RESUMO
After considering some of the successes and failures of the Canadian Association of General Surgeons as they relate to the nonacademic surgeon, the author describes in detail the practice of one nonacademic urban surgeon to provide a historical record and a guide to the educational needs of such surgeons. He compares academic and nonacademic surgical practice, emphasizing the perhaps unrecognized benefits of the latter. Future change in nonurban general surgical practice is postulated.
Assuntos
Cirurgia Geral , Padrões de Prática Médica , Canadá , Hospitais de Ensino , Hospitais Urbanos , Humanos , Sociedades Médicas , Procedimentos Cirúrgicos Operatórios/estatística & dados numéricosAssuntos
Pancreatite/terapia , Doença Aguda , Adulto , Antibacterianos/uso terapêutico , Colelitíase/cirurgia , Doença Crônica , Feminino , Glucagon/uso terapêutico , Humanos , Cisto Pancreático/cirurgia , Pancreatite/complicações , Pancreatite/cirurgia , Nutrição Parenteral Total , Insuficiência Respiratória/etiologiaRESUMO
When the pain associated with chronic pancreatitis is due to ductal obstruction, it is logical that surgical management should be designed to relieve that obstruction while preserving as much of the functioning gland as possible. A number of cases are described to illustrate the various procedures available and to indicate the features that govern the selection of the one most appropriate for a particular patient. The operations include partial pancreatectomy, Roux-en-Y pancreaticojejunostomy and longitudinal pancreaticojejunostomy; these can be modified to suit the peculiar circumstances of a given case.
Assuntos
Pâncreas/cirurgia , Pancreatite/cirurgia , Adulto , Alcoolismo/complicações , Doença Crônica , Feminino , Humanos , Jejuno/cirurgia , Masculino , Pessoa de Meia-Idade , Pancreatectomia , Cisto Pancreático/diagnóstico por imagem , Cisto Pancreático/cirurgia , Ductos Pancreáticos/diagnóstico por imagem , Ductos Pancreáticos/cirurgia , Pancreatite/diagnóstico por imagem , Pancreatite/etiologia , RadiografiaRESUMO
The clinical features of spontaneous perforation of the bile ducts in infancy differ sufficiently from those of other causes of neonatal jaundice to allow early preoperative diagnosis as demonstrated by a report of this condition in a 6-week-old infant. Despite its rarity, the clinician should be aware of this entity because early recognition and surgery will ensure cure in almost all cases. The cause of spontaneous perforation of the bile ducts is unknown. Trauma, congenital weakness and abnormal bile are considered as possible etiologic factors.
Assuntos
Ductos Biliares , Fatores Etários , Doenças Biliares/diagnóstico , Doenças Biliares/etiologia , Humanos , Lactente , Masculino , Ruptura Espontânea/diagnósticoRESUMO
The successful separation of xiphopagus-conjoined twins is described. Such an experience is of course a very gratifying and exciting surgical adventure.
Assuntos
Músculos Abdominais/cirurgia , Gêmeos Unidos/cirurgia , Feminino , Humanos , Lactente , Masculino , Cuidados Pós-Operatórios , Radiografia , Equipamentos Cirúrgicos , Gêmeos Unidos/diagnóstico por imagem , Gêmeos Unidos/epidemiologiaRESUMO
SUMMARY: In a patient with malignant carcinoid syndrome with metastasis to the liver, cardiac lesions, pulmonary hypertension, pellagra-like skin lesions and depression developed. Her disability progressed despite medical therapy and two courses of chemotherapy. The primary tumour had been resected but the metastatic mass in the liver could not be resected because of its anatomic position. The dramatic improvement after hepatic artery ligation was correlated with urinary 5-hydroxyindole acetic acid excretion.
