Biomedical subjects
W Brzezinski
Publications and source records attributed to W Brzezinski.
Acute mesenteroaxial gastric volvulus in an infant: a case report.
Only 52 cases of gastric volvulus have been reported in children and infants. The pathophysiology of the condition relates to an abnormal rotation of the stomach. The authors report a case of an 11-month-old infant who presented with an 8-hour history of retching and obtundation. Abdominal distension and left upper-quadrant tenderness were the predominant physical findings. A diagnosis of mesenteroaxial gastric volvulus with eventration of the left hemidiaphram was made by means of plain-films and an upper gastrointestinal series. The child underwent laparotomy and gastrostomy, made a smooth recovery and was well 36 months postoperatively.
Small-bowel lipoma: an uncommon cause of obstruction.
Small-bowel tumours are an uncommon cause of small-bowel obstruction. The symptoms are unusually nonspecific and intermittent. Contrast studies of the small bowel are the best means of delineating the lesion. The authors present a case in which obstruction was treated with small-bowel resection, and they give a brief account of the occurrence of small-bowel tumours in a major teaching hospital.
Prospective and retrospective analysis of colonoscopy findings in patients with a history of colorectal carcinoma in first-degree relatives.
The frequency of colorectal neoplasia was assessed by colonoscopy in 48 patients with a history of colorectal cancer in a first-degree relative. Twelve of these patients were found to have polyps in the colon, including 1 who had invasive cancer. Patients with multiple first-degree relatives who have a history of colorectal cancer were found to be at increased risk, 56% having colonoscopic findings positive for polyps. Of the 12 patients with positive colonoscopic findings, 5 (42%) had multiple lesions. These findings are similar to those reported in recent pedigree studies and further support a genetic basis for common colorectal cancer. First-degree relatives of patients with colorectal cancer should be considered a high-risk group for colorectal neoplasia. Screening with colonoscopy is recommended.
Pulmonary zygomycosis. A cause of positive lung scan diagnosed by bronchoalveolar lavage.
The diagnosis of pulmonary zygomycosis usually depends on the detection of fungal hyphae in biopsied tissue specimens. We describe a patient with a high-probability lung scan and diffuse pulmonary infiltrates due to Zygomycetes diagnosed by the demonstration of nonseptate hyphae in bronchoalveolar lavage fluid.
Transiliac bypass for infected femoral end of an aortofemoral graft.
Infection of an aortofemoral fabric graft is among the most serious complications of vascular surgery and necessitates removal of the graft. The authors chose a transosseal (iliac bone) approach to permit a new graft to be carried down to the periphery without the risk of contamination or pressure on it from the patient's position. They performed this procedure in a 71-year-old man. He underwent a transiliac bypass before the infected limb of an aortobifemoral graft was removed. He was well 11 months after the operation and the graft was functioning well with no evidence of infection.