Biomedical subjects
Publications and source records attributed to M Solowiejczyk.
Spontaneous biliary enteric fistula caused by duodenal ulcer is a rare phenomenon. In most cases it is diagnosed incidentally, because it seldom gives clinical symptoms. The fistula per se is not an indication for surgery. When surgery is recommended, the operation of choice is vagotomy and antrectomy. A short review of the literature with three of our cases is presented.
Eight hundred thirty-six patients with carcinoma of colon and rectum were treated surgically in the Ichilov Medical Center from 1968 to 1975. Forty-five patients (5.38%) suffering from perforative carcinoma were followed up. It was found that the treatment of choice for perforative carcinoma of the descending colon is primary resection without primary anastomosis. In ascending colon perforation the treatment of choice is primary resection with primary anastomosis. Thus aggressive surgical procedures afford the patient the best chance for smoother postoperative course and recovery. In patients surviving the operation, the survival time is not influenced by the type of perforation but by the stage of tumor invasion.
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The testicular feminization syndrome is an uncommon condition with a familial background. The clinical features of a typical case are presented, as well as its management. It is emphasized that these patients and their parents must be treated with the greatest sensitivity when the condition is explained to them.
From 1946 to 1977, 228 infants were operated on for congenital hypertrophic pyloric stenosis in the Tel-Aviv Municipal Medical Center, all by the method of Fredet-Ramstedt. An evaluation was made of the late morbidity in 41 patients, ranging in age from 15 to 30 years. The emphasis is on gastrointestinal diseases and their possible connection to the operation. Twenty-four of 41 patients had gastrointestinal symptoms, including dyspepsia, diarrhea, constipation, and abdominal pains. X-ray examination of the stomach was performed in 31 patients, in order to examine the structure and function of the stomach. Five patients showed clear signs of ulcer disease, four in the duodenum and one in the stomach. Another five patients showed mild deformation of the duodenal bulb, and two showed signs of gastritis. No correlation was found between the severity of the congenital pyloric stenosis and the presence of later illness or disturbances.
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An aberrant adrenal, which is a supplementary to the normal adrenal, was found in the apex of hernial sacs in ten out of 350 operated children. This tissue contains adrenal cortex, which tends to atrophy and disappear during childhood, but uncommonly may persist into adult life. Rarely it may secrete abnormally or undergo neoplastic changes. The embryological development is discussed, and the literature briefly reviewed.
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Two cases of Gardner's syndrome in one family are presented. The father presented all three stigmas of the syndrome, while in the daughter no osseous manifestations were found. In the first patient, the diagnosis was made only after the second abdominal operation, when a mesenteric fibrous mass was seen. In the second case, the intestinal polyposis was clinically suspected, considering the hereditary aspects of this syndrome, and the episode of bloody diarrhea presented by this patient. Both patients were treated by subtotal colectomy with ileo-rectal anastomosis. Both of them presented fibrous tumors after the abdominal operation (the father after six years and the daughter after one year). The authors stress the importance of postoperative followup for the detection of fibrous masses that may appear due to the surgical stimulus. The literature on Gardner's syndrome is reviewed and summarized.
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