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Biomedical subjects

W Sangster

Publications and source records attributed to W Sangster.

6 recordsLinked to original sources
PubMed1992

Biliary complications related to laparoscopic cholecystectomies: radiologic diagnosis and management.

The purpose of this study was to review the radiologic presentations and management of biliary complications related to laparoscopic cholecystectomies. Additionally, a computed tomography (CT) evaluation of asymptomatic postsurgical patients was performed to determine the uncomplicated appearance of the gallbladder fossa. Over a 24-month period 23 biliary complications were seen in patients who underwent laparoscopic cholecystectomies (group 1). Twenty asymptomatic patients were examined with unenhanced CT examinations after laparoscopic cholecystectomy (group 2). Twenty patients in group I had bilomas located in the gallbladder fossa (n = 9), subhepatic (n = 7) and subphrenic (n = 2) spaces, and diffusely distributed in the peritoneal cavity (n = 2). The bile leaks were presumed to have been proved to be from the cystic duct (n = 19), right hepatic duct (n = 1), and common bile duct n = 3) injuries and leaks. Fourteen drains were placed percutaneously using CT (n = 12) or sonographic (n = 2) guidance, and in two cases drains were placed surgically. The duration of catheter drainage average 11.3 days. Six patients underwent endoscopic retrograde cholangiopancreatography (ERCP) procedures, including sphincterotomy (n = 6) and stent placement (n = 3). Patients who were treated with a drain or ERCP procedures or who were managed conservatively all recovered without the need for additional surgery. In five cases, the bile cultures were positive for multiple organisms. Three patients underwent surgical repairs for disrupted common bile ducts. In group 2 CT examinations showed minimal fluid densities in all patients. No evidence of distinct, well-demarcated fluid collection was seen in any of the 20 patients. (ABSTRACT TRUNCATED AT 250 WORDS)

Bile↗
PubMed1988

Percutaneous endoscopic gastrostomy.

Percutaneous endoscopic gastrostomy has been shown by many investigators to be a safe, rapid means of gaining access to the gastrointestinal tract. Over a 3 1/2 year period, 155 percutaneous endoscopic gastrostomies were performed. All of the patients had an inability to nourish themselves orally. The technique described by Ponsky et al was used. Preoperative antibiotics were administered to 108 patients, and most of the procedures were performed under local anesthesia. Many of the procedures were performed in association with tracheostomies. There were 17 complications (11 percent), including 2 deaths (1 percent). Comparison of percutaneous endoscopic gastrostomy to operative gastrostomy revealed percutaneous endoscopic gastrostomy to be superior. We believe that percutaneous endoscopic gastrostomy should be considered the procedure of choice for tube gastrostomy.

Adolescent↗
PubMed1988

Patterns of injury in helmeted and nonhelmeted motorcyclists.

In the present study, the incidence of severe brain injury was 600 percent higher for patients riding without a helmet and the incidence of all brain injuries was nearly twice as high in the nonhelmeted riders. All surviving patients with severe brain injury sustained residual long-term disability. The incidence of injury and death was much higher for motorcyclists than for occupants of automobiles involved in accidents. Riding a motorcycle is dangerous and riding without a helmet is fool-hardy. Helmets also protect the face, as facial fractures were twice as common in the nonhelmeted riders. There were no significant differences between nonhelmeted and helmeted motorcyclists in terms of overall injury as measured by an injury severity score of 16 or greater. Orthopedic injuries, in this study, were so common that orthopedic surgeons performed more major operations than all other surgical specialists combined. Depth of orthopedic coverage is essential to treat significant numbers of injured motorcyclists. Neurosurgeons are key members of a trauma care team. Helmet laws would help us utilize our limited neurosurgical capacity more effectively by reducing the incidence of brain injury. Medical professionals must educate the public regarding the societal and personal cost of unhelmeted motorcycle riding. Legislation mandating helmet usage for motorcycle riders must be sought.

Accidents, Traffic↗
PubMedDate not supplied

Laparoscopic-guided feeding jejunostomy.

Access for long-term enteral nutrition has long been the job of the surgeon. While percutaneous endoscopic gastrostomy has revolutionized the way we provide gastric feedings, jejunal access usually requires laparotomy. We have developed a technique for placing a laparoscopic guided jejunostomy. Twenty-three patients have undergone this procedure without complication. We believe this technique will be a valuable addition to the surgeon's options for obtaining enteral access.

Adult↗
PubMedDate not supplied

Potential impacts of MRI accidents.

A minor accident occurred in our Magnetic Resonance imaging suite. It is minor, because no personal injury nor equipment damage resulted from it. However, this incident has prompted us to review and re-emphasize our safety precautions and to investigate means of insurance coverage for any potential effects that could result from such incidents.

Accidents↗