Biomedical subjects
Publications and source records attributed to G A Decker.
A case of colonic perforation complicating a benign gastrocolic fistula is presented. Only 2 similar cases have been previously reported in the English-language literature. Pathophysiology and management are briefly discussed.
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This is a retrospective analysis of 99 patients with perforated peptic ulcer treated in the Department of Surgery at the J. G. Strijdom Hospital over a 6-year period. The incidence of this condition is increasing in our population. The mortality rate for perforated peptic ulcer remains high (12.1%). Forty-three per cent of our patients were suffering from a major medical illness at the time of perforation, with a mortality rate of 25.6%. The mortality rate for relatively fit patients was 1.8%. While more conservative surgery is indicated for high-risk patients, a definitive ulcer operation can be performed safely in patients who are not suffering from a major medical illness. Our selective operative policy is discussed.
Three cases of gallstone ileus are reported and the literature reviewed. There seems recently to be a trend towards conservative surgery aiming at relief of the obstruction only. Definitive surgery to deal with a biliary-enteric fistula, should be undertaken primarily only in fit patients; and should be considered as a second stage procedure only in those patients who develop biliary complications.
Metaplastic squamous carcinoma of the breast presenting as an abscess in a 51-year-old woman is reported. The incidence, importance of early diagnosis, and the general clinical features are discussed.
A case of spontaneous perforation of the rectum is reported. The incidence, clinical picture, diagnosis and treatment of this rare condition is briefly discussed.
A management technique of the open abdominal wound is described. It consists of a 'sandwich' composed of a Marlex mesh and an Op-Site wound dressing with interposition of suction tubes. Such a technique prevents evisceration, protects the skin, decreases evaporation, allows accurate fluid replacement, facilitates nursing and adds to the patient's comfort.
A case of leiomyosarcoma of a Meckel's diverticulum, presenting as an acute appendicitis, is reported. The literature is reviewed with particular emphasis on current trends in the diagnosis and management of leiomyosarcomas of the small intestine.
During the last 6 years the authors have treated 99 patients with perforated peptic ulcers. Sixty-six patients had perforated pyloro-duodenal ulcers, while 32 patients were treated for perforated gastric ulcers, a ratio of 2:1. This article deals with the gastric ulcers treated by a surgical unit in an urban, 600-bed multidisciplinary hospital. The mean age of the patients was 58.7 years. In 71.8 per cent of the patients, the perforation was the first major manifestation of the ulcer disease. Seven patients (21.8%), all in the high-risk group according to the criteria of Boey et al. died. There was no death among the low-risk patient group. Eleven patients, all high-risk, had excision and/or biopsy of the ulcer followed by simple closure; three of these patients died (27.2%). Twenty patients, of whom seven were in the high-risk group, underwent gastrectomy; three deaths occurred (15%). The authors conclude that the underlying general health of the patient is a major determinant of the outcome following gastric ulcer perforation.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Splenic cavernous haemangioma is a rare cause of splenomegaly. It is a benign tumour which has seldom been diagnosed pre-operatively, because the clinical presentation is usually atypical. This is reflected in a patient who presented with splenomegaly, and in whom cavernous haemangioma of the spleen was diagnosed only after operation.
Nine South African Negroes with abdominal aortic aneurysms due to intimomedial mucoid degeneration are described. These occurred in a younger age group than atherosclerotic aneurysms and with a female predominance. The aneurysms are not syphilitic in origin and are unlike atherosclerotic aneurysms. This form of abdominal aneurysm constitutes a distinct entity which is relatively prevalent in South African Negroes and which has hitherto received little or no emphasis and attention.