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Biomedical subjects

R K Rajan

Publications and source records attributed to R K Rajan.

10 recordsLinked to original sources
PubMed2000

Sigmoid colon rupture secondary to Credé's method in a patient with spinal cord injury.

Credé's method is a manual suprapubic pressure exerted with a clenched fist or fingers, used to initiate micturition, in patients with spinal cord injury (SCI) who have neurovesical dysfunction. It is usually a benign maneuver unassociated with any major complications. This paper will illustrate a case report involving a sigmoid colon rupture secondary to Credé's method in a patient with SCI. Various techniques of Credé's method are briefly described. It is recommended that patients with quadriplegia avoid forceful use of Credé's method, as it may cause contusion of the abdominal wall and injuries to internal viscera, possibly leading to colonic rupture. It is believed that this is the first reported case of such an unusual complication of Credé's method in patients with SCI.

Abdomen, Acute↗
PubMed1986

The coexistence of carcinoid tumor and Crohn's disease.

We report what we take to be the ninth case of an intestinal carcinoid tumor coexisting with Crohn's disease; we believe that it is also the first case of Crohn's disease in which the carcinoid tumor involved both the small and large bowel, as well as the appendix. The two lesions may be remarkably similar in their clinical presentation, gross appearances, and radiologic features. We suggest that the actual incidence of their coexistence may be greater than the few reports suggest.

Carcinoid Tumor↗
PubMed1984

Ischemic myelopathy following cardiac arrest.

Ischemic myelopathy, resulting in flaccid paralysis of the lower extremities with loss of bladder and bowel control, occurred in a patient who had suffered a massive myocardial infarction and cardiac arrest, followed by prolonged cardiopulmonary resuscitation. Individual anatomic variations in the vasculature of the spinal cord and the collateral spinal circulation may be important determinants of ischemic damage.

Adult↗
PubMed1982

Bacterial endocarditis in mitral leaflet prolapse syndrome.

A 25-year-old quadriplegic man with mitral leaflet prolapse syndrome was seen for complaints of intermittent fever, chills, and cough of three months' duration. Subacute bacterial endocarditis was diagnosed. Unusual complications of this disorder included hyperplenism with pancytopenia, pericardial effusion, and multiple infections in the blood and the spleen. Antibiotic therapy was begun, and splenectomy was performed. After seven weeks of treatment, the patient was free of symptoms and was discharged with advice on appropriate antibiotic prophylaxis. We believe that although bacterial endocarditis is a major complication of mitral leaflet prolapse syndrome, it can be prevented with antibiotic prophylaxis whenever dental, surgical, or other invasive procedures are performed.

Adult↗
PubMed1982

Spontaneous bacterial peritonitis in alcoholic cirrhosis with ascites.

Aerobic enteric organisms, especially Escherichia coli, are the most common cause of spontaneous bacterial peritonitis in alcoholic cirrhosis with ascites, despite the preponderance of anaerobic bacteria in the bowel flora. The major routes of infection are transmural migration of gastrointestinal flora, lymphatic spread, and hematogenous seeding. Most patients present with fever and chills, abdominal pain, leukocytosis, and hypotension, although some may be asymptomatic. Differentiation from secondary peritonitis, which is essential in determining appropriate therapy, is difficult. Microbiologic studies of the ascitic fluid can provide valuable clues in this regard. Although most patients respond favorably to antibiotic therapy, mortality is high because of complications of the underlying disorder.

Ascites↗
PubMed1982

Spontaneous bacterial peritonitis with ecthyma gangrenosum due to Escherichia coli.

Ecthyma gangrenosum caused by Escherichia coli (E. coli) occurred in a decompensated alcoholic cirrhotic patient with spontaneous bacterial peritonitis due to the same organism. Ecthyma is usually associated with systemic sepsis from Pseudomonas aeruginosa. Isolated instances due to other bacteria have been reported, but its occurrence in spontaneous bacterial peritonitis, of which the predominant causative organism is E. coli, is unique. The frequency, varied etiology, and pathogenesis of ecthyma are briefly reviewed.

Alcoholism↗
PubMed1982

The early diagnosis of atypical thyroid acropachy.

The differential diagnosis of the condition of a patient with acral thickening and normal bone roentgenograms but without obvious signs of Graves' disease may be perplexing. A patient was seen with this disorder, in which the early diagnosis of thyroid acropachy could not be made roentgenographically but was accomplished by bone-scanning techniques. To our knowledge, this is the first demonstration of the evolution of thyroid acropachy, as temporally proved by serial roentgenograms and bone radiographs. The patient complained of severe swelling and decreased finger mobility. His hands were treated in a novel manner, using fluorinated topical steroids under an occlusive dressing, because of the failure of previously described localized medical therapeutic regimens. Treatment, using one hand as a control, resulted in a substantial decrease in hand circumference and volume, as well as increased finger mobility.

Administration, Topical↗
PubMed1981

Lumbar hernia due to defect in transversalis fascia.

Diagnosis of lumbar hernia poses difficulties because of the gastrointestinal, genitourinary, or musculoskeletal symptoms with which it may present. Lumbar hernia, though uncommon, should be considered in the differential diagnosis of back pain and upper quadrant subchondral abdominal masses.

Abdominal Muscles↗
PubMed1979

Esophageal diverticula.

Congenital, neuromuscular and motor abnormalities of the pharynx, esophagus and diaphragm, coupled with intra- and extraluminal factors, play roles in the pathogenesis of esophageal diverticula. Principal presenting symptoms are regurgitation, obstruction, aspiration, pneumonitis and esophagitis. Cineradiography and manometry are useful methods of evaluation. Treatment, which may be simple excision or myotomy, does not correct the basic motor abnormality that is often associated with the diverticulum.

Diverticulum↗