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Biomedical subjects

J E Mullens

Publications and source records attributed to J E Mullens.

At least 19 recordsLinked to original sources
PubMed1984

Chronic pancreatitis: a 5-year experience.

Of 81 patients with chronic pancreatitis admitted to the Ottawa Civic Hospital over a 5-year period, 40 had conditions that were thought to be amenable to various operations. Good results were obtained in 70%. Of note were the 75% good results of pancreaticojejunostomy. Several patients needed further operations. The proportion of good results leaves no room for complacency, but it is difficult to envisage how a damaged gland can be expected to make a full recovery from either internal or external drainage procedures. Two patients died of carcinoma within 2 years of their initial operation and may have had carcinoma of the pancreas from the outset, although their mode of presentation and results of investigation were those of chronic pancreatitis. Alcohol abuse was thought to be responsible for the condition in 72% of these patients.

Chronic Disease↗
PubMed1983

Cystadenoma and cystadenocarcinoma of the pancreas.

Cystic neoplasms of the pancreas are uncommon. The authors present one case each of a cystic carcinoma (possibly acinar, which is a rare variant of pancreatic carcinoma), cystadenocarcinoma arising in a mucinous cystadenoma and cystadenoma. These cases illustrate important features of the natural history and management of these lesions. The macrocystic cystadenoma is generally regarded as premalignant and merits aggressive treatment, while the microcystic type is considered benign. If the cystadenoma is removed completely, there should be no recurrence. The cystadenocarcinoma differs from duct carcinoma; usually, the tumour can be removed, and when this is possible the prognosis is excellent. Both the cystadenoma and the cystadenocarcinoma can be mistaken for a pancreatic pseudocyst. The distinction is important.

Adult↗
PubMed1982

Pancreatic abscess.

Pancreatic abscess, although an uncommon complication of pancreatitis, is a serious cause of morbidity and death. During the 5-year period beginning in March 1976, 19 patients with pancreatic abscess were seen at the Ottawa Civic Hospital. Abdominal pain, mass, fever and leukocytosis were common; the serum amylase value was usually normal. twelve patients underwent external drainage; in 6 the abscess was drained internally through the posterior wall of the stomach. The overall mortality was 16%. Morbidity was high; 7 (37%) of the 19 patients required reoperation for recurrent sepsis. Differentiation of pancreatic abscess from phlegmonous pancreatitis or pseudocyst can be difficult. Ultrasonography may be useful but computerized axial tomography is the the diagnostic method of choice. Prompt débridement and external drainage are the mainstays of surgical treatment but internal drainage may be appropriate in selected patients.

Abscess↗
PubMed1978

Traumatic intrapericardial rupture of the diaphragm.

A 60 year-old woman sustained an intrapericardial rupture of the diaphragm with herniation of a loop of transverse colon into the pericardium. There are ten previous reports of this condition. Reduction of the hernia and repair of the defect were readily accomplished through an upper midline abdominal incision.

Colonic Diseases↗
PubMed1978

Symposium on pancreatitis: 3. Diagnostic tools in the management of chronic pancreatitis.

The chief diagnostic tools used in planning the management of chronic pancreatitis require close collaboration of the surgeon and radiologist. Barium meal, endoscopic retrograde cholangiopancreatography (ERCP), ultrasonography and angiography are the most useful procedures. The barium meal is the initial screening procedure. Uultrasonography should follow if there is suspicion of a pseudocyst or pancreatic abscess. It is also may be of value in demonstrating localized chronic pancreatitis. The most useful of all the tests is ERCP. This shows the pancreatic duct, the common bile duct, or both ducts, so that the surgeon may avoid operation where there is no defect to correct, or it may guide him in selecting an operation that is designed to correct the anatomical abnormalities of either duct. Angiography is occasionally of use when the foregoing procedures have not provided enough information. In over 80% of patients it is possible for the surgeon to undertake an operation with foreknowledge of the pancreas that will help him select the correct procedure to alleviate the patient's symptoms.

Angiography↗
PubMed1978

Endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis of chronic pancreatitis.

In a personal series of 188 patients with pancreatic disease referred for endoscopic retrograde cholangiography (ERCP), one or more ducts were cannulated in 168 patients; of the 168 patients; of the 168 patients, 19 had carcinoma and 149 had chronic pancreatitis. Abnormalities were found in 71 of the 149 patients with pancreatitis, either in the pancreatic duct, the bile duct, or both ducts. The demonstration of these abnormalities was of critical importance in planning the management of these patients. Ducts were normal in 78 patients. No benefit could be expected from operating upon these patients. It is concluded that approximately one half of the patients with chronic pancreatitis will have demonstrable lesions amenable to operation, and one half will not. ERCP is essential in the investigation and management of patients suspected of having chronic pancreatitis.

Biliary Tract Diseases↗
PubMed1977

Persistence of proctitis in 2 cases of clindamycin-associated colitis.

Two cases of persisting proctitis after an episode of clindamycin-associated colitis are reported. Both patients had fulminant colitis and required emergency operation. Severe proctitis persisted in the rectal stumps until their removal 8 months after the initial diagnosis of colitis was made. Persisting proctitis has not previously been described in clindamycin-associated colitis.

Adult↗