Simplified method for the detection of choledochal stones.
Explore the source record for details and available documents.
Cholangiography↗
Biomedical subjects
A L Durst
Publications and source records attributed to A L Durst.
Acid corrosive gastritis. A plea for delayed surgical approach.
Acid corrosive gastritis is infrequently seen. It spares the esophagus and damages the antrum. It causes mucosal ulceration, damages the muscularis and ends in a typical antral stricture. The dynamic perpetuating pathophysiologic events, starting with coagulation necrosis, impose postponement of surgical intervention. Two cases of second degree acid corrosive gastritis are presented. Surgery was performed in both patients, only after dysphagia and vomiting became intractable.
Acids↗
Protecting the high-risk rectal anastomosis.
Anastomotic leakage is a serious complication of colonic surgery, and contributes significantly to morbidity and mortality. A new technique has been developed to reduce the danger from such leaks, which involves exteriorizing a loop of transverse colon without opeining it. Should a leak develop, this loop can be transformed into a colostomy; otherwise, it can be easily remimplanted into the abdomen once the bowel is healed.
Colon↗
Compressed air emboli of the aorta and renal artery in blast injury.
A patient with severe blast injury died shortly after his arrival in the emergency room. A massive compressed air embolism of the aorta was found during exploration of the abdominal cavity in order to use the kidneys for transplantation. The post-mortem findings in the kidney were mainly of multiple air spaces in the interstitium compressing the collecting tubules.
Adult↗
Horner's syndrome: a complication of internal jugular vein cannulation.
Percutaneous internal jugular vein cannulation has become an accepted method for placement of central venous catheters. A variety of complications connected with this procedure have been noted, but direct injury to the sympathetic trunk causing Horner's syndrome is extremely rare. A description of repeated attempts of percutaneous cannulation of the right internal jugular vein which led to the occurrence of Horner's syndrome is given.
Adult↗
A plea for conservative approach in the management of perforated diverticulitis.
Explore the source record for details and available documents.
Adolescent↗
Carcinoma of the bronchus with atypical presentation: report of a case.
A 64-year-old man presented with dysphagia due to obstruction of lower third of the esophagus. Esophagoscopy showed narrowing of the esophagus with normal mucosa. Chest X rays were normal, but on lung scan there was no perfusion of the left lung. That patient died of aspiration and on post mortem a carcinoma of the bronchus with abscess formation and perforation into the esophagus was found.
Bronchial Neoplasms↗
Transient hypoaldosteronism after renal allotransplantation.
Studies were performed to investigate the nature of the hyperkalemia and hypokaliuria observed in two patients after renal allotransplantation in both of whom the graft was functioning and urinary output was adequate. In the first patient, examinations in the upright position revealed low values for plasma renin activity and plasma aldosterone. The second patient showed similar findings, and, in addition, an angiotensin II (Hypertensin) infusion was ineffective in stimulating aldosterone secretion during the hyperkalemic state. In both patients, short-term administration of 9 alpha-fluorohydrocortisone caused kaliuresis with a definite decrease in serum potassium. There was a spontaneous correction of the biochemical and hormonal abnormalities six weeks after transplantation and the response to an angiotensin II infusion normalized. We suggest that the hyperkalemia in both of these patients was due primarily to the transient failure of the renin-angiotensin system of the transplanted kidney.
Adult↗
Factors affecting survival following radical mastectomy.
Data on 17 potentially useful factors from 152 women undergoing radical mastectomy for operable breast cancer were analyzed in order to determine the effect of each on survival and their relative importance. Only four, clinical stage, clinical and pathological lymph node involvement, and appearance of recurrence and metastases, proved to be of significant prognostic value. Axillary nodal involvement was the main single determinant of survival. Multiple regression analysis, based on factor analysis of the original input variables, was able to account for 34% of the variance in survival and is thus of only very limited use as a predictive instrument in the clinical management of prospective patients.
Adult↗
Primary neoplasms of the small bowel.
The treatment of thirty-one malignant and eleven benign neoplasms of the small intestine is reported. The most common symptom was abdominal pain followed by vomiting, diarrhea, weight loss, constipation, and gastrointestinal bleeding. In four cases small bowel perforated. Intestinal obstruction occurred in 31 per cent of patients. Preoperative diagnosis was made in 19 per cent of patients. All eleven patients with benign neoplasms were curatively treated by resection and primary anastomosis. Eighteen of the thirty-one patients with malignant tumors had curative resection, five had palliative resection, and eight had laparotomy and biopsy only. The most common benign tumor was leiomyoma. The most common malignant tumor was lymphoma (67 per cent) followed by adenocarcinoma (16 per cent), carcinoid (10 per cent), and leiomyosarcoma (3 per cent). Twenty-four patients were available for follow up; thirteen remain alive and eleven died, seven within one year and four within two years.
Adenocarcinoma↗
Paget's disease of the breast.
Twenty-nine histologically verified cases of Paget's disease of the breast treated at the Hadassah University Hospital in the years 1949-1972 were followed up and analyzed. Dividing this material into two groups according to the presence or absence of a palpable breast tumor revealed significant difference in behavior and survival. Patients with a breast mass (34%) had a 50% axillary lymph node involvement and behaved as with any other ordinary breast cancer, with a 5-year survival rate of 40% and a 10-year survival rate of 33%. Patients with no palpable breast mass (66%) had only a 10.5% lymph node involvement, the 5-year survival rate being 94% and the 10-year survival rate being 91%. Delay in diagnosis seems to play no significant factor in survival rates and outcome. We believe radical mastectomy to be the treatment of choice in all cases of Paget's disease of the breast.
Adult↗
Radical mastectomy for operable breast cancer.
The experience with radical mastectomy in the treatment of 152 cases of operable breast cancer at the Hadassah University Hospital has been analyzed. An overall 5 year survival of 75% and a 10 year survival of 62% are reported and compared with results from other methods of treatment. Based on the excellent survival rates achieved and the low incidence of local recurrence (9.8%), the present study suggests that radical mastectomy is still the most suitable surgical procedure in the treatment of operable breast cancer.
Axilla↗
Surgery in primary hyperparathyroidism.
Data were reviewed on 26 patients suffering from primary hyperparathyroidism (PHPT). The diagnosis of PHPT is increasing in frequency, due to greater awareness and better methods of detection. Delay in recognition has gradually decreased, thus permitting earlier treatment. No single test or any combination of tests can be considered satisfactorily pathognomonic of PHPT. Hypercalcemia is the most satisfactory finding suggestive of PHPT. Cervical exploration should be an integral part of the diagnostic work-up. Removal of a distinct adenoma is adequate therapy if the other parathyroid glands are normal. Subtotal parathyroidectomy should be performed only in cases of hyperplasia of all parathyroid glands.
Adolescent↗
Mesenteric panniculitis: review of the leterature and presentation of cases.
Sixty-two cases of mesenteric panniculitis collected from the literature and six cases treated by the authors are reviewed. Symptomatology, pathology, treatment, and outcome of this disorder are discussed. It seems that mesenteric panniculitis is a well established clinical entity of unknown etiology, with a benign course and favourable outcome. Radical surgical treatment is not advised. The sole surgical intervention advocated would be deviation of the gastrointestinal tract in patients with symptoms of obstruction.
Adipose Tissue↗
Gallstone pancreatitis. Exploration of the biliary system in acute and recurrent pancreatitis.
During a five-year period, 82 patients were treated for acute pancreatitis, 63 of whom were proved to have associated biliary tract disease. In 18 of the 63, the accepted preoperative diagnostic measures failed to demonstrate pathologic findings in the biliary system. In 16 of the 18 patients, stones were discovered at the time of operation, although in five they were so small as to be demonstrable only filtering the aspirated bile through gauze. In the two of the 18 without stones, cholecystitis was present. In 14 patients the ducts choledochus and the pancreatic duct had a common path. All patients had no further pancreatitis two to eight years cholecystectomy. In Israel, where alcoholism is rare, three fourths of the cases of acute pancreatitis are associated with gallbladder disease.
Acute Disease↗
Survival following complete disruption of inferior vena cava with delayed presentation.
Explore the source record for details and available documents.
Abdominal Injuries↗
Modern war surgery: operations in an evacuation hospital during the October 1973 Arab-Israeli war.
A forward evacuation hospital functioned in the southern front in October 1973 Israeli-Arab War as an intermediate unit in the Israeli casualty management logistics. Casualties were characterized by frequent multiple-system injuries and variable combinations of penetrating wounds, blunt trauma, burns, and inhalation injury, with an increased incidence of associated blunt trauma. As the result of the systems organization, the EH was able to provide the wounded with early intensive and definitive resuscitation therapy which permitted further evacuation of the casualties to the central hospitals in a better state of physiological stability. In the most critically wounded when there was imminent threat to survival, operations were performed at the EH as an integral part of the resuscitation process. Performance of operations in a forward evacuation hospital did not increase the number or severity of postoperative complications. Morbidity and mortality were related to the nature and magnitude of injury.
Egypt↗