Biomedical subjects

P C Saharia

Publications and source records attributed to P C Saharia.

4 recordsLinked to original sources

PubMed1979

Abdominoscrotal hydrocele. Case presentation and review of the literature.

Abdominoscrotal hydrocele has been known for over a century although it rarely has been reported in children. A review of the world literature revealed 84 such cases, only three cases in the pediatric age group. Our patient, a 5-mo old male, presented with abdominal and scrotal masses of 4 to 6 wk duration. The abdominal mass measured 12 x 8 cm. The scrotal mass, which clinically seemed to be a hydrocele, measured 3 x 5 cm. Both masses appeared cystic and communicated. Diagnostic work-up clearly established the diagnosis. Complete surgical excision was accomplished through an inguinal crease incision.

Abdomen↗

PubMed1977

Primary common duct stones.

Thirty patients were identified as having primary common duct stones. Criteria for diagnosis included at least a two year symptom free interval following cholecystectomy; soft, light brown stones or sludge present in the common duct; and the absence of a long cystic duct remnant or a biliary stricture from the previous surgery. The average age of the 30 patients was 66 years. The interval between cholecystectomy and the diagnosis of primary common duct stones averaged 12 years. Acute cholangitis was a frequent mode of presentation. At the time of surgery the bile duct was often dilated out of proportion to the serum bilirubin. In only one of the 30 patients was ampullary stenosis present. Twenty-six of the 30 patients had only stone extraction and insertion of a T tube for treatment of their primary common duct stones. Twenty-two of the 26 were followed for an average of four years and nine months with no evidence of recurrent stones in 82% (18/22). Four developed recurrent primary common duct stones one, five, five, and 7 years later. It is concluded that most patients with primary common duct stones do well after stone extraction alone.

Aged↗

PubMed1976

Clinical management of acute cholangitis.

In a series of 78 patients with acute cholangitis, 48 were associated with common duct stones, and in one-third of these, the stones were believed to be primary common duct stones. Even though the clinical presentation of acute cholangitis can be nonspecific with a remarkable absence of physical signs, almost all patients had elevations of serum bilirubin, transaminase and alkaline phosphatase levels, an indication of disease of the biliary tree. Initially, all of the patients were treated with antibiotics and most responded rapidly. Escherichia coli and klebsiella were the organisms involved in more than 85 per cent of the positive cultures, and penicillin and an aminoglycoside are recommended as the drugs of choice in acute cholangitis. Diagnostic procedures were then performed, and laparotomy was often not carried out for several days after admission. Eleven of the 78 patients died. Six of the 11 deaths in this series were from continuing or recurrent sepsis, and at postmortem examination, a retained stone or inadequately treated stricture was found. This points out the need for adequate diagnostic procedures prior to exploration.

Abdomen↗

PubMed1975

Carcinoma arising in thyroglossal duct remnant: case reports and review of the literature.

Two cases of thyroglossal duct cyst carcinoma are presented and the world literature is reviewed. There are only 74 cases reported to date. In nearly all the cases the clinical diagnosis was thyroglossal cyst. Although the great majority of the tumours were papillary adenocarcinomas, 13-15 per cent were of other histological types. The treatment has been quite variable, but the most common initial treatment was Sistrunk's (1928) operation. Following the establishment of the diagnosis of malignancy, thyroidectomy was done in several cases, but it failed to show any evidence of malignancy in most of the thyroids removed, which establishes firmly the de novo origin of these tumours from the thyroglossal duct remnant. In only one case had tumour disseminated to distant organs, the lung, liver, etc. The scepticism as to whether some of the carcinomas associated with thyroglossal duct remnants may not in fact represent metastases from a small primary tumour of thyroid gland is examined. It appears that, though a possibility of primary or metastatic tumour in the thyroid does exist, the probability does not appear to be high. From our own experience it is suggested that local excision followed by radiotherapy, irrespective of recurrence, may be worth considering for the treatment of such carcinomas.

Adenocarcinoma↗