ABSTRACT
Clinical central venous thrombosis (CVT) was found to be associated with a catheter tip position in the superior vena cava (SVC), but not in the right atrium (RA), in patients receiving a standard parenteral nutrition regime in which dextrose was the sole energy source. CVT was rare with standard lipid containing three in one mixes, even when the catheter tip lay in the SVC. The reasons for this are discussed and the complications associated with catheter tip position are reviewed.
Subject(s)
Catheterization, Central Venous/adverse effects , Superior Vena Cava Syndrome/etiology , Catheters, Indwelling , Humans , Parenteral NutritionABSTRACT
Operative biliary dilatation and prolonged percutaneous transhepatic biliary stenting have been useful in the management of primary sclerosing cholangitis, both intrahepatic and extrahepatic biliary strictures regressing after 12-16 months of treatment. We report the results of less prolonged treatment in a further four patients, in whom removal of a percutaneous transhepatic biliary stent 3-11 months after treatment led to an improvement in radiological appearances of the extrahepatic bile ducts, with no discernible effect on intrahepatic disease. Extrahepatic stricture recurred rapidly in one patient stented for only 3 months. Operative biliary dilatation and stenting for 5-11 months may lead to regression of extrahepatic biliary strictures in patients with primary sclerosing cholangitis, whereas intrahepatic disease requires stenting for 12-16 months. Further study is required to determine the applicability of this approach to primary sclerosing cholangitis.
Subject(s)
Cholangitis/surgery , Prostheses and Implants , Adult , Dilatation , Humans , Male , Middle Aged , RecurrenceABSTRACT
Incorporation of intravenous 75Se-methionine into duodenal juice proteins during pancreatic stimulation was measured as an index of pancreatic enzyme synthesis rates in 12 patients with a normal pancreatogram and in 6 with mild chronic pancreatitis. Isotope incorporation was significantly greater in subjects with mild chronic pancreatitis than in those with a normal pancreatogram. Thus in most patients in whom pancreatography demonstrates the characteristic radiological features of 'mild chronic pancreatitis' pancreatic acinar function is abnormal. The coexistence of morphological and functional abnormality implies that such patients do have chronic pancreatitis.
