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Biomedical subjects

E B Gottfried

Publications and source records attributed to E B Gottfried.

15 recordsLinked to original sources
PubMed1986

Pneumoperitoneum following percutaneous endoscopic gastrostomy. A prospective study.

Percutaneous endoscopic gastrostomy (PEG) is a safe and widely used technique to establish an enteral feeding route. It has eliminated much of the operative morbidity associated with gastrostomy placed by laparotomy. The authors recently observed a patient who developed a benign pneumoperitoneum following PEG. Twenty-four patients were then prospectively studied after PEG to determine the incidence and significance of this finding. Nine patients (38%) developed radiologic pneumoperitoneum. Five patients (21%) had gross evidence of pneumoperitoneum, three patients had more subtle findings of small amounts of free air, and one patient had free air found by CT scan. No patient developed signs or symptoms of peritoneal inflammation. The authors conclude that pneumoperitoneum following PEG occurs frequently and that, in the absence of signs or symptoms of peritoneal inflammation, it is a benign finding which requires no further diagnostic or therapeutic intervention.

Adult↗
PubMed1984

Prospective evaluation of hospitalized patients with nonactive lower intestinal bleeding--timing and role of barium enema and colonoscopy.

A prospective evaluation of 176 hospitalized patients with nonactive lower intestinal bleeding demonstrated that a barium enema is not a necessary prerequisite for a sensitive and safe total colonoscopic examination. Colonoscopy was better in detecting colonic polyps and colon cancers than barium enema. It was concluded that colonoscopy without prior barium enema provides a sensitive diagnostic approach to hospitalized patients with nonactive lower intestinal bleeding. This approach does not interfere with the early use of angiography and may shorten hospitalization.

Adult↗
PubMed1984

Pneumoperitoneum after percutaneous endoscopic gastrostomy.

Percutaneous endoscopic gastrostomy (PEG) is a safe and widely used technique to establish an enteral feeding route. It has eliminated much of the operative morbidity associated with gastrostomy placed by laparotomy. Although pneumoperitoneum can be seen after surgery and in association with certain endoscopic procedures, it has not been seen after percutaneous endoscopic gastrostomy. We describe a patient who developed a benign pneumoperitoneum after insertion of a percutaneous gastrostomy tube.

Aged↗
PubMed1982

Cutaneous necrosis following peripheral intravenous vasopressin therapy.

Vasopressin infusion through peripheral veins is a commonly used modality for control of bleeding esophageal varices. A cirrhotic patient in whom multiple areas of cutaneous necrosis developed during a course of vasopressin therapy is presented. The involved areas included the infusion sites as well as sites unrelated to infusion but subject to pressure. Patients receiving this form of therapy must be carefully observed for the development of ischemic cutaneous complications.

Humans↗
PubMed1982

The association of remote Streptococcus bovis bacteremia with colonic neoplasia.

We prospectively studied five patients with a remote history of Streptococcus bovis bacteremia who had not previously been evaluated for colonic pathology. This study was prompted by several reports of concomitant neoplasia in patients with recent S. bovis bacteremia. The patients were studied at a mean of 32 months after bacteremia. Despite the absence of other signs or symptoms suggestive of bowel disease, a negative test for occult blood in stool and a negative fecal culture for S. bovis, two patients were found to have neoplastic polyps of the colon. These findings suggest that the risk of colonic neoplasia in patients with remote S. bovis septicemia is similar to that found in patients with recent bacteremia, but evaluation of a larger group of these patients will be necessary to establish this risk.

Adult↗
PubMed1980

Necrotizing amebic colitis with pseudomembrane formation.

We report a case of necrotizing amebic colitis with the sigmoidoscopic finding of a confluent, grayish pseudomembrane. The patient was referred from a chronic mental institution, which represents the patient population most susceptible to fulminant amebic dysentery in the United States. The pseudomembrane was a reflection of extensive mucosal necrosis and resolved with amebicidal therapy.

Colon↗
PubMed1980

Infected gangrene. A serious complication of peripheral vasopressin administration.

Vasopressin (Pitressin) infusion through peripheral veins is a commonly used modality for control of bleeding esophageal varices. In this report we describe the development of infected gangrene at the site of accidental vasopressin infiltration in a patient with diabetes mellitus, cirrhosis and bleeding esophageal varices. Among the explanations for the development of gangrene are: 1. continuous intravenous administration; 2. diabetic peripheral vascular disease; 3. mechanical compression of extravasated fluid in a closed space. No antagonist has been clinically proven to reverse the vasoconstrictive effects of vasopressin.

Esophageal and Gastric Varices↗
PubMed1979

Idiopathic familial cirrhosis and steatosis in adults.

A family was studied in which three middle-aged siblings had unexplained cirrhosis and steatosis. Five of nine additional family members had abnormalities of liver function. Liver biopsy in those 5 revealed steatosis in 3, steatosis and fibrosis in 1, and increase in lipofuchsin pigment in another. Detailed investigation revealed no known metabolic defect, adverse environmental exposure, or alcohol abuse. We postulate that this family represents a unique type of idiopathic familial cirrhosis. The role of steatosis in the pathogenesis of cirrhosis in this family remains unsettled. The HLA haplotype A24, B18, DRW 4 X 7 was found in several family members, but the association of the disease with the HLA system remains to be established.

Adult↗
PubMed1978

Alcohol-induced gastric and duodenal lesions in man.

To determine the effect of an acute dose of ethanol on the stomach and duodenum, seven alcoholic subjects with previously normal upper gastrointestinal endoscopy were reevaluated with endoscopy and directed biopsy three hours after the oral ingestion of ethanol (1 gm./kg. body weight) as a 35 gm./100 ml. solution. After ingestion of alcohol, all seven subjects had moderate to severe antral erythema and friability and two had patchy erosions and hemorrhage in the antrum and fundus of the stomach. Five of seven subjects had changes in the duodenal bulb consisting of erythema similar to that in the antrum of the stomach. Microscopically after alcohol, four of seven demonstrated focal subepithelial hemorrhage and another had frank mucosal hemorrhage in the antrum. In the duodenal bulb, four of seven subjects demonstrated focal subepithelial hemorrhage in the tips of bulbar villi and four of seven had striking infiltration of eosinophils in the subepithelial stroma. These histologic alterations were not present in prealcohol biopsies or in biopsies in two additional subjects given club soda alone or beef bouillon, or in repeat biopsies in two subjects re-endoscoped three days after the ingestion of alcohol when the endoscopic findings were again normal. It is concluded that a single dose of alcohol consistently causes macroscopic and microscopic antral and duodenal alterations.

Adult↗