Large-vein, thrombotic, hepatic venous outflow obstruction (Budd-Chiari syndrome). A case report.

A patient with Budd-Chiari syndrome caused by large-vein, thrombotic, hepatic venous outflow obstruction, who was initially treated conservatively, is presented. The hazards of this approach are emphasised. Accurate classification of Budd-Chiari syndrome and active treatment tailored to the site and nature of the hepatic venous outflow obstruction are indicated to prevent progressive hepatic damage leading to chronic liver failure, portal hypertension and eventual death.

Avoidance of jejunostomy. A reliable method of naso-enteral tube placement after oesophageal surgery.

Nutritional maintenance after oesophageal surgery and during treatment of oesophageal disease is given high priority. A method of naso-enteral feeding tube placement suitable for these patient groups was evolved and studied prospectively. A standard nasogastric tube is used as a conduit for a guide-wire over which a soft, small-bone naso-enteral tube is threaded into position. Thirty patients underwent placement of such tubes postoperatively or during treatment of oesophageal disease. Placement and feeding was successful in all. Six patients developed controllable diarrhoea.

Recording the interdigestive myo-electrical complex: A new technique.

The interdigestive myo-electrical complex is a cyclical pattern of electrical activity occurring in the wall of the stomach and small bowel. We have recorded this pattern in 4 dogs and have devised a new computerized method of representing this electrical phenomenon.