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Biomedical subjects

H G Coons

Publications and source records attributed to H G Coons.

10 recordsLinked to original sources
PubMed1990

Percutaneous enterostomy with the Cope suture anchor.

Eighty-two percutaneous enterostomies were performed at three institutions with the Cope suture anchor for stomach or jejunal wall stabilization during alimentation tube placement. The anchors were successfully placed into the stomach or jejunum in 81 cases. Early in the series, two anchors were misplaced, with no sequelae. There were no other complications at the time of placement. In all successful cases, excellent immobilization of the viscus was achieved. Tract dilation and tube placement were easily performed, and there were no guidewire or tube dislodgments.

Adult↗
PubMed1989

Self-expanding stainless steel biliary stents.

Self-expanding stainless steel stents of a modified Gianturco design were used to relieve biliary obstruction in 31 patients. Fifteen patients had benign strictures, and 16 patients had malignant obstructions. The median age was 62 years. The stents were placed through a 10-F sheath, and in most cases multiple stents were used. Complex malignant obstructions involving multiple systems were successfully treated with stainless steel stents in order to reconstruct the biliary tree. Stents have been in place for more than 6 months in 20 of the 31 patients; occlusions have occurred in 10% of the 31 patients. Patients with benign postoperative strictures have done very well, with one patient free of symptoms at 14 months. The initial results are encouraging. Further studies will determine the role of stainless steel stents in the treatment patients with benign postoperative strictures and malignant obstructions with involvement of multiple systems.

Bile Duct Neoplasms↗
PubMed1985

Complicated pancreatic inflammatory disease: diagnostic and therapeutic role of interventional radiology.

Diagnostic and therapeutic interventional radiology techniques in 41 patients with complications of pancreatic inflammatory disease (noninfected pseudocyst, infected pseudocyst, phlegmon, abscess, hemorrhagic pancreatitis) are described. Computed tomography or ultrasound-guided aspiration or percutaneous pancreatic ductography enabled specific diagnoses in 43 of 45 patients (96%). In almost half the patients, diagnostic aspiration with 22-gauge needles was unsuccessful due to viscous contents or firm cavity walls. Single-step needle aspiration of noninfected pseudocysts was successful in only three of ten patients (30%). Catheter drainage cured six of seven noninfected pseudocysts (85.7%) and seven of nine infected pseudocysts (77.7%). Pancreatic phlegmons were aspirated in five patients to exclude secondary infection and help determine the need for surgery. Pancreatic abscesses were drained successfully in nine of 13 patients (69.2%); temporizing benefit was achieved in the other four who eventually underwent surgery in improved condition. Early diagnosis of the complications of pancreatitis may be established almost uniformly, and at least 70% of patients with infected or noninfected pseudocysts and pancreatic abscesses may be cured by nonoperative drainage.

Abscess↗
PubMed1984

Temporizing effect of percutaneous drainage of complicated abscesses in critically ill patients.

Fifteen patients who would not have been candidates for percutaneous abscess drainage previously, and who were exceedingly high-risk for surgery, underwent initial catheter drainage. The patients were critically ill and had complicated abscesses, which were poorly defined, multiloculated, phlegmonous, and had associated fistulas. The percutaneous drainages were not curative. However, the patients dramatically improved and became fit for surgery (13 patients) or another interventional procedure (three patients). Five hypotensive patients were stabilized by the catheter drainage; mean white blood cell count in the 15 patients decreased by 14,000/mm3; mean temperature decreased from 40 degrees C to 38.1 degrees C; and anemia, coagulation factors, and overall condition improved. Eventual surgery was more limited (directed to the cause of the abscess) and less time-consuming. All these high-risk patients survived with this combined radiologic-surgical approach. Temporizing percutaneous abscess drainage in gravely ill patients with complex abscesses offers significant therapeutic benefit, although it may not be curative. With realistic expectations for partial success rather than cure, the scope of candidates for percutaneous drainage has broadened.

Abscess↗
PubMed1983

Large-bore, long biliary endoprostheses (biliary stents) for improved drainage.

Seventy-one large-bore, long biliary stents were placed in 62 patients. The 12-Fr Teflon stents with multiple side holes were made to extend from the entrance point of the biliary tree to the wall of the duodenum opposite the ampulla of Vater. The entire procedure takes one week. The techniques for placement and proper fashioning of the stents are described in detail. In one patient, the biliary tree was re-entered 15 months after the initial placement of a stent. The stent was removed percutaneously and replaced by a longer stent. The technique for removal is also described. The problems of migration and obstruction have been overcome with this technique, making this the preferred method of nonsurgical drainage of malignant obstructive jaundice.

Adenoma, Bile Duct↗