Translumbar inferior vena cava Groshong catheter placement in a patient with superior vena cava occlusion.
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Biomedical subjects
Publications and source records attributed to W D Morris.
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Based on our experience with four cases of liver cysts and review of the literature, the following conclusions are reached: (1) Diagnosis can be established with routine and special radiologic studies. (2) Laparotomy is indicated for patients with symptoms or uncertain diagnosis. (3) Surgical management should be guided by cyst size, location, and content. (4) Definitive surgical treatment is indicated only for cysts larger than 10 cm.
A case of metastatic melanoma of the stomach is reported with illustrative endoscopic and radiographic findings. Metastatic melanoma of the stomach may present with vague gastrointestinal symptoms, abdominal pain, or gastrointestinal bleeding. A history of melanoma may not be readily obtainable. When gastrointestinal symptoms occur in a patient with known melanoma, gastric metastases should be considered. Polypoid or target lesions are frequently seen on barium x-ray study. Small bowel roentgenograms should be obtained. Endoscopy, cytologic study, brushing, and biopsy may yield the diagnosis. The prognosis is poor. Surgery should be performed only to relieve significant symptoms.
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Our experience with five cases of cystic dilatation of the extrahepatic bile ducts is reported and compared with the literature. The following conclusions have been reached: (1) The etiology of this anomaly is primarily congenital but may involve an acquired component. (2) Diagnosis should be suspected when any of the triad of abdominal pain, right upper quadrant mass, or jaundice is present. (3) The diagnosis can usually be made in infants based on the clinical picture and routine radiologic studies. (4) Retrograde cholangiopancreatography is a useful tool in making the diagnosis in older children and adults. (5) Roux-en-Y choledochocystojejunostomy is the procedure of choice for type I cysts, excision for type II, and choledochocystoduodenostomy for type III.
Two cases of left ventricular-right atrial shunts inadvertently produced during aortic valve replacement are described. It is surprising that this complication is not more prevalent considering the close proximity of the aortic and mitral valves to the atrioventricular portion of the membranous septum. A left-to-right shunt should be a consideration in patients who fail to improve following aortic valve surgery, especially if the valve and subaortic region were heavily calcified or septal trauma occurred during the surgical procedure.
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