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Biomedical subjects

P F Schofield

Publications and source records attributed to P F Schofield.

At least 109 records · Page 6Linked to original sources
PubMed1982

Management of perianal Crohn's disease.

Symptomatic anal disease (excluding skin tags) was observed in 49 out of 151 successive patients treated for Crohn's disease. Two main types of anal disease were encountered: anal ulceration (23 patients) and anal abscesses and fistulae (26 patients). The ulcer group rarely required local surgical treatment. In the fistula group, a low tract was demonstrated and laid open in 20 patients. The healing times after operation in these patients were compared with those of 18 patients with non-Crohn's fistula-in-ano treated by the same method. No significant difference between the two groups could be demonstrated. Surgical treatment of low fistula-in-ano may be undertaken in patients with Crohn's disease, provided the bowel disease is under adequate control.

Abscess↗
PubMed1982

A clinicopathological study of acute colitis: the dilemma of transient colitis syndrome.

In a 5-year clinicopathological study of acute colitis involving 238 adults, 42 patients were found to have 'transient colitis syndrome'. This is a term we have developed to describe those patients who have a short-duration self-limiting acute colitis of abrupt onset and negative bacteriology and which does not recur. Analysis of clinical features suggests an infective aetiology for most cases of transient colitis syndrome. The histology varied from changes of infective colitis to that of inflammatory bowel disease. It is likely that many patients who are now enjoying permanent remission after a single attack of 'inflammatory bowel disease' had this transient colitis syndrome.

Acute Disease↗
PubMed1982

Toxic dilatation and perforation in inflammatory bowel disease.

The diagnosis and management of dilatation of the colon and free intestinal perforation in inflammatory or infective bowel disease are reviewed with reference to 32 cases seen during an 8-year period. Toxic dilatation of the colon occurred in 20 patients, including 6 with infective colitis. Ileostomy with subtotal colectomy and mucous fistula is a satisfactory operation for toxic dilatation due to inflammatory bowel disease. Patients with infective colitis can generally be treated without operation. Free intestinal perforation was seen in 12 patients. Colonic perforation may occur in association with toxic dilatation, but more usually it occurs without dilatation as a complication of Crohn's disease. Free perforation of the ileum was seen after a short illness in patients with Crohn's disease.

Adult↗
PubMed1981

Complications of anterior resection of the rectum using the EEA stapling device.

Fifty patients had anterior resection of the rectum performed with end-to-end anastomosis using the EEA stapling device. The instrument certainly facilitated low anastomoses, but anastomotic dehiscence occurred in 3 cases, stenosis in 2, wound sepsis in 10, some degree os incontinence (usually only temporary) in 7 and anal fissure in 4 cases.

Adult↗
PubMed1981

Specific and non-specific lymphocyte cytotoxicity in colon carcinoma.

The cytotoxic activity of peripheral-blood (PBL), lymph-node (LNC) and tumour-infiltrating lymphocytes (TIL) from 47 patients undergoing surgery for colon carcinoma (Duke's Stage A, 1 patient; B, 24; C, 15 and C with metastases, 7) was examined in short-term 51Cr-release assays, against fresh autologous tumour cells, allogeneic colon cancer cells and the erythroleukaemia cell line, K562. Cytotoxicity against autologous cells was detected in at least one effector population in 23/47 patients (49%), with overall frequencies which did not differ for patients in different Duke's stages of disease. By contrast, lysis of allogeneic tumour cells was infrequent (11%) regardless of the effector population to which they were exposed. Cytotoxicity against K562, cells highly sensitive to NK activity, though variable, was detected in 93% of PBL of normal donors and 83% of patients, and among the latter showed no evidence of significant decline with advancing disease. However, LNC and TIL anti-K562 activity was infrequent (17%) in concordance with previous reports. There was no correlation between the ability of patients' PBL to lyse autologous tumour and K562 cells. The independence of these 2 cytotoxic actions was further explored in studies fractionating lymphocytes: autologous tumour killing was augmented in T-enriched PBL; whereas the greatest anti-K562 activity was found in the corresponding non-T fraction. Lymphocyte cytotoxicity in colonic neoplasia is thus manifest in 2 apparently independent lymphocyte populations; a relatively specific killer T-cell population, detectable in PBL, LNC and TIL, which is preferentially reactive with the autologous cells; and a non-specific killer population, largely limited to PBL, with the properties of NK cells. The activity of neither population reflects the clinical status of patients with this disease.

Adult↗
PubMed1980

Dependent proximal loop colostomy: does it defunction the distal colon?

The operation of dependent proximal loop colostomy is described. This colostomy avoids the complications of prolapse and paracolostomy hernia and is easy to close. It appears clinically to totally defunction the distal colon; his ability was studied by means of a radioactive tracer. Ten patients were given chromium-51 by mouth and it was found that none of this spilled over into the distal loop. It is concluded that dependent proximal loop colostomies effectively defunction the distal colon.

Colon↗
PubMed1979

Campylobacter colitis.

Eleven consecutive patients with diarrhoea from whose stools campylobacter were isolated were investigated by sigmoidoscopy and rectal biopsy. Eight had definite proctitis, and in seven biopsy specimens were abnormal with histological changes ranging from non-specific colitis to gross colitis with goblet-cell depletion and crypt-abscess formation. Nine of the patients passed blood in their stools, and in all but one abdominal pain was a feature of the illness. Severe campylobacter colitis may be clinically, sigmoidoscopically, and histologically difficult to differentiate from ulcerative colitis and is a differential diagnosis in acute colitis.

Adolescent↗
PubMed1979

Toxic dilatation of the colon in salmonella colitis and inflammatory bowel disease.

Toxic dilatation of the colon may be due to inflammatory bowel disease, either ulcerative colitis or Crohn's disease of the colon, but recent experience has shown that infective colitis due to salmonella can produce this complication. We present 13 cases with toxic dilatation (9 inflammatory bowel disease and 4 salmonellosis) and outline the diagnostic features and treatment in these patients. It is important to distinguish salmonellosis at an early stage because, whilst toxic dilatation in inflammatory bowel disease is an absolute indication for surgical treatment, cases with this complication due to salmonellosis may be treated conservatively in the majority of instances.

Adolescent↗
PubMed1979

A prospective randomized trial of vagotomy in chronic duodenal ulceration.

In a prospective, randomized trial, 76 patients with duodenal ulceration treated by truncal vagotomy and pyloroplasty were compared with 77 patients who underwent highly selective vagotomy. A total of 149 patients was followed up for from 1 to 4 years, the average follow-up period being 2.6 years. There was no operative mortality and no significant difference in postoperative morbidity between the two groups. The incidence of recurrent ulceration was greater after highly selective vagotomy, but this difference was not statistically significant. The clinical results were comparable in each group, and although the incidence of diarrhoea and dumping was greater after vagotomy and pyloroplasty, this difference was not statistically significant.

Adult↗
PubMed1978

Benign duodenocolic fistula.

Benign duodencolic fistula is a rare complication of a number of gastrointestinal diseases and it is seldom considered in diagnosis. Diarrhoea and weight loss are characteristic presenting features which may be masked by coexisting disease. Barium enema is the most useful diagnostic procedure. Prognosis is good if surgery is undertaken at an early stage after adequate correction of the metabolic consequences of the fistula, by administration of fluid, electrolytes and parenteral nutrition. This paper reports 4 cases of this condition and reviews the clinical features, investigation, aetiology and management.

Adult↗