ABSTRACT
Although lipolymph nodes have previously involved only pelvic or retroperitoneal lymph nodes, two patients are presented with lipolymph nodes involving the intestinal mesentery. The definitive diagnoses were made by exploratory laparotomy and multiple biopsies of intrabdominal lymph nodes. Both patients with lipolymph nodes are obese, middle-aged, and female, which is the typical clinical presentation. The microscopic picture is distinctive. The lymph nodes are entirely replaced by adipose tissue and have a thin outer rim of nodal tissue. The patient with a diagnosis of lipolymph nodes of the mesentery or the pelvis and retroperitoneum should receive conservative surgical treatment. Since the disease appears to have a benign course, surgical extirpation of abnormal lymph nodes is not needed or warranted.
Subject(s)
Adipose Tissue/pathology , Lymph Nodes/pathology , Lymphatic Diseases/pathology , Biopsy , Female , Humans , Lymphatic Diseases/complications , Lymphatic Diseases/diagnosis , Lymphatic Diseases/surgery , Mesentery , Middle Aged , Obesity/complicationsABSTRACT
This study of 106 patients who had end-to-end anastomoses (EEA) performed by 26 surgeons in 11 hospitals reports the operative and postoperative complications of using the EEA stapling device. The complications are probably exaggerated, because this study involves the initial experiences of many surgeons. The 106 patients included 78 patients with colon anastomoses, 3 with small intestinal anastomoses, and 25 with gastric anastomoses. The mortality rate included two patients (1.9%) with low rectal anastomoses who died of problems associated with the EEA stapler. The anastomotic morbidity rate included 9 operative complications (9%), which were corrected at operation, and 12 postoperative complications (11%), which included leaks (4), fistula (4), and stenosis (4). Intra-abdominal abscess occurred in 3 and wound infections in 19 patients (18%). The EEA stapler requires practice and specific skills for its safe use. The EEA stapler makes a reliable, inverted anastomosis and can be used successfully throughout the gastrointestinal tract.
Subject(s)
Surgical Staplers/adverse effects , Adult , Aged , Colon/surgery , Equipment Failure , Female , Humans , Intestine, Small/surgery , Intraoperative Complications , Male , Middle Aged , Postoperative Complications , Stomach/surgeryABSTRACT
A case report of disseminated adenomyomas of the abdominal and pelvic cavities is presented. Although the pathogenesis of these benign tumors is still unresolved, the authors postulate that they develop from the differentiation into smooth muscle of a multi-potential cell that arises from endometrial stromal cells in an area of preexisting endometriosis. Based on the authors' experience, when multiple leiomyomas are found in the peritoneal cavity, it is wise to make serial sections to determine whether endometrial tissue is present. The clinician must be alert to the fact that on gross examination adenomyomas can mimic metastatic carcinoma. Differentiation is made only through histologic examination. In addition, since adenosarcoma arising from adenomyoma is a documented occurrence, careful examination of histologic sections of adenomyomas is essential to avoid making the wrong diagnosis.
Subject(s)
Abdominal Neoplasms/diagnosis , Endometriosis/diagnosis , Pelvic Neoplasms/diagnosis , Abdominal Neoplasms/pathology , Adult , Diagnosis, Differential , Endometriosis/pathology , Female , Humans , Pelvic Neoplasms/pathologyABSTRACT
A freehand carbon dioxide laser is now available for surgical procedures. A comparison of its utility with the electrocautery was carried out in five dogs by the performance of hemisplenectomy. All dogs survived without complications. The laser proved to be an effective instrument for partial splenectomy under the terms of the experiment.
Subject(s)
Electrocoagulation , Laser Therapy , Splenectomy/methods , Animals , DogsABSTRACT
Adult hypertrophic pyloric stenosis is an unusual disease of obscure etiology which causes varying degrees of gastric outlet obstruction. Diagnosis by history, physical examination, and roentgenography is difficult but can be readily made with fiberoptic gastroscopy where a characteristic pyloric "cervix sign" is seen. All of the many operations for relief of gastric outlet obstruction have been tried with this lesion, with resection and Billroth I reanastomosis the accepted treatment. Two patients are reported with adult hypertrophic pyloric stenosis who had typical endoscopic findings. One was treated with distal gastrectomy, and the other was adequately treated by endoscopic dilatation alone. It is suggested that endoscopic dilatation is acceptable as primary therapy in suitable cases.
Subject(s)
Pyloric Stenosis/diagnostic imaging , Dilatation , Female , Fiber Optic Technology , Gastrectomy , Gastroscopy , Humans , Hypertrophy , Middle Aged , Pyloric Stenosis/surgery , RadiographySubject(s)
Hemorrhoids/therapy , Cryosurgery , Dilatation , Humans , Ligation , Perioperative NursingABSTRACT
An epidemiologic study of tuberculosis in dogs exposed to humans with recently reported tuberculosis was undertaken in Philadelphia between July 1966 and June 1968. A total of 29 dogs meeting the criteria for inclusion in the high-risk population were studied by history, physical examination, intradermal tuberculin tests, and radiographic and bacteriologic examination. Ten of the 29 dogs showed positive responses to US Department of Agriculture (USDA) standard mammalian tuberculin. Positive tuberculin tests to second strength PPD were demonstrated in five of the 10 responders to USDA mammalian tuberculin. No physical, radiographic or bacteriologic evidence of tuberculosis was found in any of the high-risk animals examined. In a comparison group of 70 dogs without knwon exposure to tuberculosis, two positive responses to USDA tuberculin were demonstrated and none to PPD.
