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Biomedical subjects

W A Whitehead

Publications and source records attributed to W A Whitehead.

5 recordsLinked to original sources
PubMed1980

Ileosigmoid knot.

The ileosigmoid knot (ISK) is a variant of midgut volvulus in which a loop of ileum wraps around the base of an elongated sigmoid colon and passes beneath itself forming a knot. A long small bowel mesentery and a sigmoid colon on a narrow pedicle are necessary prerequisites, but the wide variation in incidence of ISK across the world seems to be related to dietary habits. Rapid fluid resuscitation, preoperative broad-spectrum antibiotics, methylprednisolone in the presence of shock, and immediate laparotomy may improve the high mortality.

Adult↗
PubMed1980

Surgical treatment of carcinoma of the anus.

We studied 37 cases of carcinoma of the anus treated from 1950 to 1977, reviewing preexisting anorectal disorders, presenting symptoms, anatomic location, and histologic classification. There was a fivefold female-to-male predominance. Most patients presented in the seventh decade of life and exhibited alarming delays in seeking professional care. The crude five-year survival rate for all patients was 64%. Synchronous inguinal node metastasis is a poor prognostic sign, but some patients achieved excellent survival statistics after groin dissection. Guidelines for surgical management are presented.

Adult↗
PubMed1975

Acute perforated duodenal ulcer. An evaluation of surgical management.

The surgical management of acute perforated duodenal ulcer has been evaluated in 360 patients. Simple closure was done in 254 patients, with a mortality of 6.7%, a morbidity of 21%, and an average hospital stay of 11.9 days. In 106 patients (29%) who underwent definitive operation for treatment of duodenal ulcer disease at time of perforation, the mortality was 2.8%, the morbidity was 15%, and the average hospital stay was nine days. Follow-up studies of simple closure in patients with no previous ulcer symptoms showed that 72% of the patients remained asymptomatic; in patients with previous ulcer symptoms, only 23% were asymptomatic. Definitive operation for acute perforation is indicated in good-risk patients who have a history of ulcers. Parietal cell vagotomy and simple closure was used in four patients with excellent early results.

Adult↗
PubMed1974

Surgical management of reflux gastritis.

Reflux gastritis is now recognized with increasing frequency as a complication following operations on the stomach which either remove, alter, or bypass the pyloric phincter mechanism. The entity may occasionally occur as a result of sphincter dysfunction in the patient who has not undergone prior gastric surgery. The diagnosis is made on the basis of symptoms (postprandial pain, bilious vomiting and weight loss), gastroscopic examination with biopsy and persistent hypochlorhydria. Remedial operation for correction of reflux is indicated in the presence of persistent symptoms when conservative measures fail. Only operative procedures which divert duodenal contents from the stomach or gastric remnant are effective. Both the isoperistaltic jejunal segment (Henley loop) and the Roux-en-Y diversion have been effective as remedial operations for reflux gastritis and merit greater awareness by gastroenterologists and surgeons. Our choice is the Roux-en-Y because of its technical simplicity and lower morbidity rate.

Achlorhydria↗