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Biomedical subjects

G A Ganepola

Publications and source records attributed to G A Ganepola.

11 recordsLinked to original sources
PubMed1999

Are pancreatic tumors hormone dependent?: A case report of unusual, rapidly growing pancreatic tumor during pregnancy, its possible relationship to female sex hormones, and review of the literature.

The occurrence of a pancreatic tumor in a young patient is rare. However, when one identifies a pancreatic mass during pregnancy and particularly when the lesion is located in the tail of the pancreas, "unusual tumors" of the pancreas should be considered. The management of these tumors during pregnancy presents unusual challenges because of rapid tumor growth probably related to elevated levels of sex hormones. An immunohistochemical study was done to evaluate for hormone receptors of the tissue removed from the tumor. We present a case of a 37-year-old female patient in her 4th week of pregnancy who was found to have a pancreatic mass; she was followed with ultrasonography. At the 23rd week of gestation, the tumor increased in size to more than 12 cm and required resection. Immunohistochemical studies were done to evaluate receptors for progesterone, estrogen, PS2-estrogen-related protein, pancreatic polypeptide antigen, flow cytometry, DNA ploidy, and proliferative activity in tumor cells. Pathology showed a low-grade multiloculated mucinous cystic neoplasm of the pancreas. There was a positivity for progesterone receptor and PS2-estrogen-related protein but not for estrogen receptor in the tumor. We conclude that a pancreatic mass detected during pregnancy requires a different consideration for its management. Early tissue diagnosis with CT or ultrasound-guided biopsy is essential. Even those lesions diagnosed as benign would require early intervention because of their rapid growth, probably influenced by female sex hormones.

Adult↗
PubMed1987

Localization and retrieval of bullets under ultrasound guidance.

From May 1985 to February 1986, high-frequency B-mode real-time ultrasound examinations proved helpful in localizing bullets that were not palpable externally in the extremities and body wall of six patients. Of these, four patients had bullets removed successfully with the ultrasonically guided needle puncture technique. The entire procedure was carried out independently at the bedside by the surgical team. We further concluded that surgeons would benefit by learning and using ultrasound, a technique that is relatively easy to acquire and that has broad potential for surgical application, especially in the operating room.

Adolescent↗
PubMed1987

Thrombosis of noncatheterized internal jugular vein: a unique complication of subclavian catheterization diagnosed by ultrasound.

Using portable high-resolution real-time B-mode ultrasound, the authors observed the phenomenon of thrombosed internal jugular vein in four patients who had prolonged indwelling ipsilateral subclavian catheters with or without catheterized subclavian vein thrombosis. Of these, thrombosed internal jugular vein was found incidentally in three patients with no specific findings suggestive of this complication.The origin of this uncommon complication is thought to be flow stasis in the internal jugular vein due to multiple factors associated particularly with turbulence at the jugulo-subclavian junction and the effect of hyperosmolar solution on blood cells. Treatment consists of removal of the catheters and heparinization when indicated. The authors recommend high-resolution ultrasound in the detection and follow-up of this unusual complication.

Aged↗
PubMed1987

Cardiac tamponade resulting from massive chylopericardium after an aorta-coronary bypass operation.

Isolated chylopericardium after a cardiac operation is a rare clinical entity. A case of isolated chylopericardium with cardiac tamponade after a single aorta-coronary artery bypass graft in a 49-year-old man is presented. Nonsurgical management was unsuccessful. Multiple surgical procedures were necessary for complete control of this difficult problem. The cause of chylopericardium in this patient appears to have been injury to the tributaries of lymphatic ducts in the pericardium.

Cardiac Tamponade↗
PubMed1986

Acute soft tissue infection in intravenous drug abusers: its differential diagnosis by ultrasonography.

Portable, real-time, B-mode ultrasonography was used by surgeons to diagnose acute soft tissue infections in intravenous drug abusers. It was helpful in differentiating simple cellulitis from abscess and in detecting pseudoaneurysm and thrombophlebitis. The authors conclude that ultrasonography as an initial diagnostic method for these types of lesions provides both early diagnosis and early treatment, thereby shortening hospital stay and reducing complications.

Abscess↗
PubMed1984

A case of total esophago-gastro-duodeno-jejunectomy and partial pancreatectomy for lye burns, and reconstruction with colon interposition.

We report a unique case of extensive surgery for severe lye burns. It included total esophago-gastro-duodeno-jejunectomy and partial pancreatectomy. We were unable to find a similar successfully treated case in English-language literature. Ninety-one days after the initial emergency surgery, the patient successfully underwent reconstruction of alimentary tract with isoperistaltic left colon interposition between proximal cervical esophagus and ileum.

Burns, Chemical↗
PubMed1981

Necrotizing fasciitis.

Fourteen patients with necrotizing fasciitis seen over a 5 year period at a public hospital are reviewed. Middleaged men predominated. The disease followed such diverse initiating causes as self-injection with heroin, boil, ischiorectal abscess, perforated occult colonic cancer and trivial abrasions. In a few cases there was no evidence of an initiating lesion. Necrotizing fasciitis affected the arms, legs, trunk and neck. Bacteriologic analysis showed that the disease is usually caused by gram-negative bacilli and hemolytic streptococci, alone or in combination. Morbidity and mortality rates in the present series were influenced by associated clinical conditions such as old age, diabetes mellitus, carcinoma and gram-negative bacteremia.

Adult↗
PubMed1979

Unusual presentations of carcinoma of the right colon.

Two unusual presentations of carcinoma of the right colon are described. One of the two patients presented with a right gluteal abscess and the other presented with a colocutaneous fistula to the anterior abdominal wall at the site of a previous appendectomy scar. Despite extensive local tumor invasion of adjacent structures in both cases, all the regional lymph nodes were free of cancer and the tumors were of low-grade malignancy. A review of the literature indicates that bulky colonic tumors with extensive local invasion and negative mesenteric lymph nodes have a relatively good prognosis if adequate resection is performed.

Abdominal Muscles↗