Eosinophilic ascites without eosinophilia: a unique presentation of serosal eosinophilic gastroenteritis.
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Ascites↗
Biomedical subjects
R L Greenlaw
Publications and source records attributed to R L Greenlaw.
Cystadenoma of the liver.
We report a patient with cystadenoma of the liver who presented with jaundice and abdominal mass. Although cystadenoma of the liver is a rare neoplasm, the lesion was diagnosed preoperatively by gray scale ultrasonography, PTC and ERCP. Characteristically, cystadenoma shows a multiseptated cystic appearance. While the origin of a cystadenoma is unclear, theories of synchronous development from anomalous bile ducts, endodermal diverticula, and ectopic germ cell origins have been promoted. Approximately 85% of patients with hepatic cystadenoma are women, with an insidious onset of symptoms due to the slowly growing nature of this tumor. Common symptoms include right upper quadrant mass, abdominal distension, and dull abdominal pain. Jaundice is less common. Complications include biliary obstruction, infection, hemorrhage, and rupture. As hepatic cystadenoma tends to recur after inadequate excision, and has malignant transformation potential, hepatic lobectomy has been promoted as definitive treatment.
Adult↗
A supervised training program in flexible sigmoidoscopy: evaluating skills from residency training to clinical practice.
To assess the effectiveness of a training program in flexible sigmoidoscopy for family practice residents, we prospectively studied the performance of four residents during their training and after graduation. One hundred and four training exams performed with the assistance of an experienced gastroenterologist were compared with 118 unassisted post-training, post-residency exams. The mean depth of insertion for the post-training period was 51.1 +/- 1.2 cm, which was significantly greater (P less than .05, Student's t test) than the mean training period depth of 47.6 +/- 1.2 cm. There was no significant difference in the identification of polyps or cancer between the training and post-training periods. The mean duration of an exam was 17.3 +/- 0.6 minutes in the post-training period. No significant complications were encountered in either period. The residency trained family physicians obtained results similar to those reported by trained endoscopists in depth of examination and pathology detected, although their examinations required more time. We conclude that this model of training was effective in the development of flexible sigmoidoscopy procedural skill for family practice residents.
Clinical Competence↗