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Biomedical subjects

Y Berlatzky

Publications and source records attributed to Y Berlatzky.

At least 19 recordsLinked to original sources
PubMed1990

Primary choledochoduodenostomy for benign obstructive biliary tract disease.

Repeated surgical interventions on the biliary ductal system increase morbidity and mortality, particularly in the geriatric patient. In an attempt to prevent these complications, side-to-side choledochoduodenostomy was performed as the primary operative procedure in 54 patients, age 72 +/- 13 years. This was the patients' first surgical intervention for benign obstructive lesions of the biliary tract system. Indications for choledochoduodenostomy were: multiple or irremovable common or hepatic duct stones, doubtfulness of complete clearing of the duct, primary common bile duct stones or mud and sludge, a grossly dilated biliary duct system, and ampullary stenosis. We encountered no operative or hospital mortality among this group of 54 patients. The mean postoperative hospital stay for this aged and relatively sick group of patients was 12.3 +/- 6.2 days. Twenty-three minor postoperative complications occurred in 18 patients, none of them requiring reoperation. The patients were followed for 2-16 years. Thirteen patients (24%) were lost to follow-up. Of the 41 patients available for follow-up, 14 died, none from biliary tract associated causes--mostly from cerebrocardiovascular disease. Twenty-seven patients still alive were found to be free of biliary tract associated abdominal complaints or recurrent cholangitis for a mean period of 7.8 +/- 3.7 years. The data indicate a zero reoperation rate during long-term follow-up, zero mortality rate, and low morbidity in a group of elderly, mostly poor risk patients. This leads us to conclude that a side-to-side choledochoduodenostomy is both the best therapy as well as prophylaxis against common duct stones. This, even in this era of endoscopic papillotomy and biliary lithotripsy.

Adolescent↗
PubMed1989

[Routine omentectomy during Tenckhoff catheter insertion for peritoneal dialysis].

Peritoneal dialysis is now one of the main methods of treating acute and chronic renal failure, and the number of patients treated by continuous ambulatory peritoneal dialysis (CAPD), instead of hemodialysis, is increasing. The most commonly used device for CAPD is the Tenkhoff catheter. The major complications after its insertion are infection and catheter obstruction. To reduce the incidence of obstruction and related complications, usually the result of omental occlusion of catheter ports, we performed routine omentectomy on insertion of the catheter. During 1984-1987 we inserted 56 Tenckhoff catheters for CAPD in 32 males and 20 females ranging in age from 2.5 to 83 years (mean 50.1 +/- 19.7). 32 suffered from end-stage renal disease and 20 from acute temporary renal failure. In 87% local anesthesia was used, and in the others general anesthesia. Omentectomy was performed in 81%. In only 8 patients (15%) omentectomy could not be performed, as the omentum was either too short or was adherent to the abdominal wall as a result of previous abdominal surgery. In an additional 2 patients the omentum was not resected, in 1 because of previous surgery for a perforated duodenal ulcer and in the other because the procedure was performed at the bedside. Peritonitis followed in 14 cases, but in 12 of them it completely resolved after administration of antibiotics. Over a follow-up period of 32 months there was only 1 case of catheter obstruction, significantly fewer than reported in other series. We conclude that routine omentectomy during insertion of the Tenckhoff catheter for CAPD under local anesthesia is safe and reduces the incidence of catheter obstruction during short and long term use.

Acute Kidney Injury↗
PubMed1989

Fever caused by leaking atherosclerotic abdominal aortic aneurysm.

Two cases of leaking atherosclerotic abdominal aortic aneurysm are presented. The leakage caused fever and leukocytosis, combined with signs of peritoneal irritation. Blood hemoglobin levels were reduced. Both patients were initially treated for sepsis but within hours the cause was identified; both died in the operating theater. The experience of others is reviewed and the mechanism of fever caused by leaking aneurysm is discussed.

Aged↗
PubMed1985

Burn trauma induces anorexia and aberrations in CNS amine neurotransmitters.

A 30% surface area, full-thickness, open-flame burn of guinea pigs induced significant anorexia and rapid loss of body weight. Analysis of regional brain concentrations of amine neurotransmitters suggested burn-specific elevation of serotonergic neurotransmission, reduction of dopamine metabolism, and elevation of norepinephrine concentrations in brain areas thought to control feeding. These data suggest that specific regional aberrations in each of these amine neurotransmitters may contribute to the anorexia associated with major thermal injury.

Animals↗
PubMed1979

Carcinoma of colon after ureterocolic anastomosis: implantation on calyceal mucosa.

Two cases are reported of the development of mucoid adenocarcinoma of the colon in young patients, nineteen and thirty-four years after ureterocolic anastomosis for benign conditions. One patient showed implantation of the colonic neoplasm on the mucosa of an upper calyx in the obstructed kidney. Patients who have undergone ureterocolic anastomosis have a greatly increased risk of the development of large-bowel neoplasms. When suspected, radiologic examination of the colon using a water-soluble contrast material, together with rectosigmoidoscopy or colonoscopy, is essential. Because of the serious nature of this complication, it is suggested that the recent trend to return to the use of large bowel in urinary diversion may be hazardous, especially in the young patient with a benign disease.

Adenocarcinoma, Mucinous↗
PubMed1979

Acute blunt traumatic rupture of the diaphragm in a child.

Diaphragmatic rupture due to blunt trauma is rare in childhood. The possibility of such injury must be borne in mind whenever blunt abdominal and chest trauma is encountered. This paper reports a case of diaphragmatic rupture in a child with multiple injuries sustained in a road accident.

Accidents, Traffic↗
PubMed1979

Percutaneous cannulation of the internal jugular vein in infants and children.

A technique for percutaneous catheterization of the internal jugular vein in infants and children was used since January 1975 in 206 patients ranging in age from a few hours to 12 years old. The series included 31 premature infants weighing less than 2,500 grams and 107 babies weighing less than 4,000 grams. Five attempts at cannulation failed. Each catheterization procedure required an average of 1.8 needle insertions before the vein was entered. In 129 patients, the first attempt was successful. Sixteen complications related to the procedure occurred early in our experience, seven of which were life threatening. One death was directly ascribed to the actual insertion of the catheter and mediastinal extravasation of infusion material. Most of the early complications probably could have been injected through the catheter immediately after cannulation, in addition to aspirating the blood and lowering the infusion bottle. The 22 late complications were related to infection; one infant died because of catheter sepsis. To minimize septic complications, an arbitrary limit of seven days was set, after which the catheter was replaced. Cannulation of the internal jugular vein in infants and children should be regarded as a serious surgical procedure to be performed by a trained team and only when properly indicated.

Bacterial Infections↗
PubMed1978

A life-threatening complication of the infusion pump.

Serious disturbances in respiration and venous return developed in 2 infants in whom infusion into a central vein was controlled by a peristalic pump. The effects were the result of extravasation which led to build-up of pressure in the medistinum.

Heart Arrest↗
PubMed1978

A continent ileostomy and reservoir using the canine ileocolonic segment.

The present study was an attempt to create a simple reservoir with a reliable continent ileostomy, so as to overcome the many drawbacks of the regular ileostomy. The ileocolonic segment was isolated and the ileum was intussuscepted into the colon to augment the ileocolonic sphincter. Pressure recordings disclosed a high pressure zone in the ileocolonic sphincter area reacting with a significant pressure increase to colonic distention. The proximal ileal end was anastomosed to the colonic part of the ileocolonic segment, and the ileal part of the ileocolonic segment was maturated as an ileostomy. The colonic reservoir was emptied by catheterization. Between catherizations, the ileostomies remained completely continent to small intestinal contents and gas. The reservoir and continent ileostomy are easily constructed, offer convenience and safety, voluntary and controlled emptying and conservation of part of the water and sodium excessively lost with conventional ileostomies. The procedure should be applied only to those patients in whom the right colon is unaffected or only slightly affected by the inflammatory process.

Animals↗
PubMed1977

Choledochoduodenostomy in the treatment of benign biliary tract disease.

Recurrent surgical interventions on the biliary system for benign biliary tract diseases carry high morbidity and mortality. Choledochoduodenostomy creates a large and easily performed biliodigestive anastomosis enabling good drainage of the biliary system. Among 27 patients undergoing choledochoduodenostomy for benign biliary tract diseases, recurrent cholangitis occurred in only one patient, in whom a stenosed anastomosis was probably the culprit. The other patients have been free of abdominal complaints, cholangitis, or pancreatitis for follow-up periods of from six months to eight years. There was no operative mortality; morbidity was 45%, but hospital stay averaged only 14.7 days. The traditional objections to this procedure do not seem valid where choledochoduodenostomy is rightly indicated, the common bile duct is dilated, and a wide enough anastomosis is constructed. Our favorable results mark choledochoduodenostomy as a safe, simple, and effective procedure in the management of benign biliary tract disease, particularly in the high risk patient.

Adolescent↗
PubMed1977

Small paraduodenal hernias.

During an 18-month period, five patients ranging in age from 3 1/2 to 79 years old were treated for small paraduodenal hernia. Three had acute strangulated obstruction, while in the other two patients the hernia was found incidentally, during surgery for other causes. As the mortality of obstructing internal hernias exceeds 50%, all paraduodenal hernias, even small and asymptomatic ones, should be considered an operable condition. The operating surgeon must be aware of the various types and locations of paraduodenal hernias and look for them whenever operating for unexplained abdominal pain or obstruction. Contrary to the common assumptioh that paraduodenal hernias are rare congenital anomalies, we believe the rarity of this condition to be due to insufficient attention to the clinical picture and inadequate exploration of the paraduodenal hernia during laparotomy.

Aged↗
PubMed1977

Abdominal injuries due to blank cartridges.

Blank cartridges may produce serious injury and the recognition of this hazard must be borne in mind when treating these wounds. This paper reports two cases of complicated abdominal injury inflicted by a blank cartridge.

Abdominal Injuries↗