Biomedical subjects
Publications and source records attributed to C L Ong.
Trauma is a leading cause of death in the 1-44 age group. In our study, the most common cause is road traffic accidents followed by stab wounds and falls from height. Blunt abdominal trauma accounted for 79% of the cases. The spleen and liver were the most common organs involved in blunt abdominal trauma. Clinical assessment of blunt abdominal trauma is unreliable. The diagnostic peritoneal lavage is a useful triage tool in the initial assessment.
Explore the source record for details and available documents.
The surgical treatment of carcinoma of the pancreas remains controversial. Over a 5-year period, 38 patients with histologically proven carcinoma of the pancreas who were operated on were studied to assess the length of survival. Seven were subjected to a 'curative' resection, 27 subjected to a palliative bypass procedure and four had a laparotomy and biopsy only. The mean survival was 8.7 months for the first group, 8.1 for the second and only 1.6 for those subjected to a laparotomy and biopsy only.
Over an 18-month period, 31 cholecystectomies were performed for empyema of the gall bladder. Analysis of these 31 cases showed that clinical features referable to the diagnosis and seriousness of this condition were few. The presence of a gall bladder mass was detected in only 35% of patients. In adopting a policy of early cholecystectomy for patients admitted for acute gall bladder disease, a low mortality rate of 3.2% was achieved for this group of patients with empyema of the gall bladder. Based on these results, we found that empyema of the gall bladder is another good reason to support early cholecystectomy.
Primary gastric lymphoma is a rare gastrointestinal lymphoma. The treatment of this condition remains controversial, especially the extent of surgical resection. Ten cases were operated on over a five-year period at our institution and the outcome was reviewed. Early results suggest no difference in survival whether the margin of resection was clear or not so long as postoperative chemotherapy was given. The outcome appear to depend more on the extent of the disease at the time of surgery. Full thickness involvement of the stomach wall with lymph node involvement were bad prognostic indicators.
A series of 195 clinically solitary thyroid nodules is presented and compared with a matching series reported a decade ago. Changes in the pattern of presentation, preoperative diagnosis and options of operative management are highlighted. Although the pattern of presentation has not changed significantly over the last decade, there was a shift noted towards reliance on fine needle aspiration for preoperative diagnosis. The false negative rate was two percent in this series and there were no false positives. There was also a shift towards more conservative surgery in the form of "nodulectomies" in the present series compared to the previous one. The incidence of malignancy in this series was 10.2 percent.
Two cases of foetal intracranial teratoma, diagnosed by antenatal ultrasound, are described. One is a mature teratoma while the other an immature form. The first case presented as epignathus with extracranial extension. Very few cases of fetal intracranial teratoma have been reported. These are uniformly fatal. A review of reported cases indicates that prenatal intracranial teratoma can be accurately diagnosed. Prenatal diagnosis would allow for multidisciplinary team approach and planned delivery in a tertiary care centre.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Five hundred twenty four consecutive barium enemas done over an 18-month period were reviewed in Singapore to ascertain the prevalence and distribution of diverticular disease in the large bowel. In this study, the prevalence rate was 20 percent, which is comparable to European and American studies but higher than similar studies in Asian countries. However, the distribution of the disease showed a predominance of right-sided disease (70 percent). This is a pattern that is markedly different from that seen in Europe and North America, where the disease involves largely the left side of the large bowel. The high prevalence rate in this series is at variance with the widely held belief that diverticulosis occurs less frequently in oriental communities.
Endometriotic involvement of the bladder, although uncommon, is being reported in the literature with increasing frequency. Three cases are presented which will serve to highlight the main features of the disease and its management.
Gall bladder perforation is a rare complication of cholecystitis. A definitive diagnosis is uncommon before surgery and the morbidity and mortality associated with this condition are high. We report six patients with gall bladder perforation to show the difficulty of making an early diagnosis. The history and the clinical findings of these patients are reviewed to highlight diagnostic pitfalls.
A male newborn infant with a giant epignathus associated with intracranial teratoma and obstructive hydrocephalus detected antenatally is reported. Only 4 similar cases have been reported in the literature. This disorder is uniformly lethal. We believe this is the first reported case of epignathus with congenital intracranial teratoma diagnosed antenatally by ultrasonography.
A case of in utero intestinal volvulus with haemoperitoneum, diagnosed prenatally by ultrasonography is reported. The diagnostic technique enables planning and prompt management of acute abdomen.
Thirty-five cases of advanced gastrointestinal malignancies were treated with the Nd-YAG laser for palliation of symptoms. Of the 35, 34 experienced good relief of their symptom. There were no major complications and minor complications occurred in four. The Nd-YAG laser was an efficacious means of providing symptomatic relief for such patients.
Explore the source record for details and available documents.
Fournier's gangrene was traditionally thought to arise spontaneously. More recently, cases with urological, perianal or systemic predisposing causes have been reported. This report describes four cases of Fournier's gangrene, all associated with a predisposing cause: two with diabetes mellitus, two secondary to urinary tract pathologies, and one secondary to an infected wound after an inguinal herniorrhaphy.