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Biomedical subjects

J J Bauer

Publications and source records attributed to J J Bauer.

90 records · Page 5Linked to original sources
PubMed1981

Pneumatosis cystoides intestinalis: a complication of systemic chemotherapy.

A case of pneumatosis cystoides intestinalis following administration of chemotherapy for Hodgkin's disease is presented. Because of a poor response to nonoperative management, a subtotal colectomy was performed. Although the pathogenesis of pneumatosis cystoides intestinalis is not entirely clear, it seems likely that, in this case, mucosal ulceration secondary to methyl-gag allowed intraluminal air to dissect into the intestinal wall and surrounding retroperitoneal tissues. Because pneumatosis cystoides intestinalis is often reversible and self-limited, fecal diversion in lieu of bowel resection is entertained as a possible alternative in the operative management of selected cases. In the case presented resection was performed because of extent of the pathologic process.

Adult↗
PubMed1978

Postoperative pneumoperitoneum: an unusual etiology.

Although postoperative pneumoperitoneum is a common finding, it is particularly disturbing when there is an increase in the amount of postoperative pneumoperitoneum or when the radiographic finding of pneumoperitoneum is accompanied by such physical findings as increased abdominal tenderness, peritoneal signs or paralytic ileus. Four patients operated upon at the Mount Sinai Hospital are presented. All patients underwent abdominal surgery for treatment of some form of inflammatory bowel disease and all were receiving systemic corticosteroids in the postoperative period. Abdominal findings of tenderness, ileus and peritoneal irritation developed shortly after the removal of Penrose drains in the postoperative period. Pneumoperitoneum was confirmed by abdominal roentgenographs. The first patient in this group underwent a laparotomy with essentially negative findings other than a freely open drain tract. The subsequent three patients were managed by close observation and frequent abdominal radiographs. These three patients had contrast roentgenographic studies of the upper gastrointestinal tract to rule out perforation of a peptic ulcer, and in the patient upon whom reservoir ileostomy had been performed, a contrast study of the reservoir was performed. All patients recovered fully with this management and there were no sequelae. The mechanism for the appearance of pneumoperitoneum after removal of drains, particularly when the patient is receiving systemic corticosteroids, is discussed. Emphasis is placed on the need to consider and rule out perforation of a hollow viscus in this situation before accepting drain removal as the sole cause of post-operative pneumoperitoneum.

Abdomen↗
PubMed1977

A continent colostomy: The magnetic stoma cap.

An apparatus to create continence in an end left-sided colostomy in dogs is assessed. The device consists of a samarium-cobalt magnetic ring encased in methyl methacrylate and a magnetic cap. The ring is implanted in the abdominal wall and the colon delivered through it and matured to the skin. The stoma is later obturated by the magnetic cap to provide continence. Ten dogs exposed to "uncoated" samarium-cobalt magnets for periods of up to eight months showed no elevation of cobalt levels in the serum or tissues and no histopathologic changes on postmortem examination. In twelve dogs, magnetic rings were used to create continent colostomies. Eleven of twelve dogs followed for periods up to eight months were continent and tolerated the appliance well. One ring was extruded after a peristomal skin dehiscence occurred. Two skin strictures appeared and were readily controlled by digital dilatation. Sinus, fistula, or infection were not seen. Clinical application of this device is discussed.

Abdominal Muscles↗
PubMed1977

The reservoir ileostomy: early experience with 54 patients.

Reservoir and ileostomies were performed in 54 patients between 1972 and 1975. Primary colonic pathology included chronic ulcerative colitis in 47 patients, Crohn's colitis in one, familial polyposes in 5 and Gardner's Syndrome in one. Followup is complete and varies from 6 months to three years. All but three patients are completely continent to feces; only one of these three requires the occasional use of a stomal appliance. There were no mortalities. Complications included suture line dehiscences, small intestinal obstruction or prolonged paralytic ileus, and hemorrhage from the reservoir. All complications were successfully treated and removal of the ileal reservoir was not required in any patient. These complications and steps which may be taken to avoid them are discussed. In addition, indications and contraindications for surgery are enumerated. It is well documented that both the colonic polyposes and long standing chronic ulcerative colitis are premalignant diseases. The availability of a continent, reservoir ileostomy as an alternative to the standard, incontinent, stoma has significantly reduced patient resistance to colectomy, and permitted earlier surgery.

Adolescent↗
PubMed1976

Sweat gland carcinoma. Current concepts of surgical management.

In three new cases of sweat gland carcinoma that we observed within recent years, the sites were the axilla, back, and arm. Axillary lymph node dissections were performed in two of the patients and the nodes were normal. Preoperative diagnoses were hydroadenitis, squamous cell carcinoma of the skin, and pyogenic granuloma. In one patient who was followed up for four years, there has been no recurrence; the follow-up period for the other two has been short. Sweat gland carcinoma is an uncommon neoplasm that occurs mostly in the older age groups. It may be very slow growing and is extremely difficult to diagnose preoperatively. Lymph node metastases are frequent and overall survival is poor. Prognosis is related to histologic cell type and presence or absence of lymph node metastases. Treatment by wide local excision of the lesion and primary regional node dissection is recommended.

Adenocarcinoma↗
PubMed1976

Continent ileostomy in the pediatric patient.

Continent ileostomies have been performed in 10 juvenile patients. The operative technique and postoperative management are described. Nine patients wear only small dressings to cover the stoma. One patient is partially incontinent and frequently wears an appliance. Criteria for patient selection and contraindications are discussed.

Adolescent↗
PubMed1976

Portosystemic shunting in patients with primary biliary cirrhosis: a good risk disease.

Five patients with primary biliary cirrhosis underwent portosystemic shunting for the control of variceal bleeding. Three procedures were emergencies and two were elective. There was no operative mortality; all patients were followed until the present or until death. One patient is alive 4 years and another, 2 years postoperatively. One patient died 4 years after operation and another died 16 months postoperatively. Another patient survived for 8 years following her shunt and eventually died as a result of a cerebrovascular accident. This group of patients is compared to a larger group undergoing portosystemic shunting because of portal hypertension secondary to other forms of liver disease. The absence of operative mortality and the fact that several of these patients had moderately long postoperative survival despite apparently poor liver function suggest that the usual criteria for the assessment of operative risk are not valid in primary biliary cirrhosis.

Adult↗
PubMedDate not supplied

The use of laparoscopy in retroperitoneal pathology.

Laparoscopy is usually not performed for retroperitoneal disease. However, if the retroperitoneal process is palpable or displaces viscera, laparoscopy may allow visualization and directed biopsy. In a personal series of 316 laparoscopies reviewed retrospectively, 19 (6%) were performed primarily for retroperitoneal pathology. All patients had CT scans documenting a retroperitoneal process. A confirmed histologic diagnosis was obtained on directed laparoscopic biopsy in 16 patients, including 9 non-Hodgkin's lymphomas. There was no mortality or morbidity in this series. Laparoscopy is a useful modality in selected patients with retroperitoneal diseases, and its use should be considered when a histologic diagnosis is necessary.

Biopsy↗
PubMedDate not supplied

Laparoscopic cholecystectomy: an initial report.

Sixty consecutive patients underwent an elective attempt at laparoscopic cholecystectomy between March 15 and July 31, 1990 at the Mount Sinai Hospital in New York. Fifty-two patients had successful completion of the laparoscopic cholecystectomy (87%). The reasons for conversion to open cholecystectomy were acute cholecystitis (four patients), inability to define the cystic duct-common duct junction (three patients), and one patient with an unexpected choledochal cyst variant. Forty patients (77%) were discharged on the first post-operative day, and the remaining 12 patients on the second post-operative day. Thirty-three patients (63%) required only oral pain medication, and 11 patients (21%) needed no pain medication post-operatively. Fifty-one patients (98%) had resumed normal activities by the seventh post-operative day. Cholecystectomy remains the treatment of choice for biliary colic. Laparoscopic cholecystectomy minimizes length of stay in the hospital, lessens post-operative pain, allows quicker return to normal activities, and has a superior cosmetic result.

Adult↗
PubMedDate not supplied

Continent ileostomy.

Explore the source record for details and available documents.

Colectomy↗