A simple method for drain placement in celioscopic cholecystectomy.
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Biomedical subjects
Publications and source records attributed to M A Reiner.
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Malignant fibrous histiocytoma (MFH) of the gastrointestinal tract is extremely rare. A case of MFH of the colon associated with neurofibromatosis is presented. MFH is a high-grade soft-tissue sarcoma of fibroblast cell origin with a strong propensity for metastasis and recurrence. Immunochemical markers help to differentiate MFH from other sarcomas. The most successful treatment of MFH is surgical extirpation. Adjuvant chemotherapy and radiotherapy have not been definitively shown to be of value.
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Difficulty in resection of the uncinate process of the pancreas often results in significant hemorrhage. Partial vascular occlusion of the superior mesenteric vein with resection of the lateral wall allows complete removal of all pancreatic tissue with minimal blood loss.
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This case describes an extraordinarily elevated total bilirubin level that reverted to normal 9 1/2 wk after Fredet-Ramstedt pyloromyotomy. Although the etiology of jaundice occurring in patients with IHPS remains uncertain, theories implicating inhibition of the glucuronyl transferase system have been proposed. Infants with IHPS have a documented hypergastrinemia. An hypothesis is offered, illustrated by this case, to explain the inhibition of the glucuronyl transferase system with resultant hyperbilirubinemia by the hypergastrinemia of idiopathic hypertrophic pyloric stenosis.
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One hundred and twelve cases of primary aortoduodenal fistulas were reviewed. The most common etiological agent was an atherosclerotic infrarenal abdominal aortic aneurysm. There was a male to female predominance of 9:2 with an average age of 62 years. Most fistulas occurred between an infrarenal aneurysm and the third portion of the duodenum because of the relatively fixed position of the duodenum and its direct anatomical relationship posteriorly with the aorta. Patient symptoms may vary from abdominal or back pain with gastro-intestinal bleeding to just hematemesis or melena. Twenty per cent gave a history of abdominal aneurysm while up to 70% may have an abdominal mass on physical examination at the time of admission. Tentative diagnosis is established by history and physical examination with duodenoscopy, barium duodenogram and angiography available only if temporally feasible. Surgical exploration is the only treatment with resection of the aneurysm, synthetic graft placement and duodenal suturing as the procedure of choice.
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