Subject(s)
Appendicitis/diagnosis , Acute Disease , Adolescent , Adult , Aged , Aged, 80 and over , Child , Cough , Diagnostic Tests, Routine , Female , Humans , Male , Middle Aged , Peritonitis/etiology , Prospective StudiesSubject(s)
Bandages , Adolescent , Adult , Aged , Aged, 80 and over , Child , Female , Humans , Male , Middle Aged , Plant Extracts , Prospective Studies , Sterilization , Styrax , Sutures , Wound HealingABSTRACT
Bowel preparation by conventional methods is time-consuming and unpleasant for both patient and staff. In addition, it requires admission to hospital several days before surgery. Preparation using oral polyethylene glycol solution is more acceptable and can easily be adapted so that the patient can perform the procedure at home before admission to hospital. In a prospective series we have compared the efficacy of preparation at home using polyethylene glycol with similar preparation in hospital and with a standard bowel preparation based on magnesium sulphate. Preparation was better after polyethylene glycol and this was significant when performed at home (P less than 0.01). There was no effect on either electrolytes or haematological parameters, but polyethylene glycol did result in a rise in the number of colonic Streptococcus faecalis seen. This rise was not seen with magnesium sulphate (P less than 0.001).
Subject(s)
Colon , Colonic Diseases/surgery , Magnesium Sulfate/administration & dosage , Polyethylene Glycols/administration & dosage , Preoperative Care/methods , Administration, Oral , Aged , Enema , Female , Humans , Male , Prospective Studies , Time FactorsABSTRACT
Ultrasonography, although an accurate method of detecting stones within the gall bladder, is unreliable for the detection of bile duct stones for which per-operative cholangiography remains the standard investigation. Fifty seven patients undergoing elective cholecystectomy had both a pre-operative intravenous cholangiogram and per-operative cholangiography. The pre-operative investigation is shown to be at least as effective in the detection of common bile duct stones and only missed a duct stone in one patient. The substitution of pre-operative intravenous cholangiography for routine per-operative cholangiography would result in a significant reduction in operating time, may provide advance knowledge on the biliary anatomy and would allow advance planning of the likely procedure. It is suggested that pre-operative intravenous cholangiography, carried out on the day of admission, should be considered as a preferred alternative investigation to per-operative cholangiography.
Subject(s)
Cholangiography/standards , Cholelithiasis/diagnostic imaging , Intraoperative Care , Preoperative Care , Adult , Aged , Aged, 80 and over , Cholecystectomy , Cholelithiasis/diagnosis , Cholelithiasis/surgery , Female , Humans , Male , Middle Aged , UltrasonographyABSTRACT
One hundred and four patients with second, third degree or thrombosed prolapsed piles, treated by cryotherapy, were studied pre- and postoperatively. A computer analysis was made of all relevant data such as pile mass, freezing time and results of treatment. The method, which is easy to perform and cost effective, is aided by the use of a specially insulated speculum. To minimise complications such as pain and haemorrhage the ice-ball should be limited to the mucosal part of the haemorrhoid alone. Careful selection of patients will produce good results and a low recurrent rate. It is suggested that valium, fortral and, where necessary, a local anaesthetic should be used and that the patients remain in hospital for one night.
Subject(s)
Cryosurgery , Hemorrhoids/surgery , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Postoperative Complications , Time FactorsABSTRACT
Pilonidal sinus disease in 72 patients was treated by radical excision and primary wound closure and the results compared with those other currently practised techniques. A number of factors have been examined in an attempt to identify a group of patients in whom the risk of delayed healing is high.
Subject(s)
Pilonidal Sinus/surgery , Adolescent , Adult , Female , Humans , Male , Methods , Middle Aged , Postoperative Complications , Recurrence , RiskABSTRACT
A 59-year-old woman with complete situs inversus, developed cholecystitis in a left-sided gallbladder. The diagnosis was made radiologically and a successful operation performed. A diseased gallbladder containing two calculi, together with the appendix, was removed. An operative cholangiogram revealed a normal, but transposed, biliary system. The literature on this subject is reviewed.
Subject(s)
Cholelithiasis/complications , Gallbladder/abnormalities , Cholelithiasis/diagnosis , Female , Humans , Middle AgedABSTRACT
Tumours of the small intestine are not common. It is essential that an early diagnosis be made so that curative surgery can be carried out and the patient survive. The various clinical presentations and methods of investigation are discussed in order to create an awareness of this type of tumour. The methods of treatment are considered and also the prognosis of malignant growths, which, although poor, compares favourably with that of cancer of the stomach. The relative rarity of these tumours is probably due to the rapid passage of intestinal contents through the small bowel as compared with the stomach or colon.
