ABSTRACT
An infiltrate in the abdominal cavity in Crohn's disease does not hinder successful drug therapy in most cases. A positive effect (regression or a marked decrease in the size of the infiltrate) is achieved in 80% of patients, mostly in those with a moderately or mildly severe form of the disease in which a sufficiently prolonged, 10-12-week course of antiinflammatory treatment can be conducted. Combination of prednisolone with azathioprine and antibiotics is most justified. The prednisolone dose is determined by the severity and activity of the disease rather than by the infiltrate. Antibiotics are necessary only in high fever and treatment with them may be limited to 10-14 days in the absence of septicemia. Interrupted seasonal courses of sulfasalazine therapy may fail to prevent exacerbation and, consequently, recurrent infiltrates. These respond readily to repeated drug therapy and do not expand the indications for surgery. Operations were performed on 14 patients, in 11 of them the infiltrate did not recur again.
Subject(s)
Anti-Inflammatory Agents/therapeutic use , Azathioprine/therapeutic use , Crohn Disease/drug therapy , Inflammation/drug therapy , Prednisolone/therapeutic use , Abdomen , Combined Modality Therapy , Crohn Disease/complications , Crohn Disease/diagnosis , Crohn Disease/surgery , Drug Therapy, Combination , Humans , Inflammation/diagnosis , Inflammation/etiology , Severity of Illness Index , Treatment OutcomeSubject(s)
Colitis, Ulcerative/complications , Intestinal Neoplasms/etiology , Intestine, Large , Adult , Colitis, Ulcerative/diagnosis , Colitis, Ulcerative/pathology , Colitis, Ulcerative/surgery , Colonoscopy , Crohn Disease/complications , Crohn Disease/diagnosis , Crohn Disease/pathology , Crohn Disease/surgery , Female , Humans , Intestinal Neoplasms/diagnosis , Intestinal Neoplasms/pathology , Intestinal Neoplasms/surgery , Intestine, Large/diagnostic imaging , Intestine, Large/pathology , Intestine, Large/surgery , Male , Middle Aged , Radiography , Risk Factors , Time FactorsSubject(s)
Amputation, Traumatic/surgery , Penis/surgery , Surgery, Plastic/history , History, 20th Century , Humans , Male , Penis/injuries , USSR , United StatesSubject(s)
Pancreas/surgery , Pancreatitis/surgery , Adult , Aged , Chronic Disease , Female , Humans , Male , Methods , Middle AgedSubject(s)
Vagotomy/history , Animals , History, 19th Century , History, 20th Century , Humans , Peptic Ulcer/history , Peptic Ulcer/surgeryABSTRACT
Eight patients with chronic pancreatitis were subjected to subtotal (95%) resection of the pancreas. The authors believe that such surgical intervention should be performed when the pathological process had involved the left half of the gland, while its head remained little changed or intact. Subtotal resection is indicated also in cases of primary pancreatitis when the organ parenchyma is changed and the major pancreatic duct is not dilated. In such cases it is not expedient to make a pancreato-digestive anastomosis.