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Biomedical subjects

J Alexander-Williams

Publications and source records attributed to J Alexander-Williams.

At least 235 records · Page 13Linked to original sources
PubMed1974

Excisional surgery with ileostomy for Crohn's colitis with particular reference to factors affecting recurrence.

This paper reports the indications for, and results of, excision of the large intestine with ileostomy in 73 patients with Crohn's colitis who have been followed for a mean of nine years since resection. Sixty-four of them are still alive and all but two of the survivors are now in good health.However, 23 (33%) have developed recurrent Crohn's disease since resection. This is higher than that reported in many other series and may be due to differences in the length of follow up, the site and extent of colonic disease, the age of the patient at the time of excision with ileostomy, and differences in the pathological interpretation of the diagnosis of Crohn's disease. The high recurrence rate in this series lends caution to the view that the prognosis after excisional surgery and ileostomy for Crohn's colitis is as good as after the same operation for ulcerative colitis and should influence the decision when the alternative of medical or surgical management are being considered for patients with Crohn's colitis.

Adolescent↗
PubMed1973

Appointment of preregistration house officers.

A new programme to try and match the preferences of students and consultants in preregistration appointments has been designed after a survey of student opinion. It is based on five main principles: a standardized change-over date for posts; holding only one post in a teaching hospital; separate application for house physician and house surgeon appointments; application six months before the post becomes vacant; and two rounds for matching preferences.The programme has now been working successfully for a year and experience suggests that the ideal administrative size for it is that of a region or area health authority.

Education, Medical, Continuing↗
PubMed1973

Abscess and fistulae in Crohn's disease.

In a series of 360 patients with Crohn's disease 18% have developed a complication of abscess and/or fistula. Both complications can be spontaneous but more commonly occur in patients who have had a previous operation. There is a high incidence of fistula after laparotomy without resection of diseased bowel. Simple drainage of an abscess is usually followed by a fistula and fistulae do not close spontaneously. The optimal surgical treatment for fistula and for deep abscess is excision in continuity with the diseased segment of intestine.

Abscess↗
PubMed1973

Free perforation in Crohn's disease.

Free perforation is a rare complication of Crohn's disease. Seven cases were found in a total series of 360 in Birmingham. It occurs during an acute exacerbation of chronic disease, particularly in the presence of distal obstruction. The incidence of this complication may becoming less common and steroid therapy was not a precipitating factor. Primary resection of the perforated and distal obstructed bowel is likely to give the best results.

Adolescent↗