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Biomedical subjects

T C Simmons

Publications and source records attributed to T C Simmons.

At least 19 recordsLinked to original sources
PubMed1990

Traumatic pseudocyst of the spleen.

A rare case of a patient with a large multiloculated symptomatic pseudocyst of the spleen is presented. The splenic pseudocyst was diagnosed preoperatively by ultrasonography and computerized tomography of the abdomen. Pathologic spleen sections demonstrated benign splenic parenchyma overlying a fibrous cyst wall, the inner lining of which contained no epithelial membrane.

Abdominal Injuries↗
PubMed1989

Endoscopic sphincterotomy in the management of benign and malignant extrahepatic biliary obstruction.

One hundred twenty-one patients with extrahepatic biliary obstruction underwent endoscopic sphincterotomy (EST). This was followed by balloon occlusion catheter or dormia basket stone extraction in 106 patients with choledocholithiasis, and by transpapillary biliary endoprosthesis placement in 15 patients with malignant distal common bile duct obstruction. All patients had excellent biliary decompression. Complications not requiring surgical intervention were seen in six patients. This article shows that EST is a low-risk, effective therapy for benign and malignant extrahepatic biliary obstruction.

Adolescent↗
PubMed1989

Spontaneous gallbladder perforation.

Acute gallbladder perforation is an infrequent, although not uncommon, complication of cholecystitis. It is rarely diagnosed preoperatively and the delay in making the definitive diagnosis usually accounts for the increased incidence of morbidity and mortality associated with this complication. A case of a 92-year-old patient in whom acute gallbladder perforation was suspected peroperatively at ultrasonography of the abdomen and confirmed by technetium-99m disofenin radionuclide biliary scan is reported.

Aged↗
PubMed1989

Cystadenoma of the gallbladder.

A case of obstructive jaundice due to extrinsic common bile duct (CBD) pressure from a gallbladder mass is presented. Endoscopic retrograde cholangiopancreatography (ERCP) demonstrated a dilated CBD and a massively dilated gallbladder. Computed tomography scan of the abdomen revealed a multiseptated cystic structure originating from the gallbladder fossa. Histologic sections of the surgical specimen demonstrated a multilocular cyst lined with biliary-type epithelium. Fibromuscular proliferation of the cyst walls also was noted. A literature search did not reveal documentation of a similar gallbladder lesion. We believe this lesion represents the first reported case of gallbladder cystadenoma.

Aged↗
PubMed1989

Hepatic abscess due to transhepatic biliary endoprosthesis placement.

The authors present a patient with malignant biliary obstruction due to carcinoma of the pancreas, who developed a large pyogenic hepatic abscess after placement of a transhepatic biliary endoprosthesis. The hepatic abscess was suggested by the finding of a gas-filled defect in the right upper quadrant of the abdomen on chest x-ray and confirmed by computerized tomography of the abdomen.

Cholestasis↗
PubMed1988

Hepatic portal venous gas due to endoscopic sphincterotomy.

This report describes a patient with sickle cell disease and cholelithiasis with choledocholithiasis who developed benign hepatic portal venous gas following endoscopic sphincterotomy. The portal venous gas was rapidly absorbed without untoward sequelae.

Adult↗
PubMed1988

Pancreatic abscess associated with pancreas divisum.

Pancreas divisum has been implicated as a cause of pancreatitis. Pseudocyst development in association with chronic pancreatitis has also been observed in a few patients with this anomaly. The association of pancreatic abscess with pancreas divisum has not been observed previously. The case herein reported illustrates a coincidental finding of pancreas divisum in a patient who presented with a pancreatic abscess.

Abscess↗
PubMed1988

Early gastric cancer in clinical practice.

A description of four patients with early gastric cancer diagnosed by endoscopy is reported. All patients presented with type III (excavated or ulcerative) early gastric cancer. Early gastric cancer appeared to be slow growing in three patients, and was difficult to diagnose in two cases, especially when associated with large gastric ulcers. Endoscopic biopsy of nonhealing or recurrent gastric ulcers and endoscopic follow-up to complete ulcer healing are recommended.

Adult↗
PubMed1986

The effect of sodium bicarbonate versus aluminum-magnesium hydroxide on postprandial gastric acid in duodenal ulcer patients.

When ingested 1 hour after a meal, conventional liquid antacids have a buffering effect of approximately 2 hours, while in the fasting state their effect is brief, lasting less than 1 hour. We tested the hypothesis that equal doses of antacid, one water soluble (sodium bicarbonate) and the other water insoluble (aluminum hydroxide plus magnesium hydroxide, MaaloxR), would have similar durations of postprandial buffering if the water soluble antacid regenerates the particulate protein buffer of the meal that leaves the stomach more slowly than liquids. Tests were conducted in random order on three separate days in 10 patients with duodenal ulcer. The effects of 30 ml of 2.39 M sodium bicarbonate (6.17 g, about 1 teaspoonful), the aluminum-magnesium antacid, each equivalent to 71.7 mmol of in vitro buffer, and water as a control on pH, hydrogen ion activity, and titratable acidity were compared. Thirty milliliters of each was swallowed 1 and 3 hours after ingestion of a standard solid plus liquid. Compared to the water control each dose of sodium bicarbonate significantly increased intragastric pH and decreased hydrogen ion activity and titratable acidity for only 1 hour. Each dose of the aluminum-magnesium antacid significantly buffered intragastric contents for 2 hours. These findings indicate that sodium bicarbonate transiently buffers postprandial intragastric contents. Therefore, sodium bicarbonate fails to reconstitute the protein buffer of the meal effectively, and the observations suggest that it leaves the stomach rapidly with the liquid phase of the meal. However, the water insoluble, aluminum-magnesium antacid has a longer duration of buffering, probably because it leaves the stomach more slowly, largely with the solid portion of the meal.

Adult↗
PubMed1985

Endoscopic sphincterotomy in clinical practice.

Endoscopic sphincterotomy was performed in 22 patients with biliary obstruction. Nineteen patients had obstructing choledocholithiasis and three patients had distal common-bileduct obstruction due to malignant disease. All patients had excellent biliary decompression. Three patients had complications that responded to medical management. Endoscopic sphincterotomy is a safe and effective procedure for the nonsurgical management of obstructive-biliary-tract disease.

Adult↗
PubMed1981

Failure of gastric inhibitory polypeptide to inhibit pentagastrin-stimulated acid secretion in vagotomized human subjects.

Five vagotomized male subjects were given graded doses of pentagastrin without and with a background infusion of 2 microgram/kg/hr of gastric inhibitory polypeptide (GIP). An insulin infusion test (0.1 units/kg/hr) showed that the vagotomies were complete. GIP infusion failed to inhibit pentagastrin-stimulated acid and pepsin secretion even though plasma GIP concentration reached a plateau much higher than that measured after ingestion of a meal. We conclude that GIP does not inhibit pentagastrin-stimulated gastric acid secretion in vagotomized human subjects.

Adult↗
PubMed1981

A therapeutic trial of 15 (R)-15-methyl prostaglandin E2 in rheumatoid arthritis patients with gastroduodenal lesions.

Thirteen patients who had rheumatoid arthritis and gastroduodenal lesion (erosions, ulcers) received 200 micrograms/d of 15(R)-15-methyl prostaglandin E2 (MPGE2) for one month in a controlled, randomized, double-blind crossover study. The patients continued their usual arthritis medications. Serial assessments were made with endoscopy and multiple antral biopsies. Seven patients improved on MPGE2 and 3 improved on placebo. Two patients worsened on MPGE2 compared with 3 on placebo. No dramatic benefit was observed after one month of therapy with MPGE2, although a moderate benefit could have been missed in a small study of this type. Our experience with this study suggests that future studies in rheumatoid arthritis should first establish the natural history of lesions in a given group of patients, that a cross-over design may actually hamper interpretation and that therapy should be more prolonged.

Adult↗