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Biomedical subjects

A M Cooperman

Publications and source records attributed to A M Cooperman.

At least 91 records · Page 5Linked to original sources

Ligation procedures in the management of portal hypertension.

In the 10 year period from 1964 through 1973, 25 patients bleeding from esophageal varices underwent ligation procedures coupled with splenectomy rather than a shunt. These procedures included the transesophageal and transgastric approaches and extragastric ligations. For patients with normal liver function, the risk of this urgent or emergency surgery is comparatively low (two of 12 patients died). The chance of recurrent hemorrhage is high (nine of nine surviving patients), as is the need for subsequent surgery (eight of nine patients). Nevertheless, despite these drawbacks, nine of these 12 patients (75 percent) are alive, and seven have survived 5 or more years. In patients with cirrhosis, the initial operative mortality rate (three of 12 patients) and the subsequent mortality rate (five additional patients) reflect the greater risk because of liver disease. Only five of 13 patients (38 percent) survive, three of whom are alive 5 or more years. In patients with cirrhosis, the initial operative mortality rate (three of 12 patients) and the subsequent mortality rate (five additional patients) reflect the greater risk because of liver disease. Only five of 13 patients (38 percent) survive, three of whom are alive 5 or more years after their initial surgery. These results indicate that there are situations when ligation procedures are valuable, especially in the noncirrhotic patient.

Adult↗

Transhepatic variceal sclerotherapy.

We attempted to control variceal hemorrhage, using transhepatic variceal sclerotherapy of a coronary varix. The procedure transiently controlled hemorrhage, but bleeding resumed from short gastric varices hours later.

Adult↗

Thrombosis in a cavernous left-sided inferior vena cava. An unusual abdominal mass.

A 19-year-old man had an abdominal mass and swelling of the left thigh. The presumptive diagnosis was lymphoma. On exploration the mass proved to be a thrombosed multiloculated "cavernous transformation" of a venous structure, presumably the inferior vena cava, which on postoperative cavogram was shown to be otherwise absent. The venous system of the left lower extremity showed phlebographic evidence of old thrombosis, but that of the right lower extremity was normal. The patient did well without further treatment, despite some residual swelling of the left thigh. To our knowledge, this precise combination of inferior vena cava anomalies has not been encountered before; certainly not presenting as a mass.

Abdominal Neoplasms↗

Postoperative alkaline reflux gastritis.

1. The syndrome of reflux gastritis is produced by the actions of bile and upper intestinal and pancreatic secretions alone or in combination on an altered gastric mucosa. 2. The triad of epigastric pain unrelieved by antacids, bilious vomiting, and weight loss, particularly after a gastric operation should make one suspect this syndrome. Anemia due to loss of blood and dysphagia occur less frequently. 3. The definitive diagnosis is made by endoscopy. Barium studies are of less value. Acid secretory studies are not diagnostic and are of academic interest. 4. Medical treatment utilizes antacids and cholestyramine alone or together. Good, long-lasting results with these are infrequent. Despite these results, medical treatment should be tried first. 5. Surgical treatment consists of diversion of the biliary and upper intestinal secretions from the stomach and doing a vagotomy with or without a distal gastric resection to prevent a marginal ulcer from developing. 6. The two most popular operations are a Roux-en-Y diversion or interposed peristaltic jejunal limb. The simplicity of the former has made this more popular with most American surgeons. 7. The results of surgery are good to excellent in 75 to 95 per cent of cases. Relief of symptoms, improvement in histologic and secretory studies, and weight gain should be anticipated. 8. Less than optimal results are reported when the surgical diversion has not been total, gastric stasis persists, or other postgastrectomy sequelae accompany reflux gastritis.

Cholestyramine Resin↗

Preoperative localization of occult lesions of the breast.

An outpatient procedure that accurately localizes occult lesions of the breast has been used in 26 patients. A small biopsy is performed using local anesthesia, the excised specimen is xerographed and, if necessary, bread-loafed to identify the involved specimen. This has corroborated the xeromammographic diagnosis of cancer in six patients in whom the lesions were clinically not detectable.

Biopsy↗

Massive bleeding from a ruptured metastatic hepatic melanoma treated by hepatic lobectomy. Case report and review of the literature.

An unusual case is reported of an occult, spontaneously rupturing, hemorrhagic, metastatic melanoma of the liver treated by hepatic lobectomy, resulting in short-term survival. A long, symptom-free interval (13 years) after excision of the primary cutaneous lesion (stage I) preceded the appearance of the hepatic metastasis. This case illustrates the need for a careful and thorough history as well as the benefit of prompt hepatic resection for bleeding from ruptured hepatic malignancies.

Empyema↗

Endoscopic pancreatography: its value in preoperative and postoperative assessment of pancreatic disease.

Examples of the use of endoscopic pancreatography in the preoperative evaluation and postoperative follow-up study of patients with pancreatic disease are presented and discussed. Six cases selected from a total experience of forty-eight patients have been summarized. The direct role of pancreatography in the management of these cases is cited. There is a small but definite risk to the procedure. With increased use of endoscopic pancreatography, it is hoped that earlier diagnoses of a variety of pancreatic diseases will be obtained which will permit more accurate medical and surgical therapy.

Adult↗

Pyloroplasty.

Explore the source record for details and available documents.

Duodenal Ulcer↗

Congenital duodenal diaphragms in adults: a delayed cause of intestinal obstruction.

Congenital duodenal diaphragms in the adult are uncommon, unsuspected lesions that infrequently cause intestinal obstruction. The diaphragms may be single or multiple and are usually located near the ampulla of Vater. Three cases are summarized and the recent literature reviewed. At least 35 cases have been reported. Treatment most often consisted of duodenotomy,excision of the web and duodenal closure.

Aged↗