barium enema.

Double-contrast barium enemas can detect 96% of colonic carcinomas. This is similar to the detection rate for colonoscopy. Single-contrast enemas compare badly. Small sigmoid tumours are most likely to be missed. Inadequate bowel preparation, single-contrast examinations and observer error account for most barium enema failures.

Barium Sulfate↗

Colonoscopic diagnosis of minimal change colitis in patients with a normal sigmoidoscopy and normal air-contrast barium enema.

8 patients with normal sigmoidoscopic appearances and normal results by high-quality air contrast barium enema had substantial or total colitis diagnosed for the first time at colonoscopy performed within a month of the radiological examination. Colitis was confirmed in all 8 patients by histological examination of biopsy specimens. Barium enema radiographs were independently reviewed by three experienced observers who also reviewed other normal and abnormal radiographs. One observer regarded all 8 sets of radiographs from the patients with colitis as being of normal appearance, and 4 patients were reported as having normal radiographs by all three observers. All 7 of the rectal biopsy specimens taken showed histological features of inflammatory bowel disease. This emphasises the importance of performing a rectal biopsy in patients with gastrointestinal symptoms of unknown cause.

Adult↗

The instant enema in inflammatory disease of the colon.

The instant, or unprepared, double contrast barium enema has been used routinely at St Mark's Hospital in the investigation of active inflammatory disease of the colon since 1963. The use of air contrast is preferred to show the fine detail of the mucosal changes and to detect early involvement. With the instant enema technique the diagnostic results are satisfactory and patients are minimally disturbed by the procedure. The majority of examinations consist of a total of four films, which includes a plain film of the abdomen prior to the administration of contrast. For short-term follow-up a repeat enema with a single film is usually adequate.

Air↗

Antral mucosal diaphragms in adults.

A group of 53 patients with the diagnosis of antral mucosal diaphragm is reported. In over 50% of the cases the diaphragm was considered an asymptomatic lesion. In addition, an autopsy study in 29 unselected cases is reported with demonstration of five antral mucosal diaphragms in different forms. On the basis of these findings, it is evident that the antral mucosal diaphragm in the adult is not an acquired lesion secondary to peptic ulcer disease, but may be congenital. In addition, techniques of radiologic evaluation of the diaphragm for significant narrowing of the central aperture using the compressed barium tablet, and for significant gastric outlet obstruction using the "barium burger" examination, are described.

Adult↗

Colonoscopy for unexplained rectal bleeding.

Two hundred and thirty-nine patients underwent colonoscopy for unexplained rectal bleeding. Local anorectal conditions were excluded by digital and proctosigmoidoscopic examinations and results of barium studies were negative for all patients. A cause for bleeding was found in 95 patients. Thirty-nine had adenomatous polyps, 24 had unrecognised inflammatory bowel disease, and most importantly 23 (10% of series) had carcinomas. Forty patients had diverticular disease, but nine of them were found to have an adenomatous polyp and four a carcinoma. Colonoscopy can contribute positively to the investigation and treatment of unexplained rectal bleeding and may prevent unnecessary laparotomy.

Colitis↗