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Biomedical subjects

E J Gibney

Publications and source records attributed to E J Gibney.

18 recordsLinked to original sources
PubMed1992

Emergency appendicectomy: a one year audit.

A retrospective study of emergency appendicectomy over a one-year period at Beaumont Hospital was carried out. The overall normal appendicectomy rate was 22.8%, and was twice as high in women (31%) as in men (15%). Gangrenous or perforated appendicitis was present in 20% of cases. The overall mean assessment-surgery interval was 16.7 hours. Considerable variation in the use of antimicrobial agents was noted in the study, and many haematological and radiological investigations performed did not appear to improve diagnostic accuracy. Among patients with clinical features typical of appendicitis, 16% proved to have a normal appendix. These results point to a number of aspects of the diagnosis and management of appendicitis where there appears to be room for future improvement.

Acute Disease↗
PubMed1992

Hysterectomy in the rural tropics.

A retrospective study of hysterectomy at a rural hospital in Ghana revealed a high incidence of emergency cases. Uterine fibroids were the commonest indication for elective hysterectomy, followed by surgery for suspected cervical carcinoma. Most emergency hysterectomies were performed because of uterine rupture. The difficulties of managing these problems against the background of the diagnostic and therapeutic facilities available are discussed.

Adult↗
PubMed1991

Diverticulum of a Meckel's diverticulum containing a stone.

An 18 year old girl presented with acute abdominal pain and a calcified opacity in the pelvis. She proved to have a Meckel's diverticulum which had a secondary diverticulum at its apex, containing a stone. Meckel's stones are uncommon and diverticula of a Meckel's diverticulum exceedingly rare. This is only the second recorded case of such a diverticulum containing a stone, and the first to describe a calcified stone in this location.

Adolescent↗
PubMed1991

Volvulus of the sigmoid colon.

Volvulus of the sigmoid colon is an important condition, with multifactorial causes, that occurs worldwide, but with a marked variation in geographic incidence. Accurate diagnosis is essential for optimal management. Most patients can be managed by nonoperative decompression followed by elective resection of the sigmoid colon. When emergency laparotomy is necessary, resection is generally the best procedure. However, individualization of treatment is appropriate in medically compromised patients or in special circumstances. Current knowledge suggests that primary prevention is not possible, so better management is essential if the number of deaths associated with volvulus of the sigmoid colon are to be reduced. Sound clinical judgment still has an important role in the diagnosis and management of this disorder.

Humans↗
PubMed1990

Asymptomatic gallstones.

The increasing detection of asymptomatic gallstones leads to difficult decisions for the surgeon and patient about whether the stones should be managed expectantly or surgically. This review examines the evidence currently available upon which such decisions must be based. Gallstones may present as biliary pain, acute cholecystitis, biliary obstruction or pancreatitis, but it is not clear who will develop symptoms and what are the commonest initial symptoms. Studies of the natural history of silent gallstones suggest that a large majority of patients with such stones will remain asymptomatic. However, diabetics are at increased risk, as are patients whose stones are detected initially at laparotomy. Incidental cholecystectomy is usually safe, and preoperative detection by ultrasonic screening is an advantage in planning the operation. Prophylactic cholecystectomy is not indicated to prevent gallbladder carcinoma (except in cases of porcelain gallbladder) and there is conflicting evidence about whether cholecystectomy predisposes to colorectal carcinoma.

Adult↗
PubMed1990

Surgical aspects of malaria.

The spread of drug-resistant organisms and increased international travel makes malaria a disorder of ever-increasing importance. This report reviews those aspects of malaria of surgical relevance. The importance of the spleen in host defence against malaria and other infections makes splenic preservation desirable whenever possible after rupture of the spleen. Tropical splenomegaly is caused by an abnormal immune response to malaria and is best managed medically. Careful selection of blood donors is essential to prevent transfusion malaria, and routine antimalarial prophylaxis is indicated for blood recipients in many endemic areas. The risk of postoperative malaria may justify chemoprophylaxis in certain patients.

Female↗
PubMed1990

Coagulopathy and abdominal aortic aneurysm.

Coagulopathy has been described in association with intact, ruptured and repaired abdominal aortic aneurysm. This review examines the relationship and its clinical significance and outlines current management strategies.

Aorta, Abdominal↗
PubMed1989

Typhoid perforation.

Typhoid perforation of the bowel carries a high risk of mortality and is a common surgical problem in many developing countries. This review examines the pathogenesis, and discusses diagnosis and management.

Adult↗
PubMedDate not supplied

On-table lavage in the management of sigmoid volvulus: a review.

Sigmoid volvulus is a leading cause of bowel obstruction in many parts of Africa. Several aspects of management remain controversial, particularly the operative strategy to be adopted in patients in whom sigmoidoscopy has failed to deflate viable bowel. On-table lavage is especially useful in these circumstances, allowing safe primary resection and anastomosis. This short review summarizes the theoretical and clinical background to such an approach.

Emergencies↗