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Biomedical subjects

J S Wills

Publications and source records attributed to J S Wills.

At least 19 recordsLinked to original sources
PubMed1990

Traumatic lumbar hernia: CT diagnosis.

A lumbar hernia usually involves protrusion of extraperitoneal fat or bowel through an area of weakness in the posterolateral abdominal wall bounded superiorly by the 12th rib, inferiorly by the iliac crest, posteriorly by the erector spinae muscle, and anteriorly by the posterior border of the external oblique muscle. Most are due to an acquired nontraumatic or congenital cause. Acute blunt abdominal trauma is a rare cause of lumbar hernia; to our knowledge, the CT diagnosis of this variety has not been reported. Since 1985, approximately 850 patients have undergone emergent abdominal CT for evaluation of acute abdominal trauma at our hospital; in seven of these patients, a traumatic lumbar hernia was diagnosed prospectively. In three patients, CT showed a flank hematoma with herniation of bowel through the lumbar triangle. CT showed pelvic fractures in three other patients, accompanied by herniation of bowel in one patient, herniation of extraperitoneal fat in another, and herniation of extraperitoneal fat and blood in the third. One patient had both a flank hematoma and a pelvic fracture with herniation of bowel. Acute traumatic lumbar hernia is a rare but significant abnormality that should be considered in patients with blunt abdominal trauma, especially in those with large flank hematomas and pelvic fractures. The hernia contents, associated injuries, and disrupted muscle layers are all well demonstrated on CT.

Abdominal Injuries↗
PubMed1989

Identification of avascular necrosis in the dysplastic proximal femoral epiphysis.

Bilateral radiographic irregularities and deformities of the proximal femoral epiphyses are features of both multiple epiphyseal dysplasia and bilateral idiopathic avascular necrosis. In the past these entities have been difficult to differentiate. This report documents radiographically the occurrence of avascular necrosis in 10 patients with multiple epiphyseal dysplasia by recognizing the super-imposition of sclerosis and subchondral fissuring on pre-existing symmetrically irregular proximal femoral ossification centers. Scintigraphic (photopenia) or magnetic resonance (loss of signal) criteria of avascular necrosis confirm its added presence and help to establish an imaging scheme to identify avascular necrosis superimposed on multiple epiphyseal dysplasia.

Adolescent↗
PubMed1987

A drop in suicides around major national holidays.

To study the fluctuation of suicides around the holidays, we examined 188,047 U.S. suicides from 1973 to 1979. Correcting for the effects of extraneous variables, such as seasons and days of the week, we found that suicides dropped by an annual average of -102.5 in the period surrounding the holidays. One set of holidays (Memorial Day, Thanksgiving, and Christmas) was associated with an unusually low risk of suicide before, during, and after the holiday. Another set of holidays (New Year's Day, July 4th, and Labor Day) was associated with a low risk of suicide before the holiday and a high risk just afterwards. Almost all demographic groups experienced a low risk of suicide around the holidays: whites, blacks, males, females, retired persons, and persons of working age. Only white teenagers deviated from this pattern. Thus, the evidence does not support the widespread popular assumption that holidays are a risk factor in suicide.

Adult↗
PubMed1985

Bullet colic.

Ureteral obstruction by intramural bullet, buckshot, or related missle following penetrating abdominal trauma is rare; a search of the literature revealed only 4 previously described cases [1-4]. A fifth case of a bullet migrating from the renal pelvis to the ureter has been reported at autopsy [5]. We present 2 new cases of delayed symptomatic ureteral obstruction ("bullet colic") after abdominal gunshot wounds.

Abdominal Injuries↗
PubMed1985

Percutaneous gastrostomy: further experience.

Percutaneous gastrostomy was performed in nine patients, bringing to 17 the total number of such procedures now performed in the authors' department. As a result of this additional experience, the authors have further refined the technique and have had the opportunity to follow a number of patients for extended periods. Percutaneous gastrostomy appears to be an effective alternative to surgical gastrostomy.

Gastrostomy↗
PubMed1983

Percutaneous gastrostomy.

Percutaneous gastrostomy was performed in 7 patients using standard interventional techniques. The procedure was successful in 6 patients but was terminated in the seventh patient because of pain. In 5 cases, feeding posed no difficulty; one patient had outlet obstruction, perhaps related to a duodenal ulcer. In one patient the catheter was removed following improvement. In 3 it continued to function until death, although in one case feeding became difficult shortly before death. The seventh patient is alive and tolerating catheter feedings well, even though catheterization was difficult because of ascites. Indications for percutaneous gastrostomy include neoplasms involving the digestive system proximal to the stomach, facial trauma and burns, debilitation, and distal enteric intubation in patients who cannot tolerate gastric feeding.

Anorexia↗