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Biomedical subjects

B R Davidson

Publications and source records attributed to B R Davidson.

134 records · Page 8Linked to original sources
PubMed1987

Nissen fundoplication and pyloroplasty in the management of gastro-oesophageal reflux in children.

A retrospective study was carried out of children undergoing Nissen fundoplication and pyloroplasty for the correction of gastro-oesophageal reflux. Twenty children (thirteen males, seven females) aged 8 months to 12 years underwent surgery over a 10 year period. Forty per cent were mentally retarded. Presentation was failure to thrive in 19 (95 per cent), recurrent vomiting in 18 (90 per cent) and haematemesis in 14 (70 per cent). Four children had Barrett's oesophagus. There were no operative or perioperative mortalities. Follow-up (mean period 3 years, 9 months) revealed no further symptoms of reflux. The 'normal' children gained weight postoperatively whereas the 'retarded' group did not. Adhesion obstruction (10 per cent) was the major late postoperative complication. Regression of Barrett's epithelium was noted endoscopically. 'Gas-bloat' syndrome, a major complication following fundoplication, was not encountered.

Body Weight↗
PubMed1987

Study of common bile duct exploration and endoscopic sphincterotomy in a consecutive series of 438 patients.

The outcome of 438 consecutive patients who had exploration of the common bile duct and/or endoscopic sphincterotomy (ES) in a 5-year period was reviewed. Patients were analysed according to four groups: 59 patients had planned ES followed by surgery resulting in 14 major complications (23.7 per cent) including 3 deaths (5.1 per cent) (group 1); 248 patients had surgery alone with 21 major complications (8.5 per cent) including 10 deaths (4.0 per cent) (group 2); 114 patients with gallbladder in situ underwent ES alone with 22 major complications (19.3 per cent) including 9 deaths (7.9 per cent) (group 3); 17 patients with remote cholecystectomy also had ES alone with 3 major complications (17.6 per cent) including 3 deaths (17.6 per cent) (group 4). There was no difference in mortality between the groups. Compared with group 2, major complications were significantly higher in group 1 (chi 2 = 11.0, d.f. = 1, P less than 0.001) and in group 3 (chi 2 = 8.6, d.f. = 1, P less than 0.003). Patients in group 3, however, were significantly older than those in groups 1 and 2, and the former also had higher medical and total risk factor scores than the latter (all P less than 0.001). The results indicate that routine pre-operative ES is of questionable value. ES alone is justified in elderly high risk patients; mortality in this group might be reduced by improved management of post-ES complications.

Adolescent↗
PubMed1987

Haemorrhage into a urachal cyst presenting as an 'acute abdomen'.

A previously well 3 year old Asian girl presented as an emergency with the acute onset of generalized abdominal pain. On examination her abdomen was distended with generalized tenderness and guarding most marked centrally. Under anaesthesia a central abdominal mass arising from the pelvis was palpated which on proceeding to laparotomy was found to be a blood-filled urachal cyst. This was excised and her recovery was uneventful. Subsequent investigations have revealed no associated renal tract abnormalities.

Abdomen↗
PubMed1987

Colonic stricture secondary to blunt abdominal trauma--report of a case and review of the aetiology.

A 24 year old man sustained multiple injuries including blunt abdominal trauma in a motor cycle accident. Five months following the accident he developed a large bowel obstruction. Barium enema examination revealed a stricture of the sigmoid colon which, following surgical resection, was found to consist of a fibrous stenosis. The aetiology of such strictures following blunt abdominal trauma is likely to be a combination of mural haemorrhage and ischaemia.

Abdominal Injuries↗
PubMed1986

Incisional herniae following median sternotomy incisions: their incidence and aetiology.

A retrospective study was carried out of all patients undergoing cardiothoracic surgery through a median sternotomy incision under the care of a single surgical firm over an 8 year period in order to assess the incidence and aetiology of incisional epigastric herniae. Of the 582 procedures carried out, follow-up information was obtained in 475 (81.6 per cent) of which 20 (4.2 per cent) had developed incisional herniae (70 per cent of these within 3 months). Seven (35 per cent) of the herniae were symptomatic and required repair. The main predisposing factors were the male sex, the nature of surgery carried out (notably aortic valve replacement), obesity and the presence of postoperative complications of wound infection and left ventricular failure. Herniae were not found in those patients having wound closure using non-absorbable sutures.

Adolescent↗
PubMedDate not supplied

Hepatic indocyanine green uptake and excretion in a rabbit model of steatosis.

Transplantation of a fatty liver is associated with a higher incidence of primary non-function of the graft. Indocyanine green (ICG) has been used for assessing hepatic dysfunction but not for quantifying liver steatosis. New Zealand white rabbits were fed a normal diet (group A) or a high-cholesterol (2%) diet for 4, 8, and 12 weeks in groups B, C, and D, respectively. Laparotomy was performed for liver exposure. Hepatic artery, portal vein, and total blood flow, hepatic microcirculation, portal pressure, liver function parameters, and blood cholesterol levels were measured. The hepatic ICG concentration was measured using near-infrared spectroscopy, and its uptake and excretion rates were calculated. The severity of steatosis was assessed from liver biopsy specimens by a semiquantitative grading system. Cholesterol feeding resulted in mild steatosis after 4 weeks and in moderate steatosis after 8 and 12 weeks. Mild steatosis was associated with insignificant changes in haemodynamic parameters, liver function, and ICG handling as compared with controls. Moderate steatosis caused a significant reduction in portal and total hepatic blood flow and microcirculation with a significant increase in hepatic artery flow and portal pressure. These haemodynamic changes were associated with a significant alteration in liver function tests. With moderate steatosis, ICG uptake and excretion were significantly reduced. The ICG uptake rate significantly correlated with total blood flow and microcirculation. The ICG excretion rate significantly correlated with the changes in bilirubin, liver enzymes, and albumin. Direct ICG quantification by near-infrared spectroscopy could be used to assess the severity of hepatic steatosis by reflecting impaired parenchymal perfusion and liver dysfunction.

Animals↗