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Biomedical subjects

S Rabinson

Publications and source records attributed to S Rabinson.

13 recordsLinked to original sources
PubMed1993

Malignant duodenocolic fistula. The role of extended surgery.

Malignant duodenocolic fistula is a seldom-seen complication of advanced right colon carcinoma. We describe four patients who illustrate the sometimes rewarding results of aggressive treatment. Because duodenocolic fistula is always associated with severe nutritional impairment, operation should be deferred until total parenteral nutrition (TPN) and blood transfusions have improved the clinical state. Whenever feasible, resection offers the best treatment; lesser techniques such as bypass and exclusion result only in minimal palliation. A direct approach and fistula disconnection are contraindicated. The benefit of exploration should almost always be offered, even in such secondary fistulas, as a better quality of life and long-term survival are realistic goals.

Aged↗
PubMed1992

[Actinomycosis mimicking abdominal neoplasm].

A case of actinomycosis mimicking abdominal neoplasm in a 56-year old woman is presented. Actinomyces israelii is a common saprophyte found in the mouth and gastrointestinal tract. It is an anaerobic, Gram-positive, branching filamentous fungus related in many respects to the bacteria. Damage to the mucosa by trauma, disease or surgery is an essential prerequisite to infection with this organism. In 20% of the cases the abdomen is involved, but an abdominal mass is a rare presentation. In such cases diagnosis prior to exploratory laparotomy is difficult.

Abdomen↗
PubMed1992

Epithelioid angiosarcoma of the adrenal gland with cytokeratin expression. Report of a case with accompanying mesenteric fibromatosis.

A case report of epithelioid adrenal angiosarcoma is presented. Tumor cells showed expression of cytokeratin, Factor VIII-related antigen, Ulex europaeus agglutinin-I, and vimentin. The patient also was found to have mesenteric fibromatosis (abdominal desmoid tumor) and an elevated serum level of estradiol. The authors discuss the unique appearance of these rare tumors, their relationship to hyperestrinism, and review the recent data in the literature showing cytokeratin expression by malignant epithelioid vascular tumors.

Adrenal Gland Neoplasms↗
PubMed1991

[Primary cholesteatoma of the external auditory meatus].

Primary cholesteatoma of the external auditory meatus is a rare condition manifested by erosion of the external auditory meatus due to the development of a noncleansing pocket lined by squamous epithelium. The salient features of the disease are: unilateral protracted otalgia and purulent otorrhea in an elderly patient. 2 cases are presented, aged 64 and 80 years, both men, diagnosed by otomicroscopy and CT scan. Treatment is either conservative, by local cleansing of the pocket in the outpatient clinic, or surgical, by wide excision of the pocket and necrotic bone, then covering the area with temporal fascia. When the disease is detected early, treatment is simpler and shorter, and the outcome better.

Aged↗
PubMed1990

[Neonatal respiratory distress due to congenital laryngeal cyst].

Severe, progressive, neonatal respiratory distress in a 27-month-old girl which required endotracheal intubation, was due to a congenital supraglottic saccular cyst, a rare cause. Aryepiglottic fold bulging and medial displacement of the left side of the larynx, resulting in considerable narrowing of the air-way, were prominent direct laryngoscopic findings. Transoral needle aspiration temporarily improved the infant's condition, but recurrences required repeated endotracheal intubation and needle aspiration. CT imaging demonstrated an intralaryngeal, supraglottic saccular cyst. At 2 months of age the cyst was successfully excised via a paramedian thyrotomy, and tracheotomy avoided. We suggest surgical excision of congenital saccular laryngeal cysts in infants who do not respond to repeated needle aspiration, as effective definitive treatment.

Cysts↗
PubMed1990

Surgical management of congenital supraglottic lateral saccular cyst.

A case is described of a neonate with a rare, congenital, supraglottic, lateral, saccular cyst presenting with stridor and asphyxia. Repeated needle aspirations of the cyst failed to provide sustained clinical improvement. CT scans proved useful for precise intralaryngeal location of the cyst and planning of the surgical excision. At two months of age the cyst was successfully excised by a paramedian thyrotomy via an external cervical approach, avoiding tracheostomy.

Cysts↗
PubMed1990

Self-retaining intraurethral stent: an alternative to long-term indwelling catheters or surgery in the treatment of prostatism.

The self-retaining intraurethral coil is a device to stent the urethra in men who have severe urethral obstruction. It allows them to empty their bladders and still remain continent and sexually active. The device can be used in place of long-term indwelling catheters or as an alternative to surgery. During 1 year, we inserted the stent in 26 men who were poor operative risks. The treatment was successful in 20 (77%). All 20 were able to void satisfactorily. Four of the 20 resumed sexual activity, which previously had been prevented by indwelling catheters. Two patients who had delayed prostatic surgery because of fear of impotence were able to empty their bladders properly and to remain sexually active. Three patients subsequently had surgery, two after anticoagulant therapy could be stopped and one after renal function improved. No difficulties caused by the stent were encountered during surgery. Follow-up was for 2-12 months. Four patients who had had the stent in place for 12 months had no difficulties. In 16 of the 18 patients who had indwelling catheters and infected urine before insertion of the stent, sterilization of the urine was obtained after relatively short courses of antibiotic treatment. Short-term complications associated with the stent were incontinence or urinary retention. These were treated by repositioning the stent. Frequency of urination after insertion of the stent either disappeared spontaneously or was treated with anticholinergic drugs. In six patients, frequency was so severe that removal of the stent and insertion of an indwelling catheter were necessary. Slight to mild dysuria occurred immediately after surgery in all patients but eventually disappeared. Our experience suggests that the self-retaining intraurethral stent has considerable promise for the treatment of prostatic obstruction of the urethra.

Aged↗
PubMed1986

Importance of small bowel involvement in bleeding angiodysplasia.

Lower intestinal bleeding related to enterocolic angiodysplasia is now accepted as a common clinical situation in the elderly. A planned approach is mandatory to allow early localization and appropriate therapy. Colonoscopy, scintigraphy and angiography used judiciously have almost entirely replaced exploratory laparotomy as a diagnostic tool. Nonoperative treatment comprising arteriographic selective vasopressin infusion and endoscopic coagulation has been followed in some cases by hemorrhage control. Such techniques, if easily obtainable, have their place; however, surgery remains the ultimate method for definitive treatment. A previous knowledge of the nature of ileal involvement is essential if surgical hemostasis is to be achieved. The recent successful management of three patients exemplifies the problems found in dealing with iliocecal bleeding angiodysplasia.

Aged↗
PubMed1985

Fourth pharyngeal pouch sinus.

This is the first description and documentation of an extremely rare developmental anomaly of the pharyngeal apparatus in a 15-year-old female. The clinical, radiological, histological, and anatomical findings indicated that the anomaly originated in the pharyngeal fourth pouch. It presented as a recurrent lateral neck abscess which was due to a paratracheal sinus. This sinus penetrated the larynx and after a translaryngeal course ended in the pyriform sinus. It was caudad to the superior laryngeal nerve and external to the recurrent laryngeal nerve. Its penetration into the larynx at the cricothyroid joint region could serve as a useful surgical landmark.

Abscess↗