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Biomedical subjects

R E Hermann

Publications and source records attributed to R E Hermann.

At least 91 records · Page 5Linked to original sources
PubMed1977

Ligation procedures in the management of portal hypertension.

In the 10 year period from 1964 through 1973, 25 patients bleeding from esophageal varices underwent ligation procedures coupled with splenectomy rather than a shunt. These procedures included the transesophageal and transgastric approaches and extragastric ligations. For patients with normal liver function, the risk of this urgent or emergency surgery is comparatively low (two of 12 patients died). The chance of recurrent hemorrhage is high (nine of nine surviving patients), as is the need for subsequent surgery (eight of nine patients). Nevertheless, despite these drawbacks, nine of these 12 patients (75 percent) are alive, and seven have survived 5 or more years. In patients with cirrhosis, the initial operative mortality rate (three of 12 patients) and the subsequent mortality rate (five additional patients) reflect the greater risk because of liver disease. Only five of 13 patients (38 percent) survive, three of whom are alive 5 or more years. In patients with cirrhosis, the initial operative mortality rate (three of 12 patients) and the subsequent mortality rate (five additional patients) reflect the greater risk because of liver disease. Only five of 13 patients (38 percent) survive, three of whom are alive 5 or more years after their initial surgery. These results indicate that there are situations when ligation procedures are valuable, especially in the noncirrhotic patient.

Adult↗
PubMed1976

Obstructing duodenal ulcer.

The incidence, pathogenesis, symptoms, roentgenographic, and endoscopic findings of patients with gastric outlet obstruction from a chronic duodenal ulcer have been reviewed. In the experience of many surgeons, including myself, vagotomy and an adequate drainage procedure (Finney pyloroplasty, gastrojejunostomy, or gastroduodenostomy) provide excellent decompression of the obstructed stomach. as well as excellent control of the ulcer disease in most patients. Postvagotomy gastric atony has not been a problem.

Duodenal Obstruction↗
PubMed1976

Intraluminal duodenal diverticulum associated with trisomy 21.

An intraluminal duodenal diverticulum is an uncommon congenital abnormality that may produce intermittent ostruction. The true pathogenesis of this lesion is still disputed, but it probably results from ballooning of a congenital web or diaphragm with prolonged peristalsis. An intraluminal "wind sock"-like structure filed with barium and surrounded by a radiolucent halo is the classic and diagnostic radiologic appearance. An association with trisomy 21 is made.

Adolescent↗
PubMed1976

Preoperative localization of occult lesions of the breast.

An outpatient procedure that accurately localizes occult lesions of the breast has been used in 26 patients. A small biopsy is performed using local anesthesia, the excised specimen is xerographed and, if necessary, bread-loafed to identify the involved specimen. This has corroborated the xeromammographic diagnosis of cancer in six patients in whom the lesions were clinically not detectable.

Biopsy↗
PubMed1975

Control of arteriovenous fistula of splenic vessels by Fogarty catheter.

A large arteriovenous fistula of the splenic vessels was identified by angiography. A splenic-artery-to-splenic-vein fistula developed shortly after a staging procedure for Hodgkin disease. A second surgical procedure failed to adequately control the arteriovenous communication. Intra-arterial obliteration of the fistula was accomplished by use of a Fogarty catheter.

Adult↗
PubMed1975

Endoscopic pancreatography: its value in preoperative and postoperative assessment of pancreatic disease.

Examples of the use of endoscopic pancreatography in the preoperative evaluation and postoperative follow-up study of patients with pancreatic disease are presented and discussed. Six cases selected from a total experience of forty-eight patients have been summarized. The direct role of pancreatography in the management of these cases is cited. There is a small but definite risk to the procedure. With increased use of endoscopic pancreatography, it is hoped that earlier diagnoses of a variety of pancreatic diseases will be obtained which will permit more accurate medical and surgical therapy.

Adult↗
PubMed1975

Silastic T tube splints for biliary repair.

Silastic rubber T tubes have been compared with latex rubber T tubes in the biliary system of dogs. It was found that Silastic rubber T tubes evoked a significant foreign body reaction within the biliary system, producing bile salt precipitation and debris. Alarmingly, in these studies in dogs, Silastic rubber T tubes did not cause sufficient intraperitoneal adhesions around the tube to form an intraperitoneal tract walling off the tube from the general peritoneal cavity. Thus, when the Silastic rubber T tube was removed, bile leakage into the peritoneal cavity occurred. Based on studies in dogs, Silastic rubber T tubes should not be used in the clinical situation in which the T tube would be removed postoperatively.

Animals↗
PubMed1975

Diagnosis and management of bile duct strictures.

In the majority of patients, strictures of the common bile duct result from an injury to the duct. The earlier the injury is repaired or the more quickly the diagnosis of stricture is made and repaired, with antibiotics to prevent infection, the better are the results of the repair. Five types of repair have been utilized: (1) choledochoduodenostomy, (2) duct-to-duct repair, (3) choledochojejunostomy, (4) plastic revision of the stricture, or (5) dilatation of a previous stricture when multiple, previous operative procedures or the difficulty of operative exposure proves too great for adequate repair. Our overall results after repair of biliary stricture are good or excellent in 84 per cent of patients. We have had the best results in patients in whom choledochoduodenostomy was performed.

Anti-Bacterial Agents↗