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T D Gopichandran

Publications and source records attributed to T D Gopichandran.

8 recordsLinked to original sources
PubMed1999

Carotid stenosis in the real world--can Doppler ultrasound replace angiography in a district general hospital setting?

Large trials have confirmed the benefit of carotid endarterectomy in the prevention of stroke in patients with transient ischaemic attacks and > or =70% stenosis of the ipsilateral internal carotid artery. Invasive confirmatory angiography carries some risk, but these patients can be identified by Doppler ultrasound. Non-invasive confirmatory testing with spiral computed tomographic angiography or magnetic resonance angiography is not easily available in many hospitals. In this study, criteria have been developed for use in this unit to identify significant carotid artery stenosis and enable selection for surgery after Doppler ultrasound alone, with known degrees of sensitivity, specificity and accuracy. Carotid arteriography is reserved for a minority of cases.

Blood Flow Velocity↗
PubMed1999

Ultrasound evidence of gas in the fissure for ligamentum teres: a sign of perforated duodenal ulcer.

We present a case of confined duodenal ulcer perforation diagnosed on ultrasound. Locules of gas were visible in the fissure for ligamentum teres along with a small amount of free fluid in Morrison's pouch and thickening of the gall bladder wall. To our knowledge, "free" intraperitoneal gas confined to the fissure for ligamentum teres has not previously been reported as an ultrasound finding in perforated duodenal ulcer.

Duodenal Ulcer↗
PubMed1998

Ultrasound-guided unilateral neck exploration for sporadic primary hyperparathyroidism: is it worthwhile?

The role of preoperative localisation tests before initial neck exploration for primary hyperparathyroidism (PHP) remains controversial, as does the optimal surgical approach. We report our experience with preoperative ultrasound (US) and the operative management of sporadic PHP between 1990 and 1995. Preoperative US was carried out by an experienced radiologist. Three surgeons adopted a policy of 'selective' US-guided unilateral neck exploration (UNE); the fourth surgeon performed routine bilateral neck exploration (BNE). There were 72 patients: 26 men and 46 women, with a mean age of 57.4 +/- 12.5 years (range 21-80 years). All patients underwent initial neck exploration for 'sporadic' PHP, of whom 63 had preoperative US. This was positive in 52 patients; 27 of whom underwent a UNE, 23 had a BNE, and two patients had a UNE converted to a BNE. Patients with 'negative' US (n = 11), and those receiving no preoperative localisation test (n = 90) underwent a BNE. The sensitivity, specificity and accuracy of US were 80% (52/65), 100% (61/61), and 90% (113/126), respectively. Comparable success rates were achieved (BNE: 97% (33/34) vs UNE: 93% (27/29), P < 0.05), with very low morbidity. Failures with the scan-guided UNE were caused by missed contralateral adenomas. An experienced radiologist and a low incidence of multiglandular disease (MGD) are essential prerequisites for the scan-guided unilateral approach. An experienced surgeon, on the other hand, is the only prerequisite for the 'gold standard' bilateral approach.

Adenoma↗
PubMed1992

Case report: metastatic transitional cell carcinoma presenting in a urinoma.

We describe a case of transitional cell carcinoma (TCC) metastasising into a urinoma cavity in a patient where the primary tumour arose at the ipsilateral ureterovesical junction. Seeding of transitional cell carcinoma into contiguous structures following surgical intervention has been reported, but to our knowledge, this is the first report of spread into a distant urinoma.

Carcinoma, Transitional Cell↗
PubMed1987

Tuberculosis affecting the oesophagus.

Three Asian patients presenting with dysphagia were shown to have oesophageal involvement secondary to adjacent tuberculous mediastinal lymph nodes. The findings included fistula between the oesophagus and the tracheobronchial tree and extrinsic compression of the oesophagus. These cases reflect the increasing incidence of mediastinal lymphadenopathy in adult tuberculosis, especially in our immigrant community.

Adult↗
PubMed1980

Metoclopramide in double contrast barium meals.

A prospective controlled trial was carried out to evaluate the usefulness of the administration of Metoclopramide (Primperan) prior to double contrast barium meal examinations. The results indicated that this did not significantly alter the quality of the examination.

Adolescent↗