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N Gagic

Publications and source records attributed to N Gagic.

4 recordsLinked to original sources

Toxic megacolon associated with anticancer chemotherapy.

The majority of gastrointestinal side effects associated with anticancer chemotherapy are relatively mild and self-limiting and can be managed empirically. However, severe side effects, such as necrotizing enterocolitis and ischemic colitis, sometimes do occur after chemotherapy. The authors present a case of toxic megacolon associated with anticancer chemotherapy. This is a relatively uncommon but potentially lethal complication of ulcerative colitis.

Adult

The results of cholecystostomy for the treatment of acute cholecystitis.

Six of 22 patients with acute cholecystitis who had a cholecystosomy died. All six deaths were attributed to cholangitis, none of the patients had undergone common bile duct decompression at the time of cholecystosomy. Cholecystostomy must be accompanied by choledochotomy in the treatment of acute suppurative cholangitis. Cholecystostomy is a safe procedure, can be performed rapidly, and is recommended in a select group of patients with acute cholangitis without jaundice or for clinical signs of cholangitis.

Aged

Acute cholecystitis.

The mortality rate for acute cholecystitis was 9.4 per cent. Those patients who underwent cholecystostomy had a mortality rate of 27.3 per cent, cholecystectomy 2.2 per cent, cholecystectomy and choledochotomy 7.4 per cent. Factors found to have an adverse effect on mortality in acute cholecystitis included sphincterotomy, perforation or gangrene of the gallbladder and cholagitis. Cholecystectomy is the operation of choice in acute cholecystitis in the absence of or history of jaundice or evidence of a common duct stone or cholangitis. Operative cholangiography and pressure and flow measurements through the cystic duct are advocated to avoid a retained common duct stone. Cholecystostomy should be reserved for the critically ill patient or a patient who deteriorates during operation, and it should be done only if the operator visualizes clear bile returning through the cystic duct.

Acute Disease