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Biomedical subjects

F F Chou

Publications and source records attributed to F F Chou.

At least 73 records · Page 4Linked to original sources
PubMed1991

The role of sonography in the diagnosis and management of urachal abscesses.

Eighteen cases of urachal abscess were studied with sonography. Their configurations were cone shaped in 11 cases, tubular in 4, curved club shaped, and oval and irregular in one each. Their complications, such as intraperitoneal spread, chronic cystitis, and adhesion to the omentum or the colon, could also be suggested by ultrasonography. Gas was found in 50% of the lesions, which were all larger than 1 cm in diameter. An abscess smaller than 1.2 cm in diameter (which can be as long as 5 cm) can be treated with antibiotics or incision and drainage without total excision. A lesion within the extraperitoneal fat space of abdominal wall at the midline below umbilicus suggests the diagnosis of urachal abscess in cases of umbilical discharge and/or when the lesion extends to the umbilicus.

Abscess↗
PubMed1991

Intrahepatic cholangiocarcinoma in hepatolithiasis: A frequently overlooked disease.

Five cases of intrahepatic cholangiocarcinoma were found among 101 cases of hepatolithiasis. There was no definite sign of cholangiocarcinoma in ERCP and image studies of four cases. The possibility of the existence of occult cholangiocarcinoma should be kept in mind, especially when unusual presentations, such as body weight loss, anemia, palpable abdominal mass, and intractable pain, appear. An intraoperative frozen-section examination should be considered under the following circumstances: (1) whitish nodular mass over liver, (2) mucinous substance within bile duct, and (3) enlarged, firm lymph nodes clustered along the hepatic arteries and/or celiac arteries.

Adenocarcinoma↗
PubMed1991

Acinar cell carcinoma of the pancreas: a rare cause of left-sided portal hypertension.

Isolated splenic vein obstruction with left-sided portal hypertension is a rare clinical condition. Owing to the close relationship of the splenic vein and the pancreas, this rare phenomenon is usually secondary to pancreatic inflammation or neoplasm. Acinar cell carcinoma has long been recognized as a distinctive, rare type of pancreatic carcinoma. A case of isolated splenic vein obstruction with left-sided portal hypertension secondary to acinar cell carcinoma of the pancreas, which we are reporting here, is thought to the first documented in the literature.

Carcinoma↗
PubMed1990

[Pyogenic liver abscess--report of 72 cases].

Seventy-two patients with pyogenic liver abscess treated from Jan. 1986 through June 1988 were reviewed retrospectively. The average age was 55 years with a male to female ratio of 1.4:1. Most patients presented with the typical fever, chills and RUQ pain, but unusual signs and symptoms were also common. The right lobe was more commonly involved than left lobe. Biliary tract stone was the most frequent etiology (44.4%) and association with DM was common (37.5%). An elevated alkaline phosphatase and leukocytosis were useful clues to a liver abscess, but diagnosis depended on imaging of an abscess cavity either by echo or CT scan. The average time from onset of Symptoms to diagnosis was 9.3 days and a delay in diagnosis by the doctors was common. The most common complication was septicemia and factors with poor prognosis were old age (greater than or equal to 60 yrs), septicemia, cancer, peritonitis, and serum bilirubin greater than or equal to 5 mg/dl. The overall mortality was 29% with no difference between the group with surgical drains (28.5%) and the group with percutaneous transhepatic aspiration or drains (29.4%).

Adolescent↗
PubMed1990

Hepatic tuberculosis; a rare case of bleeding gastric varices.

A laparotomy was performed on a 68-year-old female who, in spite of medical treatment, suffered from uncontrolled upper gastrointestinal bleeding due to ruptured gastric varices. Histological examination of the liver tissue taken during operation revealed tuberculosis. Hepatic tuberculosis, although rare, should be kept in mind as one of the differential diagnosis when there is unexplained, noncirrhotic bleeding gastric varices.

Aged↗
PubMed1990

Choledochotomy for biliary lithiasis: is routine T-tube drainage necessary? A prospective controlled trial.

Thirty patients with stones in the common bile duct were allocated alternately to have choledocholithotomy carried out with either T-tube drainage or with primary closure. Choledochoscopy was done during every operation, and the patency of the common bile duct tested by perfusion. There were no operative deaths. The length of operation was shorter with primary closure (p less than 0.01) but there were no differences between the groups in operative blood loss, days in hospital after operation, postoperative morbidity and mortality, and final outcome at follow up. There was no change in the incidence of postoperative bacteraemia, the number of adverse reactions, and the incidence of bile peritonitis after removal of the T-tube. Patients who had T-tubes reported greater discomfort and inconvenience than those without, and their treatment cost more. We conclude that primary closure of the common bile duct is a reasonable alternative to T-tube drainage in selected cases.

Aged↗
PubMed1990

[High incidence of tetanus in the middle-aged and elderly].

Tetanus is a disease which has a high mortality rate, caused by clostridium tetani. It presents with trismus, difficulty in swallowing, and more ominously difficulty in breathing, or opisthotonus. Included in this retrospective study are 23 cases of tetanus treated in Chang Gung Memorial Hospital between Jan. 1986 and Dec. 1989. Age ranged from 36 to 87, with the highest incidence in the middle-aged and elderly (91% older than 40 years of age). In 20 cases a wound was found as the source of infection, most of which were minor injuries. Of the nine patients who received no medical attention, three received herb drugs. Of the eleven patients who did seek medical attention at the time of injury, four received tetanus toxoid but none of them received human tetanus immunoglobulin. Tetanus is a totally preventable disease. Prevention includes three basic principles: local wound management, active immunization, and passive immunization. When treating injured patients, it is important to recall that many middle-aged and older adults are not adequately immunized against tetanus. Such patients should receive human tetanus immunoglobulin as well as tetanus toxoid.

Adult↗
PubMed1989

[Prognostic nutritional index in hepatobiliary surgery].

Malnutrition has long been recognized as a potential source of increased morbidity and mortality in patients with various disorders, including those undergoing hepatobiliary surgery. To elucidate the role of malnutrition in postoperative complications in hepatobiliary surgery, the nutritional status of 73 patients was evaluated with the Prognostic Nutritional Index (PNI) devised by Dr. Mullen. PNI was calculated based on the following parameters: albumin, transferrin, triceps skin folds and delayed cutaneous hypersensitivity (DH). DH was performed with four skin antigens: candida, trichophyton, streptokinase/streptodornase and PPD. Based on the results the patients were stratified into two groups, a low-risk group with PNI less than 40 and a high-risk group with PNI greater than or equal to 40. Complications occurred in 10 of 34 patients (29%) in the low-risk group and in 15 of 39 patients (38%) in the high-risk group. There were 2 deaths in the latter and none in the former group, the difference was not statistically significant. We conclude that PNI fails to predict postoperative complications in hepatobiliary surgery patients. Either the formula of PNI, which is derived from gastrointestinal surgery patients, is not applicable to patients undergoing hepatobiliary surgery, or factors other than nutrition are involved in the development of postoperative complications in hepatobiliary surgery.

Biliary Tract Diseases↗
PubMed1989

Hepatic resection in 120 patients with hepatocellular carcinoma.

During the 11-year period from 1977 through 1987, hepatic resections were carried out in 120 patients with hepatocellular carcinoma (HCC). Twenty-five had HCCs smaller than 5 cm in diameter. There were 97 male and 23 female patients, with an average age of 51.5 years. Among them, 45.8% had liver cirrhosis and 80.8% were positive for hepatitis B surface antigen. Fourteen with ruptured HCCs underwent hepatic resection to control the intra-abdominal hemorrhage. Operative mortality within one month after surgery was 4.1%. The postoperative course was complicated by pleural effusion in 5.8%, subphrenic abscess in 2.5%, postoperative bleeding in 1.6%, hepatic failure in 1.6%, and bile leakage in 0.8% of the patients. The overall five-year survival rate in this series was 25.9%, while survival for the last five years was better (42.3% vs 11.9% for patients treated between 1977 and 1982). The cumulative survival rate had no relation to tumor rupture or liver cirrhosis. The group of patients with smaller tumors (diameter, less than 5 cm) or without vascular invasion by tumor had better survival.

Adolescent↗
PubMed1989

Duodenal hemangioendothelioma: report of a case.

A case of duodenal hemangioendothelioma with bleeding is reported. The possibility of duodenal hemangioma should be borne in mind when there is unexplained bleeding from the gastrointestinal tract. This lesion was visualized by endoscopy, removed surgically, and confirmed upon histological examination.

Adult↗
PubMed1987

Vascular ectasia of the duodenum detected by duodenoscopy.

A 65-yr-old Chinese woman suffered from repeated episodes of upper gastrointestinal bleeding for 5 yr. Despite repeated panendoscopic and angiographic studies, the bleeder was not found until a duodenoscopic examination was performed. A small bleeder was found near the papilla vater area. The lesion was excised and proved to be a vascular ectasia of duodenum.

Aged↗
PubMed1983

Hematobilia from ruptured hepatic artery aneurysm. Report of two cases.

Hematobilia secondary to hepatic artery aneurysm must be considered in the differential diagnosis of unexplained gastrointestinal tract hemorrhage. We treated two patients with ruptured hepatic artery aneurysm. One had hepatic artery aneurysm proximal to the gastroduodenal artery; the other had an intrahepatic pseudoaneurysm in the right lobe of the liver. The first patient was treated with obliterative endoaneurysmorrhaphy. The second required ligation of feeding vessels, cholecystectomy, and reconstruction of cholecystoduodenal fistula.

Aneurysm↗
PubMed1983

Use of fiberoptic choledochoscope in common bile duct and intrahepatic duct exploration.

This report summarizes our experience with 339 consecutive flexible fiberoptic choledochoscopic examinations performed in the course of 598 common bile duct explorations for biliary tract stones. Routine choledochoscopy added 5 to 10 minutes to the operation and caused no complications. In 81 of the patients, additional stones were discovered with choledochofiberscopy after completion of routine bile duct exploration. Postoperative cholangiography demonstrated a retained stone in 57 patients (two in the common bile duct and 55 in the intrahepatic ducts). Forty-two patients with stones retained in the intrahepatic ducts were diagnosed during operation with the fiberoptic choledochoscope, but those stones were very difficult for us to remove. The accuracy of postexploratory choledochoscopy in diagnosis of stones in the common bile duct and intrahepatic ducts was 99.0% and 90.5%, respectively. Choledochofiberscopy is useful in exploration of the common bile duct and a safe procedure in the diagnosis of biliary tract stones during operation.

Bile Ducts, Intrahepatic↗