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Biomedical subjects

G W Slagle

Publications and source records attributed to G W Slagle.

14 recordsLinked to original sources

Clinical significance of diminutive polyps of the rectum and sigmoid colon.

A retrospective review of 637 consecutive colonoscopies with polypectomy in 526 patients was performed to determine the association of small polyps of the rectum and sigmoid colon with more proximal colonic neoplasms. All colonic polyps were proximal to the sigmoid colon in 117 procedures. Proximal neoplasms were found in 32 percent of patients with a single polyp in the rectum or sigmoid colon. The incidence increased to 83 percent for those with three or more polyps. The occurrence of proximal colonic neoplasms was not affected by the size or histologic type of the rectosigmoid polyps. These findings would suggest that total colonic evaluation be considered in all patients with a polyp in the rectum or sigmoid colon regardless of the size or histologic type of the polyp.

Adenoma↗

Protein C activity, stage of disease, and vascular thrombosis in colon carcinoma.

To determine the etiology of the increased incidence of postoperative deep venous thrombosis (DVT) in patients with carcinoma of the colon, serum levels of protein C were measured preoperatively in 65 patients with colorectal adenocarcinoma. Noninvasive lower-extremity Doppler studies were performed on all patients prior to discharge to assess patency of the deep veins. Six patients (9%) were found to have DVT. The protein C level was considered elevated if it was greater than 125% of control values and reduced if less than 75% of control values. The development of DVT was found to be independent of the serum carcinoembryonic antigen, albumin, total protein, hemoglobin, hematocrit, platelet count, prothrombin time, partial thromboplastin time, and the patient's age and percentage of ideal body weight. There was an inverse relationship between the protein C level (p less than 0.001), Dukes stage of the tumor (p less than 0.001), and the development of DVT. Linear regression analysis revealed that only the tumor stage and the protein C level could be used to predict the development of DVT. The data show that for these patients with colorectal malignancy, the development of DVT may be related to decreased levels of protein C.

Adenocarcinoma↗

Small bowel obstruction after colon resection for benign and malignant diseases.

To determine the etiology and outcome of patients with small bowel obstruction after a colon resection for benign and malignant diseases, the medical records of 118 patients who underwent 120 laparotomies for small bowel obstruction were reviewed. Contrary to previous reports, benign adhesions were responsible for the obstruction in all patients with a history of benign colon disease, 82.6 percent of patients with a history of adenocarcinoma of the colon without known recurrence, and 30.1 percent of patients with known recurrent malignancy. The morbidity and mortality was more related to the etiology of the obstruction rather than the preoperative delay or operative procedure performed. Considering the high likelihood of adhesive obstruction in patients with a history of, or known, metastatic colorectal carcinoma, it is suggested that these not deter surgeons from aggressive early surgical intervention in these patients who develop small bowel obstruction.

Adenocarcinoma↗

Reliability of colonoscopy.

In an effort to determine the reliability of colonoscopy the authors retrospectively reviewed preoperative colonoscopic findings and compared them with the postoperative pathologic specimen reports. Only lesions greater than 0.5 cm were included in the comparison. Over a 13-year period, 429 patients with colorectal cancer underwent preoperative colonoscopy. Four hundred thirteen (97 percent) of the colonoscopic examinations correlated with the pathologic specimen, but, in 16 cases (3 percent), lesions were missed. In total, 17 adenomatous polyps and 3 cancers were found in the surgical specimens that were not documented at colonoscopy. Eighteen patients had total preoperative colonoscopy and total abdominal colectomy, which makes for a reliable model to judge the accuracy of colonoscopy. In these 18 patients, 17 of the pathologic specimens correlated with the endoscopic findings, which yields an accuracy rate of 94 percent. Blind areas in the colon, plus misjudgment that the scope had reached the cecum, are responsible for the majority of colonoscopic errors.

Colonoscopy↗

Colonic endometriosis: its clinical spectrum.

We have reviewed two cases of colonic endometriosis. The first demonstrates the more frequently encountered symptoms of partial large-bowel obstruction. The second demonstrates the less frequently encountered cyclic rectal bleeding occurring at or near the time of menses. Conventional diagnostic methods may strengthen a preoperative suspicion, but definitive diagnosis rests with exploratory laparotomy. Although hormonal and antigonadotropic agents have their places in therapy, surgical excision remains the choice procedure.

Adult↗

Crohn's disease of the epiglottis, aryepiglottic folds, anus, and rectum.

A 23-year-old white women complained of sore throat and difficulty in breathing. Examination of her larynx revealed chronic inflammatory changes of the epiglottis and aryepiglottic folds, and a biopsy demonstrated chronic granulomatous reaction. Six months later she developed chronic diarrhea, rectal pain, and typical anorectal findings of Crohn's disease. Biopsy of the anus revealed the same microscopic features as in the laryngeal structures. Treatment in keeping with the acceptable but limited measures for Crohn's disease brought improvement in both areas of inflammation. We feel this patient has Crohn's disease in the larynx, involvement which preceded that of the gastrointestinal tract.

Adult↗

Arterio-enteric fistulas.

The colorectal surgeon may well see arterioenteric fistulas in patients who have rectal bleeding. The initial bleeding usually stops, allowing time for evaluation, which should be done promptly because subsequent bleeding may be fatal. Exploratory laparotomy is frequently necessary to arrive at the correct diagnosis. Surgical management necessitates individual assessment of each case, but best results seem to be obtained when the infected graft is completely removed.

Aged↗

Drug-induced pseudomembranous enterocolitis: a new etiologic agent.

Pseudomembranous enterocolitis is an iatrogenic illness resulting from the oral or intramuscular use of broad-spectrum antibiotics. It is characterized by diarrhea, mucosal inflammation, and pseudomembrane formation in the gastrointestinal tract. The diagnosis is established by an index of suspicion in individuals who have been on antibiotic therapy, proctosigmoidoscopic examination, stool smears, cultures, and sensitivity. Treatment should be directed to eliminating the etiologic factor and replacing the physiologic abnormality.

Adolescent↗