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Biomedical subjects

M Schein

Publications and source records attributed to M Schein.

At least 235 records · Page 13Linked to original sources
PubMed1986

Perforated peptic ulcer at the J.G. Strijdom Hospital. A retrospective study of 99 patients.

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.

Adult↗
PubMed1986

Management of gallstone ileus. A report of 3 cases.

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.

Aged↗
PubMed1986

The 'sandwich technique' in the management of the open abdomen.

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.

Abdomen↗
PubMed1986

The open management of the septic abdomen.

The mortality rate of severe intra-abdominal infections is still very high. The open management of the abdomen is a method of treatment which has gained popularity over the past few years. Its advantages include a better drainage of the peritoneal cavity, a greater protection of the parietes, an improved perfusion of the abdominal viscera and a decrease in postoperative pulmonary complications. It is indicated in patients with severe intra-abdominal sepsis, especially when multiple re-explorations of the abdomen are likely. A variety of techniques, including the use of Marlex mesh have been devised to contend with possible complications: spontaneous fistulas, exogenous bacterial contamination, evisceration and massive fluid losses. The open method of management has not made the treatment of septic abdomen much easier; it requires intensive care support and repeated assessment of the peritoneal cavity. The closure of the abdomen is a problem which must be addressed when the sepsis has subsided. The value of this technique is still difficult to assess in the absence of controlled randomized trials.

Abdomen↗
PubMed1986

Perforated gastric ulcers. A retrospective study of 32 patients.

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.

Adult↗
PubMed1985

Colonic necrosis in acute pancreatitis. A complication of massive retroperitoneal suppuration.

Colonic necrosis is a rare complication of peripancreatic sepsis following acute pancreatitis. Three patients with colonic necrosis associated with extensive retroperitoneal suppuration are reported. The pathogenesis of this syndrome may be explained by the tendency of pancreatic abscesses to extend widely in the retroperitoneum. Management is discussed, emphasizing the need for an aggressive surgical approach and multiple operations.

Abscess↗
PubMed1985

A foreign body related actinomycosis of a finger.

An extremely rare case of foreign body related actinomycosis of the finger is described. To the best of our knowledge, this condition had not been previously reported. Subtotal excisional biopsy followed by penicillin therapy eventually yielded a well functioning finger.

Actinomycosis↗