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Biomedical subjects

J D Wig

Publications and source records attributed to J D Wig.

At least 37 records · Page 2Linked to original sources
PubMed1997

Pancreatoduodenectomy in abdominal trauma: a viable alternative.

Pancreatoduodenectomy was performed in five patients with severe pancreatoduodenal trauma following vehicular accidents. Three of them presented within five hours of injury and two patients, four and ten days later. Surgery was performed within 6-12 hours of hospitalization. All patients underwent pancreatoduodenectomy; in one the pancreatic stump was closed completely owing to its friability. Three patients survived; two succumbed to ongoing preoperative septicemia due to late presentation. The results of pancreato-duodenectomy are good when patients are operated on early, before the development of sepsis.

Abdominal Injuries↗
PubMed1997

Primary gastrointestinal lymphoma--disease spectrum and management: a 15-year review from north India.

OBJECTIVE: To analyze retrospectively the disease spectrum and outcome of primary gastrointestinal lymphoma (PGIL) in a tertiary referral center in north India. MATERIAL: Seventy five patients presenting with PGIL between January 1971 and December 1985 were evaluated. RESULTS: The 49 males and 26 females were aged 3.5-69 years (mean 34) at presentation. Abdominal pain, weight loss and vomiting were cardinal symptoms at presentation; the stomach was the most common site of involvement. Histologically, a majority of patients were classified as having diffuse poorly-differentiated lymphocytic lymphoma (46.7%) and diffuse histiocytic type (30.7%). Twenty seven (36%) patients had stage I disease, 31 (40%) stage II, 11 (14.7%) stage III, and 6 (8%) stage IV. At laparotomy, primary resection and anastomosis was carried out in 66 patients, while only biopsies were taken in nine. Forty eight patients received adjuvant radiation with or without chemotherapy. The mean follow-up was 3.9 years (range 1-14). The 5-year actuarial survival was 34%, 25% and 16% for stages I, II, and higher-stage disease, respectively. The survival was significantly better (p < 0.01) for gastric location (44%) compared to other sites (24%). CONCLUSION: PGIL was more common in the 3rd and 4th decades of life, with the stomach being the predominant site of involvement. Survival was better among patients with stages I and II disease, and gastric location of lesion.

Adolescent↗
PubMed1996

Radiology of pancreatic tuberculosis: a report of three cases.

We report three cases of biopsy proven pancreatic tuberculosis. The patients presented with abdominal pain and intermittent fever. Ultrasound and computed tomography revealed a diffusely enlarged pancreas with focal hypoechoic/hypodense lesions in all three patients. In addition, one patient had a large pancreatic cyst with internal echoes. Associated findings included peripancreatic and mesenteric lymph nodes, bowel wall thickening of ileocecal junction, focal hepatic or splenic lesions, splenic vein thrombosis, and ascites. Pancreatic tuberculosis should be considered in the differential diagnosis of focal pancreatic lesions, especially if associated with ancillary findings such as enlarged hypodense nodes in the peripancreatic region or in the mesentery in patients presenting with longstanding fever and abdominal pain.

Adult↗
PubMed1995

Eosinophilic gastroenteritis presenting as acute intestinal obstruction.

Eosinophilic gastroenteritis is a rare disorder of the gastrointestinal tract. Three cases of eosinophilic gastroenteritis presenting as intestinal obstruction are reported. Two patients had stenotic lesions in the jejunum whereas the ileum was involved in the third. None had peripheral eosinophilia. All underwent resection-anastomosis of the bowel and are symptom-free at follow-up ranging from 8 months to 6 years.

Acute Disease↗
PubMed1995

Colovesical fistula complicating colonic diverticulosis.

Two cases of colovesical fistulae secondary to colonic diverticulosis are reported. Urinary symptoms were the prominent presenting features. Barium enema was helpful in documenting the fistulae, which cystoscopically was not localised. Definitive treatment included resection of the fistula and the diseased segment of the intestine. Both patients are well on follow-up. Diverticulosis coli should be considered in the differential diagnosis of colovesical fistulae even in tropical countries.

Aged↗
PubMed1993

Bile duct cysts: presentation in adults.

Bile duct or choledochal cysts are rare congenital anomalies and presentation in adult is infrequent. Seven cases of type I/IV bile duct cysts presenting in adult life have been treated by the authors during the past 2 years. The diagnosis was made using a combination of ultrasound and cholangiography (endoscopic retrograde cholangiopancreatography/percutaneous transhepatic cholangiography). All cases underwent total cyst excision and Roux-en-Y hepaticojejunostomy. There were no operative complications and all patients were asymptomatic in the follow-up period, which ranged from 3 to 23 months.

Adolescent↗
PubMed1992

Double pigtail cystogastric stent in the management of pancreatic pseudocyst.

We describe placement of a double pigtail cystogastric stent in 5 patients with pancreatic pseudocyst using real-time ultrasonography and fluoroscopy as guidance techniques. This was done as a two-step procedure. First, a transgastric drainage catheter was placed for a period of six days. All the patients continued to have high drainage output and the cyst size decreased, as seen sonographically. Simultaneous barium meal and sinogram were then done to measure the distance between the posterior gastric wall and the cyst. A polyurethane double pigtail stent of appropriate size was then introduced to achieve cystogastric drainage. The cyst resolved in all the patients by four weeks to six weeks, when the stent was removed endoscopically. There was no recurrence of pseudocyst during follow-up for 6 months to 13 months. None of the patients suffered any complication. Cystogastric drainage using a double pigtail stent is an easy and safe alternative to surgical cystogastrostomy.

Adult↗
PubMed1992

Periampullary carcinoma with special reference to their mucin characteristics--a pathologic study of 53 cases.

Histological features and mucin characteristics of 53 cases of periampullary carcinoma, a rare group of epithelial tumors is presented. The cases comprised of 17 resected specimens and 36 endoscopic biopsies. Jaundice was the commonest symptom. The mean tumor size was 2 cms diameter (1-6 cms). Forty cases were characterised as well differentiated adenocarcinoma, 5 as moderately differentiated adenocarcinoma, 5 as mucin secreting adenocarcinoma, 3 as papillary adenocarcinoma and 1 as undifferentiated carcinoma. Desmoplasia and insignificant mitosis were amongst the commonly encountered histological features. Forty four cases (83%) stained positive for mucin (PAS-AB) with a majority of them (66%) predominantly showing acidic mucin. The likely prognostic implication of this feature is discussed.

Adenocarcinoma↗
PubMed1991

Giant perforations of duodenal ulcer.

Over a period of eleven years, eight patients were treated for duodenal ulcer perforation measuring more than one centimetre in diameter. In five of these patients, the perforation was sealed using a jejunal loop as serosal onlay patch; one patient underwent gastrectomy and in two patients catheter duodenostomy was done. Two patients died, both due to renal failure. The six surviving patients were discharged with the advice for a subsequent 'ulcer-curing' operation after six months. Two patients developed life threatening complications during this waiting period and one of these died. Giant perforations of duodenal ulcer can safely be closed using a jejunal loop as serosal patch. Delay in doing the second stage definitive surgery for the ulcer may be dangerous.

Aged↗
PubMed1990

Fine needle aspiration cytology of rectal masses.

This paper describes the results of transproctoscopic fine needle aspiration cytology in the diagnosis of rectal lesions. Fifty one consecutive patients referred with a presumptive diagnosis of rectal mass were subjected to proctoscopic examination when fine needle aspiration cytology, brush cytology and biopsy samples were taken. Of the 30 patients of malignancy of rectum in whom all the three sampling techniques were applied, the biopsy was positive in 27 (90%), brush cytology in 25 (83.3%) and fine needle aspiration cytology in 29 (96.6%). A combination of fine needle aspiration cytology with brush cytology gave a positive yield in 96.6% while that fine needle aspiration cytology with brush cytology gave a yield of 100%. Fine needle aspiration cytology was most helpful in infiltrative tumours. All 10 patients with secondaries in the pouch of Douglas or rectovesical pouch, and the single patient with submucosal rectal carcinoma were correctly diagnosed at fine needle aspiration cytology. There were no false positive results with fine needle aspiration cytology and no complications were encountered with the procedure.

Adenocarcinoma↗
PubMed1989

Cholangiographically guided aspiration cytology in the management of malignant biliary obstruction.

Fifteen patients with malignant biliary obstruction were subjected to fine needle aspiration cytology (FNAC) under fluoroscopic guidance. Fourteen (93%) of them were correctly diagnosed to have a malignancy at FNAC. Simultaneous with FNAC or at a later date, all the patients underwent percutaneous biliary drainage with a drop in serum bilirubin from a mean of 23.2 mg/dl to 8.5 mg/dl. Ten patients were subjected to exploratory laparotomy and biopsy at which the diagnosis of FNAC was confirmed in nine of them. The tenth patient with a negative yield at FNAC had a 1.0 cm cholangiocarcinoma. The usefulness of FNAC combined with biliary drainage as an alternative to surgery is highlighted.

Adenoma, Bile Duct↗
PubMed1988

Benign disease of the common bile duct.

The incidence of common bile duct (CBD) pathology in a group of patients with benign biliary disease (n = 505) was found to be 23.2 per cent. The spectrum included 111 patients (90.2 per cent) with CBD stones, 37 of whom (33.3 per cent) had no symptoms or findings pre-operatively indicating CBD involvement. Five patients had papillary stenosis, three had postoperative CBD strictures, one had a choledochal cyst and one had an external biliary fistula. Of the 100 CBDs measuring more than 10 mm in diameter, 90 harboured calculi. In the remaining 23 CBDs measuring less than 10 mm, calculi were present in 21. The presence of CBD calculi was demonstrated by intra-operative cholangiography in 49 patients. In the remaining patients (n = 74), the diagnosis of CBD pathology was made either by percutaneous transhepatic cholangiography, endoscopic retrograde cholangio-pancreatography, T-tube cholangiography or peroperative palpation. The surgical procedures performed included choledochotomy and T-tube drainage (n = 74), transduodenal sphincteroplasty (n = 27) and choledochoduodenostomy (n = 18). The overall mortality and morbidity of CBD exploration was 3.3 per cent and 24.4 per cent respectively, which was significantly greater than that for cholecystectomy alone (0.3 per cent and 8.6 per cent respectively). Transduodenal sphincteroplasty carried a much higher mortality (11 per cent) and morbidity (52 per cent) when compared with other procedures.

Cholangiography↗