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Biomedical subjects

K L Wang

Publications and source records attributed to K L Wang.

49 records · Page 3Linked to original sources
PubMed1990

[Etiology of intestinal obstruction--4 years' experience].

In order to find out the etiological patterns of intestinal obstruction, we reviewed 1205 cases diagnosed as intestinal obstruction at our hospital. The operative findings, locations of obstruction and pathological results were analyzed among 707 cases who were operated on. The most common cause of colon obstruction was tumor (78.7%). The etiologies of small intestinal obstruction were: adhesions, 47.4%; hernia, 22.1%; tumor, 11.8%; intussusception, 8.8%; foreign bodies, 3.7%; and miscellaneous causes, 6.2%. In the patients older than 40 years, the most common causes of intestinal obstruction were adhesion and malignancy, in contrast to hernia and intussusception that were commonly found in children. The mean age of the patients with colon obstruction was older than those with small bowel obstruction, 55.7 +/- 21. vs 39.4 +/- 17.3 (P less than 0.001). Of the patients with previous abdominal surgery, adhesions caused the obstruction in up to 60.5%. Among the 102 cases who had been operated for abdominal malignancy, the cause of intestinal obstruction was due to recurrent tumor in 78 patients (76.4%). Of patients without previous abdominal surgery, the etiologies of intestinal obstruction were: incarcerated hernia, 36.7%; tumor, 21.1%; intussusception, 15.6%; and adhesion, 13.8%. The incidence of strangulation obstruction was 25.7%, of which the major causes were adhesions, 51.7%; and hernia. 43.0%. We concluded that the most common cause of colon obstruction was tumor. The two most common causes of small intestinal obstruction were adhesions and hernia. Age and past history of abdominal surgery can much help for the differential diagnosis.

Adolescent↗
PubMed1990

Gastrointestinal phytobezoar in children.

Phytobezoars are composed of fruit or vegetable matter, including seeds, nuts, and pits, and are the most common type of bezoar associated with gastrointestinal obstruction. Eleven gastrointestinal phytobezoar in children (less than 15 years old) seen within a period of 8 years (1981-1988) were analysed. Six were boys and 5 were girls. On history, 6 patients developed symptoms after ingestion of persimmon. All cases except one occurred in late fall and winter. In 8 patients, phytobezoar was found in a single location with 5 in the ileum and 3 in the jejunum. Multiple locations were found in 3 patients. Emergency laparotomy was performed on all cases who had typical mechanical intestinal obstruction. Treatment consisted of fragmentation of bezoar with pushing toward the cecum in 9 patients, combined with gastrotomy in 3 patients, and enterotomy in 2 patients. Because the persimmon ingestion is the most common cause of bezoar formation, a careful dietary history will usually suggest the diagnosis preoperatively. All the gastrointestinal tract should be thoroughly examined intraoperatively, especially the stomach and terminal ileum, to prevent another intestinal obstruction caused by an undiscovered phytobezoar.

Bezoars↗
PubMed1989

Nonoperative treatment of blunt hepatic injury in children.

Between January 1983 and December 1986, 35 Children with blunt hepatic injury were treated in Chang Gung Memorial Hospital. After vigorous resuscitation, 10 Patients required emergency laparotomies: 9 for massive bleeding, and 1 for associated bowel injury. Exploratory surgery was necessary 5 days after the initial resuscitation in one patient due to rebleeding. The remaining 24 patients who responded well to resuscitations were managed nonoperatively. Imaging examinations (ultrasound, radioisotope scan or computerized tomography scan) provided the diagnosis of liver trauma in all. The hospital courses in all cases were uneventful and there were no complications. In every patient follow-up imaging examinations showed complete resolution of the lesions. We conclude that nonoperative management of selected patients with blunt hepatic trauma is reasonable. With the help of serial imaging examinations, this conservative approach is safe and practical.

Adolescent↗
PubMed1989

Radical hysterectomy with pelvic lymph node dissection for treatment of cervical cancer: a clinical review of 954 cases.

Nine hundred fifty-four patients, who received a radical hysterectomy and a bilateral pelvic lymphadenectomy, were included in this study which ran from January 1971 to December 1986. The subjects, by in large, ranged in age from 41 to 60. Of these cases, 62.5% were in clinical stage IB, while 26.2% were in stage IIA. Urinary tract fistula formations occurred in 2.4% of the cases and substantially decreased from 6.1% during 1971-1978 to 0.9% in the subsequent period from 1979 to 1986. The operative mortality rate was 0.4%. The follow-up included 438 cases that came from 1971 to 1981, and each was evaluated over a period of 5 years. Of these cases, 28 patients were lost during the follow-up period and were presumed to have died from cancer. The absolute 5-year survival rates for the patients in stage IB, stage IIA, and IIB were 86.1, 71.7, and 60.1%, respectively. The respective 5-year survival rates for patients with stage IB LN(-) and LN(+), i.e., without or with lymph node metastasis, were 87.7 and 73.1%. The survival rates for patients with stage IIA LN(-) and LN(+) were 79.8 and 40.9%, respectively. In retrospect, the 5-year survival rates seem to be related to age, parametrial involvement, and histological type. This study shows that because of improving surgical techniques and anesthesia, acceptable operative morbidity and mortality, as well as favorable 5-year survival rates, radical surgery seems to be the treatment of choice for patients with early invasive uterine cervical, and especially for younger women.

Adolescent↗
PubMed1988

Retinal detachment due to firecracker injury.

Seven cases of retinal detachment due to firecracker injury are reported. Most involved young boys. Associated anterior segment changes as well as the nature of the retinal breaks attested to the similarity between firecracker injuries and blunt contusion injuries. Despite successful retinal reattachment in all cases, visual results were poor. To prevent visual loss from firecracker injury, educational programs directed to school age boys seem needed.

Adolescent↗
PubMed1988

Biliary sludge-cast formation following liver transplantation.

The development of biliary sludge, in the absence of anastomotic obstruction in the common bile duct, has become a very rare complication following orthotopic liver transplantation since the adoption of modern techniques of biliary reconstruction and routine biliary flushing before cold preservation. We describe the successful treatment of this serious complication in an 18-year-old woman whose biliary sludge aggregated into firm casts occupying the extrahepatic and intrahepatic bile ducts causing obstruction and cholangitis necessitating operative intervention followed by interventional radiological approaches to treat the intrahepatic bile duct strictures. Postoperative choledochofiberscopy was also used to remove the retained biliary casts. The pathogenesis of biliary sludge appeared to be multifactorial, but cold ischemic damage to the bile duct wall seemed to play an important role in this case.

Adolescent↗
PubMedDate not supplied

Primary testicular tumors in children.

Twenty-six primary testicular tumors in children (less than 15 years old) seen within a period of nine years (1978-1986) were analyzed. Of these, 16 (61.5%) were benign mature or immature teratomas and ten (38.5%) malignant. This is obviously different from most of the western series in which a 75-80% rate of malignancy has usually been reported. Sixteen benign testicular tumors, which were either mature or immature teratomas, showed no evidence of tumor one to nine years after high inguinal orchiectomy. Serum alpha-fetoprotein (AFP) levels were available in 14 of these patients and all of them were below 50 ng/ml. In the ten malignant tumors, eight were yolk sac tumors and two embryonal rhabdomyosarcomas. High inguinal orchiectomy only was performed for stage I disease with sequential monitoring of AFP level for two years. For stage II or III tumors, chemotherapy and/or irradiation were added in the treatment regimen. Retroperitoneal node dissections were not performed in this series. Eight out of these ten cases were alive without evidence of disease after one to seven years, one expired for an unknown cause and one was lost to follow-up. We advocate this conservative approach to childhood testicular tumors which have a better outcome than adult tumors.

Adolescent↗