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D N Adamthwaite

Publications and source records attributed to D N Adamthwaite.

18 recordsLinked to original sources
PubMed1984

Malignant intra-abdominal testis. A case report.

A case of malignant change within an intra-abdominal testis is reported. The development in a Black man of a malignant testicular lesion with a mixed cellular picture on histological examination, the absence of serum tumour markers in the presence of a seminoma and the presence of local invasive spread--all uncommon features of testicular tumours--in combination make this a rare case. Orchiopexy does not reduce the risk of malignant change and in the postpubertal patient does not influence spermatogenesis. Orchiectomy is therefore advised for all maldescended testes and should be considered mandatory for all intra-abdominal testes.

Adult↗
PubMed1984

Laparoscopy at Baragwanath Hospital, Johannesburg.

The results of diagnostic laparoscopy in 42 patients are reviewed. A histological diagnosis was achieved in 23 of 26 cases of suspected intraperitoneal disease (15 cases of malignant disease, 4 cases of peritoneal or intra-abdominal tuberculosis and 4 cases of benign hepatic lesions in which percutaneous biopsy had failed to obtain a representative specimen). In 10 patients with abdominal trauma the source of the problem was identified, and in 2 of these successful conservative management was undertaken on the basis of the laparoscopic findings. In 6 patients with abdominal pain of unknown cause no lesion could be identified, and the procedure was abandoned in 2 patients because of dense intraperitoneal adhesions. There was no associated mortality and the morbidity rate was 0,5%.

Abdomen↗
PubMed1984

Gallstone ileus. A case report from Baragwanath Hospital.

Gallstone ileus is a rare complication of cholelithiasis and even rarer in negroid people, in whom cholelithiasis is far less common than in Whites. A case of gallstone ileus in a Black patient is reported. The clinical presentation was typical and spontaneous resolution with rectal passage of the calculus occurred on conservative management.

Adult↗
PubMed1984

Squamous carcinoma of the nail bed. A case report.

Primary carcinoma of the nail bed is a rare occurrence, and all cases yet reported arose in the fingers. Although often masked by chronic disease of the overlying nail or surrounding tissues, the lesion is slow-growing and spread of the tumour before diagnosis is rare. A case of primary squamous carcinoma of the nail bed of the right hallux, in which spread to regional lymph nodes had occurred, is reported. The tumour was treated by amputation of the toe, block dissection of the regional lymph nodes and adjuvant bleomycin chemotherapy. These advanced lesions are so rare that there is no standardized therapeutic regimen, but we believe that ablative surgery with adjuvant chemotherapy affords the best chance of cure. We recommend that biopsies be performed in all cases of recurrent and persistent disease of the nail bed so that early diagnosis and treatment can be instituted while the tumour is confined to its primary site.

Adult↗
PubMed1984

Melanin-producing medullary carcinoma of the thyroid gland. A case report.

A case of melanin-producing medullary carcinoma of the thyroid gland is reported. The histological characteristics of the tumour were typical of medullary carcinoma, immunohistochemical testing for calcitonin was positive, and neurosecretory granules were found to be present on ultrastructural examination. In addition the tumour was producing melanin and melanosomes were identified in the same cells which contained neurosecretory granules, suggesting that the tumour arose from a common precursor cell of neural crest origin capable of producing both calcitonin and melanin.

Adult↗
PubMed1984

Diaphragmatic hernia presenting itself as a surgical emergency.

Thirty-four cases of diaphragmatic rupture which presented themselves as acute emergencies are reviewed. The need for rapid and accurate diagnosis in these urgent cases is stressed and the place of various investigations is discussed. X-ray examination of the chest was found to be the best diagnostic aid, and in the difficult case computerized tomographic scanning was found to be time saving and accurate. Surgical repair through an abdominal incision is advised for most cases.

Adolescent↗
PubMed1983

Treatment of haemorrhoids with rubber band ligation.

Over a 2-year period 52 patients with symptomatic haemorrhoids were treated by rubber band ligation using a Baron haemorrhoidal ligator. Of a total of 123 haemorrhoids 94 resolved after the initial procedure, 17 required a second treatment before resolution, and 12 required a third treatment. In spite of physical resolution of all haemorrhoids treated, 6 patients still had symptoms, although 5 of these reported an improvement. Symptoms which appeared after ligation in 7 cases were of a minor nature and disappeared without further therapy. The procedure is recommended as first-line treatment for symptomatic haemorrhoids.

Hemorrhoids↗
PubMed1983

Traumatic pericardiophrenic hernia: a report of 3 cases.

Three cases of traumatic intrapericardial diaphragmatic hernia are reported. The defect was limited to the central tendon of the diaphragm in all 3 cases with herniation of the transverse colon (n = 2) or small bowel (n = 1) into the pericardial sac. A correct preoperative diagnosis was made in all 3, using a dilute barium meal in 2 patients, and from the chest X-ray examination alone in 1. Successful operative repair was performed. Previous reports suggest that barium studies of the gastrointestinal tract are the most accurate method of diagnosis but should be used with caution as they may precipitate cardiac tamponade through distension of herniated bowel.

Adult↗
PubMed1983

Particulate activity in urine.

A new method of measuring urinary particulate activity is described. The analytical process, using a Coulter Counter, is designed to have minimal effect on the dynamic nature of the specimen. Emphasis is placed on conducting the analysis during the first 5 min following voiding, preventing changes in temperature and pH and avoiding any form of dilution of the specimen. Urinary particulate activity is measured by quantitatively evaluating the spontaneous changes which occur in particulate number and size. Resulting values demonstrate clearly defined differences between urine specimens which appear biochemically similar. The results are reproducible under stable conditions but are significantly altered by temperature and pH change, or dilution of the specimen. This method measures the urinary potential to form precipitates and ultimately stones, and should be included in any investigation of urinary calculus disease.

Humans↗
PubMed1983

Urinary particulate activity in urinary calculus disease.

In urinary calculus disease there remains a group of patients with no demonstrable biochemical abnormality. A method is described measuring particulate activity in freshly voided urine using a Coulter Counter, which demonstrates the abnormality in these cases. Urine from 100 normal controls and 100 persons with urinary calculus disease was analysed, demonstrating a statistically significant difference between the 2 groups (P less than 0.001).

Humans↗
PubMed1983

Traumatic diaphragmatic hernia.

The etiology, diagnosis and management of traumatic diaphragmatic hernias were discussed, and a personal series of 61 hernias was reviewed. The need for a greater clinical awareness of the condition was stressed. Chest roentgenograms were shown to be the most effective diagnostic method, and thoracoscopy was recommended in all hernias that occurred within 24 hours of the injury. Barium contrast studies of the gastrointestinal tract have limitations, and caution was advised with these methods when dealing with patients presenting in acute crisis. Computerized tomographic scanning is becoming increasingly more valuable in the investigation of this condition, but the author hesitates to recommend its routine use. A plea was made for the abdominal approach to diaphragmatic hernias. The value of this approach was illustrated by the successful repair of 58 of 61 hernias through a laparotomy.

Adolescent↗
PubMed1982

Penetrating injuries of the diaphragm.

Thirty-two cases of penetrating injuries of the diaphragm are reviewed. The problems of clinical and radiological diagnosis are outlined and the pitfalls of barium contrast studies are illustrated. Thoracoscopy is advised in all cases seen within 24 hours of the injury. Surgical access via laparotomy is recommended in both acute and chronic cases and where additional thoracotomy is necessary, separate abdominal and thoracic incisions are advised. The presence of colonic injury is shown to increase the risk of both wound sepsis and empyema postoperatively, whilst other visceral injuries do not appear to affect postoperative morbidity.

Adolescent↗
PubMed1978

Management of blunt pancreatic trauma. A report of 3 cases.

Three cases in which the sole injury was a major pancreatic laceration secondary to closed abdominal injury are presented, and the literature on major closed injuries of the pancreas is reviewed. The diagnosis, surgical management and complications of closed injuries of the pancreas are discussed. Delay in diagnosis, inadequate surgery and failure to recognize common complications of pancreatic injury are responsible for the current high mortality rates for this form of closed abdominal trauma.

Adult↗