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G Morris-Stiff

Publications and source records attributed to G Morris-Stiff.

35 records · Page 2Linked to original sources
PubMed1998

Pancreatic inflammatory pseudotumour: an uncommon childhood lesion mimicking a malignant tumour.

We describe a rare case of pancreatic inflammatory pseudotumour that clinically presented as a malignant tumour in an 11-year-old boy. We also review all six previously described cases, including three that occurred in children. Complete surgical removal is regarded as the best choice of therapy, and follow-up in our case showed no evidence of disease after 3 years. It is important to be aware of this lesion, since it can be confused with a malignant tumour both radiologically and clinically.

Child↗
PubMed1998

Gastroschisis and total intestinal atresia.

Gastroschisis is an uncommon condition which is now being detected at an earlier stage due to the use of routine antenatal ultrasound scanning. The presence of intestinal atresia secondary to impairment of the vascular supply is well recognised and is associated with a poorer outcome because of the potential for loss of bowel length. We report a case of gastroschisis in which there was resorption of the bowel and closure of the abdominal wall defect. At laparotomy there was total intestinal atresia.

Adult↗
PubMed1998

The continuing challenge of parastomal hernia: failure of a novel polypropylene mesh repair.

In an attempt to reduce the high recurrence rate after repair of parastomal hernia, a technique was devised in which non-absorbable mesh was used to provide a permanent closure of the gap between the emerging bowel and abdominal wall. Seven patients were treated during the period 1990-1992. Five-year follow-up has given disappointing results, with recurrent hernia in 29% of cases and serious complications, including obstruction and dense adhesions to the intra-abdominal mesh, in 57% and a mesh-related abscess in 15% of cases. This study highlights a dual problem--failure of a carefully sutured mesh to maintain an occlusive position, and complications of the mesh itself. The poor results obtained with this technique together with the disappointing results with other methods described in the literature confirms that parastomal hernia presents a continuing challenge.

Adult↗
PubMed1998

Chicken fancier's spleen.

Splenic epidermoid cysts are rare congenital lesions which usually present insidiously with non-specific symptoms such as dull left upper quadrant pain, or as incidental findings on clinical examination. We present a chicken breeder who presented as an emergency with a tender left upper quadrant mass and septicaemia secondary to zoonotic infection of a primary splenic cyst with Salmonella enteritidis. The cystic nature of the swelling was confirmed by ultrasound and the anatomy assessed with computed tomography. She was aggressively resuscitated and underwent laparotomy and splenectomy, after which she made an uncomplicated recovery. The importance of early diagnosis and surgical treatment is discussed, together with the measures required as prophylaxis against overwhelming post-splenectomy sepsis.

Adult↗
PubMed1998

Simple technique for non-operative removal of ureteric stents after renal transplantation.

Ureteric stents are employed peroperatively in renal transplantation when there is actual or suspected damage to the donor ureter. We describe a simple technique of suturing the distal end of the stent to the tip of a urinary catheter at the time of construction of the ureteric anastomosis. The stent is simply removed by gentle traction on the urinary catheter. This method obviates the need for a minor operative procedure or exposure to ionising radiation, which are the techniques commonly utilised at present. The procedure is also applicable to reconstructive urological procedures in which short-term stenting may be required.

Adolescent↗
PubMed1997

Conversion from cyclosporin to tacrolimus in a patient with prolonged acute tubular necrosis.

Acute tubular necrosis (ATN) is a common condition of following cadaveric renal transplantation with an incidence in many series of nearly 50%. The aetiology is uncertain; however, it would appear to be related to damage to the transplant kidney either prior to retrieval, During cold preservation or during re-warming of the kidney at the time of anastamotic construction. There is no specific therapy for ATN and treatment is comprised of an expectant policy with supportive dialysis and fluid restriction. Renal function improves in the majority of cases, though there may be delayed function for several weeks. We report a case of dialysis-dependent ATN that had persisted for 5 months following transplantation. Following conversion to tacrolimus there was immediate improvement in renal function, and after a month of tacrolimus therapy the patient was dialysis-independent.

Adult↗
PubMed1997

Abdominal wall hernia in autosomal dominant polycystic kidney disease.

BACKGROUND: Autosomal dominant polycystic kidney disease (ADPKD) is a common cause of renal impairment with a number of well recognized extrarenal associations. A high incidence of abdominal wall hernia was noted in patients with ADPKD. METHODS: A retrospective review of the notes of all patients with ADPKD on the South Wales renal replacement therapy database was performed. These patients were compared with age- and sex-matched patients with renal failure but without ADPKD and with general surgical patients. RESULTS: The prevalence of hernia in patients with ADPKD was 38 of 85 (45 per cent) compared with seven of 85 (8 per cent) for other forms of renal failure and three of 85 (4 per cent) for general surgical controls (P < 0.001). There were significantly greater numbers of inguinal (P < 0.001), incisional (P = 0.019) and paraumbilical (P = 0.007) hernias in patients with ADPKD compared with the other two groups. CONCLUSION: These results show a significantly greater incidence of hernia, which could be an additional manifestation of the underlying defect in extracellular matrix production identified in patients with ADPKD.

Adult↗
PubMed1997

Long-term results of surgery for childhood achalasia.

Childhood achalasia is an uncommon condition characterised by the absence of oesophageal peristalsis together with increased resting pressure and failure of relaxation of the lower oesophageal sphincter. The currently accepted management is a modified Heller's cardiomyotomy with Nissen fundoplication; however, the long-term results are uncertain. A retrospective review of the notes of 10 children undergoing surgical treatment of achalasia at our institution over a 23-year period were reviewed. There were six boys and four girls. The median age at onset of symptoms was 123 months and at diagnosis was 133 months. Five children were below average weight at the time of presentation. All underwent a modified Heller's operation and Nissen fundoplication. The follow-up ranged from 12 to 277 months with a mean of nearly 10 years. The results were excellent in terms of symptomatic improvement in eight of ten with one good and one moderate outcome. All children below average weight have shown improvement postoperatively. We would conclude that the management of achalasia in childhood should consist of an extended Heller's cardiomyotomy performed by the abdominal approach with the addition of an antireflux procedure such as Nissen fundoplication.

Adolescent↗