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Biomedical subjects

J O Vieta

Publications and source records attributed to J O Vieta.

11 recordsLinked to original sources
PubMed1985

The use of dura mater allograft in the surgical repair of large defects of the abdominal wall.

The dura mater allograft is being used as an abdominal fascia substitute and major advantages are documented. It was used successfully in four patients at this institution, with a ten month follow-up period. Its strength, durability, tissue tolerance, flexibility, ease of handling, nonallergenic property, availability and stability in the presence of infection make it a good graft to be used in the repair of large abdominal hernias. We are quite convinced that long term follow-up results will verify the results of the animal experiments done by others and affirm the durability of the graft. In one patient, this graft has been shown to be adequate for placement in an infected bed and to have a definite resistance to infection. The results of incidental operative biopsy in another patient, have shown an excellent incorporation of the dura graft into the surrounding tissues. In our hands, the experience with the dura graft using monofilament sutures has been quite positive.

Abdominal Muscles↗
PubMed1978

Jejunal diverticulosis with massive hemorrhage.

A case of a relatively uncommon disease, jejunal, diverticulosis, is reported. The case presented an unusual complication, massive melena. The patient was successfully treated and cured by resection of the involved portion of jejunum. In the management of gastrointestinal hemorrhage in the elderly one must always have in mind this infrequent pathological entity, especially when the small bowel is suspected as the site of bleeding.

Aged↗
PubMed1978

Recurrent renal carcinoma causing intestinal hemorrhage.

Three cases of gastrointestinal bleeding caused by secondary renal carcinoma are presented. Hemorrhage occurred secondary to invasion of bowel anatomically related to the primary tumor. Bleeding can best be controlled by excision of tumor and involved intestine. Surgery is justified by the unpredictable prognosis for renal carcinoma with secondary disease.

Adenocarcinoma↗
PubMed1977

Perforation of the colon in unsuspected amebic colitis: report of two cases.

Two cases of amebic colitis that resulted in perforation of the colon, an ominous complication, are presented. The first was diagnosed preoperatively as acute ulcerative colitis with toxic megacolon, and the second as peritonitis complicating acute cholecystitis. In both instances the correct diagnosis was made after operation. The first patient recovered after colectomy and antiamebic therapy, but the second patient died in the early postoperative period, in septic shock. Amebic colitis occurs infrequently in the United States, and the diagnosis is rarely considered. In most cases an initial diagnosis of ulcerative or granulomatous colitis is made and the true diagnosis is recognized only after operation for colonic perforation or hepatic abscess. It is suggested that amebic colitis should be considered more frequently in cases of patients who have diarrhea. Stool examination for ova and parasites is often negative in amebic colitis. The IHA is usually positive in emebiasis, and should be performed early in casesof patients who have bloody diarrhea or other clinical symptons when amebiasis is suspected. Rectal biopsy is also a useful diagnostic approach, but failed to reveal amebae in one of our cases. Finally, it is suggested that operation be performed urgently when fulminating amebic colitis is not reversed by antiamebic therapy, when peritonitis occurs even with antiamebic treatment in progess, and for colonic perforation or toxic megacolon even when antiamebic therapy has not been indicated.

Adult↗
PubMed1977

Paraduodenal hernias.

Paraduodenal hernias comprise approximately 50% of all internal hernias. The clinical diagnosis of this condition is analyzed. Two cases are presented and two theories for the embryological development of these malformations and their surgical management are discussed.

Adult↗
PubMed1976

Malignant duodenocolic fistula: report of two cases, each with one or more other synchronous gastointestinal cancers.

Two patients had duodenocolic fistulas, each following a carcinoma of the colon in the area of the hepatic flexure that had perforated into the duodenum. The first patient was treated by a radical pancreatoduodenectomy with right colectomy; the second by subtotal colectomy with excision of the duodenal wall and suture. Both patients are alive and without evidence of recurrent disease. In addition, the first patient had two other primary carcinomas, in the cecum and in the stomach, and the second patient had another primary in the sigmoid. The definitive procedure had to be adjusted to encompass all lesions. The radical operation in one stage seems to be the preferred procedure and certainly is most satisfactory as a cancer operation. Our patient treated by this procedure has survived more than 11 years. An intestinal fistula related to colonic carcinoma, evan though rare, should not be considered as a separate entity. Treatment of the cancer with an en-bloc resection of the communicating organs should be employed if possible.

Adenocarcinoma↗
PubMed1975

Barium peritonitis.

A case of generalized peritonitis, secondary to a rupture of the rectosigmoid portion of the colon is presented. The surgical management is discussed, a basic part of which is the use of a Baker tube to splint the small intestine while adhesions form in a pattern along the tube, as a substitute method for a Nobel plication, to prevent chronic small intestinal obstruction. Extensive lavage of the peritoneal cavity should also be carried out. Energetic fluid replacement with careful monitoring of the fluid and electrolyte balance is essential before, during and after the surgical procedure. Adequate broad spectrum antibiotic coverage is important. We believe that the management of these cases should be by surgical intervention and institution of the above mentioned measures and not by expectant therapy and treatment of complications.

Aged↗