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Biomedical subjects

S G Pollard

Publications and source records attributed to S G Pollard.

50 records · Page 3Linked to original sources
PubMed1989

Renovascular hypertension in neurofibromatosis.

We present two patients with renovascular hypertension in association with neurofibromatosis. In both cases the diagnosis was established by angiography. The first patient suffered occlusion of the right renal artery combined with intrarenal arterial lesions. Treatment was by autotransplantation. The second patient suffered bilateral intrarenal arterial lesions alone and was treated medically. In both patients, control of the hypertension was established. We discuss the aetiology of renovascular hypertension in neurofibromatosis and consider its treatment.

Adolescent↗
PubMed1989

Surgery for recurrent colorectal carcinoma--is it worthwhile?

A series of 45 patients undergoing a second operation for recurrent colorectal cancer is reported. The majority developed recurrence within 2 years of their initial surgery. Despite regular follow-up, in only 27% of patients submitted to further surgery was the recurrence detected at routine review, and only three of these were asymptomatic at the time of diagnosis. A potentially curative second procedure was undertaken in 47% of cases, with a 2-year survival of 71% and a 5-year survival of 29%. Of those undergoing palliative surgery, this was worthwhile in 64%, providing palliation for more than 6 months. Mean survival following a palliative procedure was 10 months. Palliation was better, and operative mortality lower, when the bulk of the tumour could be removed. In obstructed patients the outcome following palliative resection was better than for palliative bypass procedures. Following resection of metastases there is the prospect of long-term survival, but it is difficult to predict those patients who will do well.

Adult↗
PubMed1988

Villous tumours of the large bowel.

A series of 110 patients with villous tumours of the colon and rectum treated by a single surgeon over an 18-year period is reported. Multiple lesions were present in 15 per cent of patients and 24 per cent of cases contained invasive malignancy, of which 83 per cent were Dukes' A. The major lesion was in the rectum in 84 per cent of patients and in the sigmoid colon in 12 per cent. Rectal bleeding and diarrhoea were the most common presenting symptoms; 6 per cent of patients were asymptomatic. Digital assessment proved a more reliable indicator of the presence of malignancy than either random biopsy or barium enema. In all, 70 of 76 (92 per cent) benign rectal lesions and 15 of 22 (68 per cent) malignant rectal lesions were successfully removed by peranal submucous excision or snaring and none of the malignancies so treated has developed a recurrence to date. Benign recurrence has developed in 13 per cent of all patients; the majority appeared within 4 years and were at the same level as the initial lesion. Of the 79 patients with benign tumours 7.6 per cent have subsequently developed large bowel carcinomas, after 2-16 years; all were symptomatic, half were at the same level as the previous benign lesion, and half were suitable for peranal removal.

Adenoma↗
PubMed1988

Symptoms arising from Double-J ureteral stents.

We investigated whether use of the Double-J ureteral stent causes untoward symptoms and complications. Of 20 patients evaluated by questionnaire 18 suffered 1 or more symptoms in the upper (for example loin pain) or lower (for example dysuria and frequency) urinary tract in the absence of infection. Despite the undoubted benefit in many patients, troublesome symptoms are common. We recommend early removal of the stents but we cannot implicate any correctable technical factors.

Abdomen↗
PubMed1987

Colovesical fistula.

The experience of 66 cases of colovesical fistula is reported. The most common cause was diverticular disease (71%), the remainder being due to malignancy, Crohn's disease, radiotherapy, appendicitis and trauma. The most sensitive investigation was barium enema, which was abnormal in 98% and actually showed the fistula in 57%. In 32 patients a single stage resection was performed, without mortality or significant morbidity and we would advocate this form of treatment for fistulae which are not complicated by gross sepsis or obstruction.

Colon↗
PubMedDate not supplied

The recognition of previous abdominal surgery by computed tomography.

Knowledge regarding previous surgery is important when reporting abdominopelvic CT. We have examined 50 consecutive patients undergoing abdominopelvic CT to establish whether careful scrutiny of the images can reliably reveal evidence of previous surgery. The radiologist performing the CT study inspected the patient's abdomen for scars and established their nature by discussion with the patient. A second radiologist, unaware of the patient's clinical details, reviewed the CT images and predicted whether there had been any previous surgery. These predictions proved inaccurate: Only 51% of scars were recognised at this initial assessment (63% following retrospective review). Although the absence of major organs was reliably reported, even large paramedian scars were missed. Old scars were missed more frequently than recent ones. Accurate details of previous surgery are necessary when interpreting abdominopelvic CT.

Abdomen↗