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Biomedical subjects

L E Perino

Publications and source records attributed to L E Perino.

6 recordsLinked to original sources

Gastrointestinal symptoms, motility, and transit after the Roux-en-Y operation.

Roux-en-Y patients have symptoms that vary from almost none to inability to tolerate oral feedings. This study was designed to determine whether there is a relationship between a patient's symptoms and the function of the gastric remnant or the Roux-limb. Gastric remnant and Roux-limb emptying were studied in eight patients with technetium-99m-labeled oatmeal and Roux-limb motor activity was measured with a water-perfused manometry system. We found that gastric emptying was rarely significantly slowed, but emptying of the Roux-limb was delayed in several patients. We also found that there was a rough correlation between the patient's symptoms and the degree of abnormal motility found in the Roux-limb. There is no known reason for these abnormalities in Roux-limb function in some patients after a Roux-en-Y, but our finding of worse abnormalities in those who had multiple previous gastric surgeries suggests that the symptoms and dysfunction may be related to the number of surgeries, as well as to the type of surgery.

Adult↗

Chyloperitoneum with collateral lymphatic drainage involving abdominal skin.

A 58-year-old man with poorly differentiated lymphoma and chyloperitoneum, who developed periumbilical white vesicular skin lesions, is presented. These skin lesions represent collateral lymphatic drainage pathways for the chyloperitonium as evidenced by drainage of chylous fluid from these lesions and communication with the peritoneum as demonstrated by intraperitoneal 99mTc sulfur colloid injection.

Abdomen↗

Cocaine-induced hepatotoxicity in humans.

A patient with hepatonecrosis associated with cocaine use is presented. Postmortem examination of the liver showed marked periportal inflammation and necrosis, and mild diffuse fatty infiltration. These pathologic findings are identical to those previously reported in a mouse model of cocaine hepatotoxicity.

Adult↗

Esophageal perforation after fiberoptic variceal sclerotherapy.

Our experience and review of the literature suggests that perforation follows fiberoptic sclerotherapy at an incidence of 1-6% per patient. Perforation is delayed for 2-14 days after the procedure and is due to chemical necrosis of the esophageal wall. The risk of perforation is higher in Child's class C patients. The use of large volumes or high concentrations of sclerosant may increase the risk of perforation. To reduce this risk, we suggest a cautious approach to Child's class C patients, with no more than two sclerosis sessions during the first 2 weeks of treatment using less than or equal to 10 ml of 1.5% sodium tetradecyl sulfate per session.

Adult↗

Radiation-induced intestinal pseudoobstruction.

A case of intestinal pseudoobstruction occurring 30 yr after radiation therapy is described. Mechanical causes of obstruction were excluded by laparotomy. Histology of full-thickness sections of the small bowel revealed vascular ectasia and sclerosis, serosal fibrosis, neuronal proliferation within the submucosa, and degeneration of the muscle fibers of the circular layer of the muscularis propria. On the basis of the clinical and histologic findings we conclude that, in this patient, intestinal pseudoobstruction was due to muscular and neuronal injury from abdominal irradiation.

Aged↗