Biomedical subjects

Thomas Satyadas

Publications and source records attributed to Thomas Satyadas.

4 recordsLinked to original sources

PubMed2007

Does moderate celiac axis stenosis identified on preoperative multidetector computed tomographic angiography predict an increased risk of complications after pancreaticoduodenectomy for malignant pancreatic tumors?

OBJECTIVES: To identify any association between celiac artery compromise found on computed tomographic angiography and the incidence of postoperative and perioperative complications. METHODS: The computed tomographic angiograms of 36 patients who underwent the Whipple procedure for pancreatic adenocarcinoma were examined retrospectively. The association between the results and surgical course was investigated. RESULTS: Twelve patients (33%) had significant postoperative complications. Ten (28%) had evidence of celiac artery stenosis. Stenosis ranged from 20% to 60%. There was no evidence of a difference between the 2 groups. CONCLUSION: There seems to be no evidence of an increased risk of postoperative or perioperative complication in patients undergoing the Whipple procedure, with a celiac stenosis of up to 60%.

Adenocarcinoma↗

PubMed2002

Spontaneous resolution of a superior mesenteric vein thrombosis after laparoscopic nissen fundoplication.

A previously fit 37-year-old man developed superior mesenteric venous thrombosis after undergoing a laparoscopic Nissen fundoplication. Despite receiving thrombo-embolic prophylaxis on postoperative day 16, he presented with a gradual onset of vague, but severe, umbilical and epigastric pains. Laboratory tests, abdominal ultrasound scan and gastroscopy were all unremarkable. Contrast enhanced abdominal spiral computerised tomography (CT) revealed a partial occlusion of the superior mesenteric and portal vein due to a thrombus; abnormal flow was confirmed on colour Doppler ultrasound. A predisposing hyper-coagulable condition was excluded. The patient responded rapidly to expectant management and a repeat spiral CT scan, 3 weeks after the initial presentation, demonstrated complete re-canalisation of the vessel. Although rare, superior mesenteric venous thrombosis is probably underdiagnosed due to the vague nature of the symptoms, the lack of clinical signs, a low index of suspicion on the part of the clinician, and then subsequent failure to request the optimal investigation--namely contrast enhanced abdominal spiral CT scan. We discuss the possible mechanisms by which laparoscopic surgery may increase the risks of developing superior mesenteric venous thrombosis, the pitfalls in diagnosis and treatment options.

Abdominal Pain↗

PubMedDate not supplied

Combined endoscopic approach for the management of a difficult recto-sigmoid anastomotic stricture.

A 48-year-old woman underwent an emergency laparotomy for a perforated diverticular abscess. At operation, a peritoneal lavage was carried out, but no colonic resection was undertaken. Subsequently, she developed recurrent sepsis and underwent a second laparotomy. The patient was referred to our institution for a definitive left hemicolectomy and diverting loop colostomy. Before closing the colostomy, a contrast enema revealed obstruction of the lumen at the anastomotic site. This was refractory to conventional colonoscopic dilatation. A simultaneous endoscope was passed through the distal loop of the colostomy in addition to a conventional approach. A defect was created that allowed passage of a guide-wire and balloon dilator. One week later, the anastomosis remained patent, and the colostomy closed. The patient remains well, with normal bowel function. This novel combined endoscopic approach for dealing with colonic stenoses avoids the higher morbidity and mortality associated with an open surgical procedure.

Constriction, Pathologic↗

PubMedDate not supplied

An unusual case of ectopic or "parasitic" leiomyoma excised by laparoscopic surgery.

A 47-year-old woman underwent a laparoscopic resection of a large ectopic or "parasitic" fibroid filling the pelvis and placed within the rectosigmoid mesentery. The tumor was excised completely without a need for hysterectomy. Immunohistochemical and ultrastructural studies confirmed a "parasitic" leiomyoma, excluding sarcoma or a gastrointestinal stromal tumor. Because of its bizarre location in relation to the large bowel, a combined general surgical and gynecological approach was used successfully. The pathology of this rare tumor is reviewed.

Female↗