Ejaculatory pain associated with a pelvic arteriovenous malformation.
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Biomedical subjects
Publications and source records attributed to D F Shepherd.
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A series of 1578 consecutive colonoscopies performed by radiologists in training is reviewed, with specific reference to patients with colorectal neoplasms. The contribution of the radiologist to the practice of colonoscopy is discussed. This input to the colonoscopy service of a hospital carries several benefits, including the following: a link is established between radiologists and gastroenterologists which improves the standard of both barium enema and colonoscopic examinations; informed discussion is made possible about the suitability of a barium enema lesion for endoscopic removal; the endoscoping radiologist acquires an impartial view of each examination and is able to choose the more appropriate investigation; direct visualisation of the colonic mucosa and its abnormalities may facilitate the interpretation of barium radiographs and enhance the quality of the radiological training that can be offered. In our experience, participation in a weekly colonoscopy session has had no adverse effect on the routine work of the radiology department.
Angiodysplasia of the colon is a relatively common cause of blood loss in the elderly. Electrocoagulation through a colonoscope is a common mode of treatment for this condition. Three patients are presented who had associated hemostatic defects and electrocoagulation resulted in life threatening secondary hemorrhage. In two of these patients a right hemicolectomy was performed. On the basis of these findings we suggest that patients with angiodysplasia and associated hemostatic disorders have a greatly increased risk of secondary hemorrhage following electrocoagulation treatment. These patients should be followed closely for two-three weeks following this treatment.
The rare finding of a cecal fecalith in an 8-year-old child is described together with a review of similar cases. These indicate not only the difficulty of diagnosis, but the dilemma faced by the surgeon at the operation.
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The frequency and extent of lumbar spondylosis is no greater in patients with Paget's disease (osteitis deformans) affecting the lumbar spine than in control groups, whether or not the disease is accompanied by deformity of vertebrae, and we have found no evidence that Paget's disease predisposes to our enhances lumbar spondylosis. The similarity of distribution of the Paget's disease and of degenerative spondylosis raises the possibility that bone stress may be an aetiological factor in the formation of Paget's disease of bone.