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Biomedical subjects

R B Dietrick

Publications and source records attributed to R B Dietrick.

7 recordsLinked to original sources
PubMed1984

Experience with liver abscess.

One hundred ninety-two liver abscesses in 190 patients were treated: 109 by needle aspiration, and 83 by operation. Mortality and complication rates were lower in the aspiration group, and the average hospital stay was shorter. This was true for both pyogenic and sterile abscesses, the latter being presumed to be amebic, although trophozoites were recovered from liver pus in only two patients. Patients with pyogenic abscess were, on the average, considerably younger than patients with the condition in the United States for reasons that are not immediately apparent. The preponderance of amebic abscesses found in men is less than usual, again for reasons that are not clear. Both pyogenic and amebic abscesses were commonly associated with fever, chills, and tenderness and pain in the right upper abdomen and hepatomegaly on physical examination. We found metronidazole effective in the treatment of both pyogenic and amebic abscesses.

Adult↗
PubMed1981

Results of decortication in chronic empyema with special reference of paragonimiasis.

During a recent 6 years period, we managed chronic empyema by decortication, either alone or in combination with thoracoplasty, in 58 patients: In 16 patients, the empyema was a complication of Paragonimus westermani infestation (PWI), in 20, tuberculosis (TB), and in 22, of varied origins. There were no operative deaths, and satisfactory or good results were obtained in 55 patients (94.8%). We believe that the result in a patient in whom thoracoplasty is required should be called satisfactory, not good. Only 55% of the TB group achieved a good result, compared with 89% of the other patients. Of the 10 patients who required a thoracoplasty, seven were in the TB group. Empyema complicating TB is associated with a higher incidence of fistula formation and is more difficult to treat than other empyemas. The empyema associated with PWI develops more slowly, tends to form fewer fistulas, and eventuates in a good result more often than empyema associated with TB. Two of our three poor results stemmed from failure to do a thoracoplasty when the lung did not expand. We recommend thoracoplasty when the lung does not expand well at operation; it should be done at the time of decortication to avoid the necessity for a second major procedure. Chronic empyema is a common complication of paragonimiasis in Korea and by inference in other parts of the world where PWI is endemic. As international travel increases, some patients with PWI and complicating empyema may be seen in the United States. American thoracic surgeons should be aware of this disease, its treatment and its chest complications.

Adolescent↗