ABSTRACT
Breast cancer affects one in ten women during their lifetime. Recognizing the importance of early detection in the prognosis of this condition, the American Board of Obstetrics and Gynecology has stated guidelines encouraging breast disease education in obstetrics and gynecology training programs. To fulfill this academic responsibility, we have organized a multidisciplinary Breast Disease Detection and Treatment Clinic where patients with abnormal mammograms or any breast-related complaints are evaluated and managed. In cooperation with the radiology department and general surgery service, a mammogram review conference has been instituted. Abnormal mammograms are reviewed with a radiologist. Our activities have been coordinated such that a general surgery staff member and resident are present during the breast clinic hours to review mammograms and to examine the patients with the gynecologist, providing immediate consultation. Needle aspiration of breast cysts, repeat imaging studies, and general surgery referrals for breast biopsies are performed as indicated. The patient receives integrated care of her breast problem in one visit, and our residents gain the experience of diagnosing and managing breast problems which, before establishment of this clinic, were referred to the general surgery department. This multidisciplinary approach developed in our institution helps us provide the most efficient care to our patients, while providing our residents with integrated teaching and training concerning the diagnosis and management of breast disease.
Subject(s)
Breast Diseases , Gynecology/education , Internship and Residency , Obstetrics/education , Ambulatory Care Facilities , Breast Diseases/diagnosis , Breast Diseases/therapy , Education, Medical, Continuing , Female , General Surgery/education , Humans , Radiology/educationABSTRACT
A 30-year-old American Indian male with a history of chronic pancreatitis and prior blunt abdominal trauma was preoperatively diagnosed as having a splenic pseudocyst. The patient was successfully treated surgically with decapsulation of the pseudocyst instead of a splenectomy.
Subject(s)
Abdominal Injuries/complications , Cysts/etiology , Splenic Diseases/etiology , Adult , Cysts/diagnosis , Cysts/surgery , Humans , Male , Spleen/injuries , Splenic Diseases/diagnosis , Splenic Diseases/surgery , Wounds, Nonpenetrating/complicationsABSTRACT
A simple, inexpensive technique for placement of the T tube or Jackson-Pratt closed suction drainage catheter through the skin is described herein. This is an ideal procedure to use when treating a patient who has underlying ascites and is at a higher risk of having a leak develop through the standard procedures of placing drains.
Subject(s)
Catheterization/methods , Drainage/methods , Catheterization/instrumentation , Drainage/instrumentation , HumansABSTRACT
Three new instances of adult duodenal web and associated peptic ulcer disease are presented. In addition, 33 instances of adult duodenal web from the literature are reviewed. Peptic ulcer disease occurred in association with duodenal web in six of these 33 patients. Operative management of these patients was reviewed and the difficulty in diagnosis of duodenal web was emphasized. Optimal treatment of adult duodenal web was web excision and duodenoplasty. This treatment was successful in all 20 instances in which it was used. The added complication of peptic ulcer disease in nine patients with duodenal web required an anti-ulcer procedure in addition to standard treatment of duodenal web. The outcome in these nine patients was excellent.
