Biomedical subjects

R J Lucas

Publications and source records attributed to R J Lucas.

50 records · Page 3Linked to original sources

PubMed1980

Paraganglioma of the duodenum: a case report.

Paraganglioma of the duodenum is a tumor which typically occurs in the ampullary region and which has been regarded as benign. This patient, as well as most of the 25 similar cases previously described, presented with upper gastrointestinal bleeding. Diagnosis may be elusive, particularly when a Billroth II anastomosis has been done previously. Careful identification of the ampulla is mandatory to ensure safe excision of the tumor. The possibility of multicentricity in these tumors heightens the necessity of distinguishing them from ampullary carcinoma at operation.

Ampulla of Vater↗

PubMed1978

Inframesocolic transduodenal approach to the distal biliary-pancreatic ductal system.

The usefulness of the inframesocolic transduodenal approach to the distal biliary system in patients in whom numerous previous procedures had been performed was evaluated. First, the feasibility of the technique was ascertained by anatomic study. Ten anatomic dissections were performed during routine postmortem examinations. This proved that the duodenum, ampulla of Vater, distal common duct, and head of the pancreas could be adequately exposed via the inframesocolic approach and that it was reasonable to use the procedure clinically. This approach has been used successfully in five cases. It was found that (1) the inframesocolic approach to the duodenum and distal biliary system is useful, particularly in those patients requiring second operations in the right upper quadrant; and (2) the approach allows ready access to the area through virgin territory and has distinct advantages in exposure, operative time, and information available.

Aged↗

PubMed1977

Epidermoid splenic cysts.

Five young women were treated by splenectomy for epidermoid cysts of the spleen. They all had vague abdominal symptoms, and had a mass palpable in the left upper quadrant of the abdomen. The hematologic indices were unremarkable. The diagnosis was suggested by routine radiologic examinations (including chest roentgenogram, upper gastrointestinal x-ray series, barium enema, and excretory urogram). It was confirmed in one patient by gray-scale ultrasonography, and in another by selective splenic arteriography. Of the true cysts of the spleen, the epidermoid cyst is the rarest, representing 10% of the benign, nonparaslitic cysts. The symptoms are completely relieved by splenectomy, and this remains the treatment of choice.

Adolescent↗

PubMed1976

Gastroduodenal Crohn disease.

Symptomatic involvement of the stomach and duodenum is an uncommon manifestation of Crohn disease. Our experience with three young women who had upper gastrointestinal tract symptoms indicates the seriousness of the condition. All three patients required operation for relief of symptoms. Two operations were performed for gastric outlet obstruction and one for massive hemorrhage (a rare complication of gastric involvement). All patients had roentgenographic or gastroscopic evidence suggestive of Crohn disease, and in each the diagnosis was confirmed by histopathologic means. The operative procedures consisted of distal gastrectomy in two cases and gastrojejunostomy in the third. All three patients have or have had evidence of Crohn disease of the small intestine and none of them responded to medical management. (In the most recent case, medical management included intravenous hyperalimentation.) In our experience, symptomatic involvement of the stomach in Crohn disease will not respond to medical treatment and will require surgical measures for relief.

Adolescent↗

PubMed1973