ABC of colorectal diseases. Colorectal neoplasia--I: Benign colonic tumours.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to P F Schofield.
Explore the source record for details and available documents.
Eleven consecutive patients with diarrhoea from whose stools campylobacter were isolated were investigated by sigmoidoscopy and rectal biopsy. Eight had definite proctitis, and in seven biopsy specimens were abnormal with histological changes ranging from non-specific colitis to gross colitis with goblet-cell depletion and crypt-abscess formation. Nine of the patients passed blood in their stools, and in all but one abdominal pain was a feature of the illness. Severe campylobacter colitis may be clinically, sigmoidoscopically, and histologically difficult to differentiate from ulcerative colitis and is a differential diagnosis in acute colitis.
Toxic dilatation of the colon may be due to inflammatory bowel disease, either ulcerative colitis or Crohn's disease of the colon, but recent experience has shown that infective colitis due to salmonella can produce this complication. We present 13 cases with toxic dilatation (9 inflammatory bowel disease and 4 salmonellosis) and outline the diagnostic features and treatment in these patients. It is important to distinguish salmonellosis at an early stage because, whilst toxic dilatation in inflammatory bowel disease is an absolute indication for surgical treatment, cases with this complication due to salmonellosis may be treated conservatively in the majority of instances.
In a prospective, randomized trial, 76 patients with duodenal ulceration treated by truncal vagotomy and pyloroplasty were compared with 77 patients who underwent highly selective vagotomy. A total of 149 patients was followed up for from 1 to 4 years, the average follow-up period being 2.6 years. There was no operative mortality and no significant difference in postoperative morbidity between the two groups. The incidence of recurrent ulceration was greater after highly selective vagotomy, but this difference was not statistically significant. The clinical results were comparable in each group, and although the incidence of diarrhoea and dumping was greater after vagotomy and pyloroplasty, this difference was not statistically significant.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Benign duodencolic fistula is a rare complication of a number of gastrointestinal diseases and it is seldom considered in diagnosis. Diarrhoea and weight loss are characteristic presenting features which may be masked by coexisting disease. Barium enema is the most useful diagnostic procedure. Prognosis is good if surgery is undertaken at an early stage after adequate correction of the metabolic consequences of the fistula, by administration of fluid, electrolytes and parenteral nutrition. This paper reports 4 cases of this condition and reviews the clinical features, investigation, aetiology and management.
Explore the source record for details and available documents.
A study of the alterations of intestinal microflora that occur in acute small and large bowel obstruction is presented. The results are discussed in relation to the duration of obstruction, the site of obstruction, the recovery following relief of obstruction and the septic complications which profoundly affect the prognosis of these common surgical emergencies.
Morbidity after closure of a colostomy is low if a simple antiseptic technique of intraperitoneal closure is used. In 26 patients there was no example of major wound sepsis and only 2 faecal fistulas both of which rapidly closed spontaneously. A randomized study of preoperative bowel preparation incorporating an elemental diet showed no apparent advantage for this method using our criteria for assessment.
Small-bowel content was examined bacteriologically whilst fresh and after storage for 24, 48, and 72 h in a modified Stuart's medium. There was little alteration in the viable count of individual intestinal organisms. For accurate quantitative analysis, 0-3 ml of intestinal content was enough. Specimens of small-bowel content were obtained by needle aspiration, and a qualitative and quantitative study was made of the microflora of patients with acute intestinal obstruction and of a control group of patients. Results in the control group confirmed the findings of the results of intubation studies by other workers, that a quantitative gradient of aerobic and anaerobic organisms exists from jejunum to distal ileum. In acute small-bowel obstruction and acute large-bowel obstruction there was a loss of the normal gradient and an increase in the absolute numbers of organisms present; this was particularly marked for anaerobic organisms in large-bowel obstruction.
Explore the source record for details and available documents.
A series of fifteen patients with abdominal tuberculosis, managed personally by two clinicians over a five-year period, is presented. These fall into three broad groups: tuberculous peritonitis, gastrointestinal tuberculosis and tuberculous hepatitis. In more than half of the patients the chest radiographs were normal and three patients had negative tuberculin reactions. In emphasizing the fact that abdominal tuberculosis is not longer a rarity in Britain, attention is drawn to the many different ways in which the disease may present. One patient in the series, who presented as a possible case of cholera, had duodeno-colic fistula (only the third proven case in the literature) and two other patients presented with jaundice due to hepatic tuberculosis, again a rare form of abdominal tuberculosis.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.