Biomedical subjects

R C Cheek

Publications and source records attributed to R C Cheek.

13 recordsLinked to original sources

PubMed1976

Ruptured submucosal gastric artery microaneurysm.

A patient with massive upper gastrointestinal hemorrhage from a ruptured submucosal gastric artery microaneurysm is described. Intraoperative diagnosis was made and wedge resection of the lesion resulted in survival of the patient. Forty-two cases in this entity have been reported in the literature, with nonoperative therapy being uniformly fatal; there were only four cases of successful surgical management. An increased awareness of this entity in cases of unexplained gastrointestinal hemorrhage is the key to diagnosis and successful management.

Aged↗

PubMed1976

A surgical approach to bilateral hypernephroma using "benchwork" excision and autotransplantation.

A case of bilateral hypernephroma treated by right heminephrectomy in situ and "benchwork" excision of two tumors from the left kidney followed by autotransplantation is presented. Follow-up examination has demonstrated good renal function with no evidence of tumor recurrence or metastasis. This case illustrates the feasibility of benchwork operation and its application to renal tumors, particularly when these tumors are bilateral and preservation of renal tissue is imperative. Long-term follow-up of patients managed by this technique is mandatory.

Adenocarcinoma↗

PubMed1976

Arteriovenous fistulas for hemodialysis: experience with 100 cases.

One hundred radial-cephalic fistulas were surgically created for hemodialysis between April 1970 and September 1973. A side-to-end anastomosis was constructed in 86 per cent of cases. Overall patency interval was 13 months. Factors responsible for shunt failure are outlined. Blood vessel quality and surgical technique are the most important factors in achieving a low failure rate. Use of the fistula for early hemodialysis has not been associated with complications and is advocated.

Arteries↗

PubMed1976

Chronic torsion of the spleen.

Wandering spleen may result from congenital failure of splenic attachments or acquired laxity of attachments due to stretching. The wandering spleen is quite vulnerable to the complication of torsion, which is seen most often as an acute abdominal emergency due to splenic infarction. A more unusual variant is chronic torsion which causes intermittent mild to moderate abdominal pain, gastrointestinal disturbances and, in one case, hypersplenism. A mass has been present in most cases and may be anywhere in the abdomen or pelvis. Splenectomy should be performed for all cases of wandering spleen with or without torsion.

Adolescent↗

PubMed1976

Gunshot wounds of the suprarenal abdominal aorta.

Four cases of gunshot wounds to the suprarenal abdominal aorta are described. All required prosthetic graft replacement including one or more visceral arterial branches. Two patients survived. Factors important in survival were rapid transportation permitting early resuscitation and retroperitoneal tamponade which delayed exsanguination and permitted stabilization with systematic management. The major problem in management of gunshot wounds of the suprarenal abdominal aorta is limitation of visceral ischemia, particularly hepatic and renal. Special adjuncts such as local renal hypothermia, as used in these cases, or bypass techniques are necessary and should be available before exploration of a periaortic hematoma due to gunshot wound in this area.

Abdominal Injuries↗

PubMed1976

Volvulus of the sigmoid colon.

A 30-year experience with sigmoid volvulus from the City of Memphis Hospital is presented with 121 cases. Differentiating viable from gangrenous sigmoid volvulus is difficult from history, physical examination, or laboratory data and one must rely on sigmoidoscopy. Sigmoidoscopy with insertion of a colon tube is the initial management with operative detorsion only if sigmoidoscopy fails. Elective sigmoid resection is advocated in view of the high recurrence rate. In gangrenous sigmoid volvulus, a Hartmann's procedure is preferred. There is a significant rate of "recurrent sigmoid volvulus" after elective resection.

Colonic Diseases↗

PubMed1975

Diagnosis and management of major vascular injuries: a review of 200 operative cases.

In a series of 250 civilian vascular injuries, 85 per cent were due to firearms and 50 per cent involved the torso, both of which represent an increased frequency of occurrence over other reports. There were 40 deaths, 31 of which occurred during operation or in the recovery room and were due to irreversible shock or coagulopathy. Of the nine late deaths, failure of the vascular repair was responsible for only three. In 124 extremity artery injuries, there were 12 leg amputations (10%) with shotgun wounds responsible for nine and popliteal artery injuries involved in seven. In gunshot wounds of the aorta and iliac arteries, there were five suture line disruptions in nine primary repairs and no disruptions in 11 patients repaired by grafts. The evidence indicates that an antibiotic soaked dacron graft is the method of choice to repair gunshot wounds of the aorta and iliac arteries at this time.

Amputation, Surgical↗

PubMed1974