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Biomedical subjects

I H Friedman

Publications and source records attributed to I H Friedman.

At least 19 recordsLinked to original sources
PubMed1995

Acute cholecystitis with calculous biliary duct obstruction in the gravid patient. Management by ERCP, papillotomy, stone extraction, and laparoscopic cholecystectomy.

The pregnant patient with cholelithiasis is subject to the manifold complications associated with this disease. The management of a gravid patient with acute cholecystitis complicated by biliary duct obstruction utilizing combined endoscopic therapy and laparoscopic cholecystectomy is reported. The benefits to the patient and fetus when successful are apparent, but it is important to anticipate potential problems associated with laparoscopy in pregnancy and to avoid them. Various safeguards such as fetal monitoring, careful trocar placement, and intra-abdominal pressure monitoring have been suggested and should be appropriately utilized to enable a satisfactory outcome. Case reports such as this may further clarify the interdependent role of laparoscopic cholecystectomy and ERCP and their application to the pregnant patient.

Acute Disease↗
PubMed1994

Pneumothorax associated with laparoscopic cholecystectomy.

Pneumothorax is an uncommon but potentially serious complication that can occur during laparoscopic procedures. A patient under-going laparoscopic cholecystectomy developed an 80% pneumothorax during the course of the procedure and required chest tube insertion. She then underwent an uneventful recovery. The etiology of this complication as well as methods for avoiding this problem have been reviewed. Because of the potential serious nature of this complication, it is imperative that the surgeon be aware of the possibility and implement appropriate immediate therapy.

Adult↗
PubMed1985

Late failure of a stapled small-bowel exclusion procedure.

Late failure of a stapled small-bowel exclusion without transection of the bowel resulted in recurrence of an enterovaginal fistula. This necessitated reoperation and division of the small bowel, following which the patient has remained well. A review of the literature indicates that this problem might occur in similar procedures and suggests that the bowel should not only be cross stapled, but transected when performing exclusion procedures.

Aged↗
PubMed1981

Simultaneous occurrence of gastric carcinoma in identical twins.

Gastric carcinoma is a rare entity in twins at any age. A 31-year old black male presented with a nine-month history of epigastric pain and was found to have cancer of the stomach. His asymptomatic twin was therefore evaluated and also found to have gastric carcinoma. Both patients underwent gastric resection. Pathologically the cancers were similar, although the associated changes of the gastric mucosa showed some remarkable differences. The uniqueness of carcinoma in twins has resulted in extensive utilization of twin studies in an attempt to clarify genetic, environmental and immunological factors in the development of cancer. The results of these studies reported in the literature, however, are inconclusive. Gastric cancer is quite uncommon in the younger population but must be promptly excluded when symptoms doe not quickly respond to usual therapy.

Adenocarcinoma↗
PubMed1980

Morbidity and mortality following intraperitoneal closure of transverse loop colostomy.

A retrospective analysis of 153 patients having intraperitoneal closure of transverse loop colostomies was performed. The mortality was 1.4 per cent. The morbidity rate was 15 per cent, including 7 per cent wound infection was not significantly improved by the use of systemic or nonabsorbable intestinal antibiotics. Intraperitoneal drainage resulted in the highest rate of wound infection. However, the use of intraperitoneal drains seems justified for the control of fecal fistula if it should occur. The lowest incidence of complication was noted when colostomies were closed in 2--4 months. Particular attention must be given to cases with diverticulitis as these have a greater morbidity. Factors which reduce morbidity appear to be directly related to clean and careful dissection of the bowel with a sound technique of anastomosis.

Adult↗
PubMed1980

Fused inflammatory polyps simulating carcinoma in ulcerative colitis.

A 33-year old female with a 10-year history of ulcerative colitis developed a large polypoid filling defect in the distal transverse colon, suggestive of carcinoma of the colon. Biopsy indicated an inflammatory polyp but subtotal colectomy was performed because of the long history and the radiographic appearance. Pathologic examination revealed an unusual aggregation of filiform polyps entrapping a semisolid fecal mass. The development of this unique lesion is elaborated.

Adult↗
PubMed1977

Stenosis of the small intestine due to nonocclusive ischemic disease.

Intestinal stenosis following nonocclusive disturbances of mesenteric circulation will probably be encountered with increasing frequency as patients with low blood flow states resulting in transiently ischemic but viable bowel are treated early and successfully. The case reported here clearly documents the temporal sequence of dated cardiogenic shock and the subsequent onset of abdominal pain, culminating in intestinal stenosis and obstruction and necessitating later bowel resection. The pertinent literature has been reviewed. It is suggested that the likelihood of this complication be entertained in high-risk patients and supportive therapy be employed promptly and judiciously.

Humans↗
PubMed1977

The value of laparoscopy in general surgical problems.

Laparoscopy offers a simple, rapid and safe way to evaluate and diagnose definitively intra-abdominal disease. An analysis of 65 consecutive patients supports this contention and demonstrates the real advantages and safety of this readily available modaility. A 90 per cent success rate, defined as accomplishing the diagnosis, was achieved in this study. There were no complications and no deaths. Local anesthesia was almost exclusively used and is strongly recommended. Laparoscopy represents an underused diagnostic modality which, when properly performed, can effect significant medical and fiscal economies in patient care.

Abdomen↗