Biomedical subjects
D K Bhargava
Publications and source records attributed to D K Bhargava.
Cytologic examination as an adjunct to laparoscopy and guided biopsy in the diagnosis of hepatic and gallbladder neoplasia.
Laparoscopic examination guided biopsy and cytologic examination of samples obtained by aspiration, brush or scrape from the liver or gallbladder were performed on 26 patients suspected of having hepatic or gallbladder neoplasia. Laparoscopic findings were diagnostic of hepatic neoplasia (primary or secondary) in 13 cases and gallbladder carcinoma in 9 cases. The yields of positive diagnoses on biopsy alone, cytology alone and combined biopsy and cytology were 11 (84.6%), 11 (84.6%) and 12 (92.3%), respectively, in cases of hepatic neoplasia and 4 (44.4%), 5 (55.5%) and 5 (55.5%), respectively, in cases of gallbladder carcinoma. The cytologic typing concurred with the histologic typing in six of ten cases (60%) of hepatic neoplasia and all four cases (100%) of gallbladder carcinoma. It is suggested that cytologic examination be used as an adjunct to histologic examination of guided biopsies in the diagnosis of hepatic neoplasia. It is also concluded that it is possible to make a tissue diagnosis in patients with gallbladder carcinoma by obtaining material for cytology and biopsy through laparoscopy.
Endoscopic sclerotherapy of oesophageal varices.
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Colonoscopy for unexplained lower gastrointestinal bleeding in a tropical country.
Two hundred and forty consecutive patients with recurrent lower gastrointestinal bleeding were studied by colonoscopic examination. These included 187 adults and 53 children. The procedure was successful either in identifying the lesion or in excluding it up to the cecum in 216 (90% patients). The source of bleeding was identified in 138 (74%) adults and 43 (81%) Children. Predominant lesions in adults were nonspecific colitis and ulcers (58%), polyps (19%), cancer (10%), rectal varices (4%) and tuberculosis (3%). Juvenile polyps (77%) and nonspecific colitis and ulcers (23%) were the cause of bleeding in children. Both in adults and children, 92% of these lesions involved the left colon. Rectum and sigmoid colon were mainly involved. Diffuse lesions were seen when nonspecific colitis and ulcers were the source of bleeding. Thus colonoscopic examination was useful in localizing the cause of rectal bleeding and the predominant lesions were different from those reported in the Western hemisphere.
Gastrointestinal leiomyomas in a developing country.
Twenty one consecutive patients with leiomyoma of the gastrointestinal tract were studied. Recurrent gastrointestinal bleeding was found in 18 (85.7%) and recurrent intestinal obstruction in 3 (14.3%) patients. The commonest site of the lesion was the stomach followed by ileum, jejunum and duodenum. Barium meal examination and gastrointestinal endoscopy were suggestive of the diagnosis in 8 and angiography in 2 patients. The remaining patients were diagnosed peroperatively. All patients underwent excision and remained asymptomatic on follow up except two patients who had a recurrence of the tumor as leiomyosarcoma.