PubMed Health⌕ Search

Biomedical subjects

E Mavor

Publications and source records attributed to E Mavor.

24 records · Page 2Linked to original sources

Cecal volvulus.

A review of 561 cases of cecal volvulus that were published between 1959 and 1989 along with 7 new cases, was performed to characterize the clinical and laboratory profile and to evaluate the various surgical options in treating this life-threatening condition. The age and sex distribution of these patients have changed over the years and shifted toward older patients (mean, 53 years) and female predominance (female:male ratio, 1.4:1). The clinical presentation was usually of distal closed-loop small bowel obstruction. Forty-six percent of the plain abdominal radiographs were suspected for cecal volvulus, but only 17 percent were diagnostic. Barium enema had a high rate of accuracy (88 percent) and was associated with minimal complications. True volvulus was 6 times more common than bascule, and gangrenous cecum was found in 20 percent of cases. Detorsion alone and cecopexy had almost similar complications, mortality, and recurrence rates (15, 10, and 13 percent, respectively), whereas, resection, which was performed primarily for gangrenous cecum, had higher rates. However, the highest rates of complications (52 percent), mortality (22 percent), and recurrence (14 percent) were noticed after cecostomy. These data suggest that resection should be reserved for patients with necrotic cecum and that detorsion is sufficient for patients with viable cecum. Cecostomy should be abandoned.

Adolescent↗

[Retroperitoneal desmoid tumor and familial polyposis coli].

A 43-year-old woman with familial polyposis coli (FPC) and adenocarcinoma of the rectosigmoid was treated by total colectomy, mucosal proctectomy and construction of an ileal pouch with ileoanal anastomosis. A year after operation she developed a huge retroperitoneal desmoid tumor which on exploratory laparotomy was found to be nonresectable. A 21-month course of indomethacin followed by tamoxifen failed to induce regression of the tumor. Desmoid tumors appear in 3.5-29.0% of patients with FPC, mostly after colectomy. This possibility must be considered in the differential diagnosis of recurrent carcinoma of the colon. The preferred treatment of abdominal and retroperitoneal desmoid tumors is conservative, and includes the use of non-steroidal antiinflammatory drugs, ascorbic acid and tamoxifen.

Adenomatous Polyposis Coli↗

Brachial artery injury after cardiac catheterization.

During a 3-year period, 12,158 cardiac catheterizations were performed via the brachial artery. During this same period, 106 patients were operated on for complications of brachial artery injury and/or thrombosis, an incidence of 0.9%. The indication for the cardiac catheterization was coronary artery disease in almost 92% of the patients. Early (less than 4 days) brachial artery repair was done in 90% of the patients. The operative findings were thrombosis (91%), intimal injury (54%), stenosis (13%), laceration and/or perforation (11%), and atherosclerotic plaque (6%). Because of vessel injury, localized resection was done in two thirds of the patients. Vascular continuity was obtained with axial reanastomosis in 45 patients and interposition vein graft in 26 patients. Primary lateral repair was performed in 23 patients (22%). Ninety-five percent (101 patients) had initial excellent results. Of the five patients who required reoperation, flow was restored in four patients. Thus, 99% of patients had restoration of a patent brachial artery. Contributing factors for brachial artery complications are "redo" catheterization, prolonged catheterization time, catheter change, brachial artery atherosclerosis, improper arteriotomy closure, experience of cardiologist, female patient, and failure to use heparin. Because of the unpredictability of ischemic symptoms occurring after brachial artery thrombosis, the need for bypass graft surgery when delayed, and the good results with early surgical intervention, early exploration of brachial artery complications after cardiac catheterization and appropriate repair are recommended.

Adult↗

Nutritional effects of postgastrectomy reconstructions.

To compare the nutritional effects of two modes of reconstruction after total gastrectomy, a Hunt-Lawrence pouch was constructed in five mongrel dogs, whereas five other dogs had a simple Roux-Y esophagojejunostomy performed. Total body weight, daily food intake, serum albumin values, and intestinal absorption of carbohydrates, fats, and amino acids were evaluated in both groups over a period of 3 months. All values decreased postoperatively when compared with the preoperative values; however, there was no significant difference between the two groups. This study suggests that there is no nutritional benefit from a Hunt-Lawrence pouch over a simple Roux-Y esophagojejunostomy after total gastrectomy.

Animals↗