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Biomedical subjects

S K Chawla

Publications and source records attributed to S K Chawla.

At least 37 records · Page 2Linked to original sources
PubMed1979

Familial achalasia of the esophagus in mother and son: a possible pathogenetic relationship.

Familial achalasia most often has been recorded in siblings, and only rarely (twice previously) in a parent and offspring. This report concerns a third case of achalasia in a parent and offspring (mother and son). Clinical and radiographic features of the esophageal achalasia are presented. The possibility that genetic factors may play a role in the etiology of this disorder is discussed.

Aged↗
PubMed1977

Coronary obstruction secondary to direct cannulation.

Four patients are reported with obstruction of the proximal left main coronary artery that developed following prosthetic replacement of the aortic valve. Angina pectoris and ventricular arrhythmias were the presenting clinical manifestations. Anterior descending coronary artery bypass was used in 3 of the patients and vein patch angioplasty in the fourth. One patient died in the hospital. The 3 survivors achieved reflief from angina and ventricular arrhythmias. One patient died from nephropathy 2 1/2 years later. Two patients remained asymptomatic 1 1/2 and 3 years later, respectively. This review emphasizes the need for prompt coronary angiography in patients experiencing angina pectoris after aortic valve replacement, and it shows that coronary revascularization can be performed with satisfactory results.

Adult↗
PubMed1977

Percutaneous transhepatic cholangiography and needle biopsy in the differential diagnosis of obstruction of bile flow.

Twenty-four patients with clinical evidence of obstructive jaundice were examined by percutaneous transhepatic cholangiography (PTC) and needle biopsy (NB) of liver. The presence of extrahepatic bile duct obstruction was confirmed by surgery in 21 cases. PTC and the combination of both methods were superior to NB alone in the differential diagnosis between extra- and intrahepatic biliary obstruction. Sampling bias added to the difficulties of NB in distinguishing beween these two types of obstruction. The combination of both precedures proved most useful in three cases with intrahepatic obstruction, in which the patients were spared unnecessary surgery. In five cases the NB provided additional information about the nature of the tumor metastases and gave suport to the clinicians in their therapeutic approach.

Bile Duct Neoplasms↗
PubMed1977

Hypoglycemia secondary to metastases to the liver. A case report and review of the literature.

A 76-year-old man presented with hypoglycemic coma associated with metastatic liver disease. Serum immunoreactive insulin excluded insulinoma as a cause of hypoglycemia. Negative glucose responses to glucagon and epinephrine testing indicated failure of compensatory glycogenolysis. The patient's increased glucose requirements of 500 g per 24 hr were reduced to normal only after shrinkage of the liver tumor bulk was accomplished with chemotherapy. Hepatic hypoglycemia is discussed and the literature is reviewed.

Aged↗
PubMed1977

Uncommon presentation of pancreatic pseudocyst.

Five cases of pancreatic pseudocyst are presented with unusual manifestations. Clinical features of each entity are discussed to enable one to diagnose the rare manifestations and complications of pancreatic pseudocyst. Reasonable understanding of such cases enables accurate diagnostic work-up for confirmation and early surgical intervention.

Adult↗
PubMed1976

Carotid body tumor: resection or reflection.

We have studied a series of 24 cases of carotid body tumor, comprising our total experience during the past two decades. Twelve patients had symptoms related to compression or invasion of the surrounding structures. Two patients had malignant changes, while three individuals had bilateral lesions. Thirteen patients underwent neck exploration for diagnosis or attempt at surgical removal of the tumor prior to admission to our institution. Definitive procedures in 24 cases resulted in one postoperative death, a rate of 4%. Internal carotid flow was preserved in every case. Intraluminal shunting was employed during the last decade, and no instance of cerebral damage was encountered. It is our intention to emphasize the importance of an accurate diagnosis by carotid angiography prior to surgical management. We also wish to encourage routine excision of these tumors as they are diagnosed, before they reach an enormous size.

Adult↗
PubMed1976

Pulmonary venoocclusive disease.

Pulmonary venoocclusive disease has been established as a definite clinical entity characterized by congestive cardiac failure with pulmonary arterial hypertension, chronic interstitial pulmonary edema, and normal wedge pressure on cardiac catheterization. This disease was diagnosed and confirmed in a patient during life. A review of the 32 patients reported earlier has been done in an attempt to fine possible etiological agents. Early recognition and treatment with anticoagulants, methylprednisolone, aspirin, and dipyridamole may improve the prognosis.

Adult↗
PubMed1975

Acute renal failure complicating ruptured abdominal aortic aneurysm.

Ruptured abdominal aortic aneurysm complicated by renal failure is associated with a mortality greater than 90%. Aggressive management, which included the early use of hemodialysis, was employed. Between 1970 and 1973, a total of 43 patients had surgery for proved ruptured abdominal aortic aneurysm. Fourteen patients developed acute and fixed renal failure. Nine of these 14 patients had undergone hemodialysis with treatments beginning as early as the second postoperative day and lasting as long as ten weeks. There were six survivors, with a hospital mortality of 33%. This represents an improvement in survival compared with our earlier experience where the mortality in this type of patient was 93%. Early use of hemodialysis in the postoperative management of patients with acute renal failure complicating ruptured abdominal aortic aneurysm is recommended.

Acute Kidney Injury↗
PubMed1975

Pancreatic ascites: diagnostic importance of ascitic lipase.

10 cases of pancreatic ascites are presented. Ascitic fluid lipase is complementary to the determination of ascitic amylase in the diagnosis of pancreatic ascites and may be a more reliable diagnostic indicator of pancreatic ascites on a random ascitic fluid sample. Conservative management, consisting of abdominal paracentesis with or without diurectics, proved to be the treatment of choice in 3 of our patients who failed to reveal an associated pseudocyst.

Adenocarcinoma↗
PubMed1975

Diffuse small bowel involvement in malignant histiocytosis.

The extremely unusual patient reported here had malignant histiocytosis with extensive gastrointestinal involvement. The presenting symptoms were those of a gastrointestinal disorder and barium studies of the upper gastrointestinal tract revealed an infiltrative process of the entire small bowel. A biopsy of the small bowel demonstrated abnormal malignant cells and the diagnosis of malignant histiocytosis was considered and confirmed at postmortem. Strongyloidiasis, which was also found in this patient, may represent a hyperinfestation phenomenon due to altered host-parasite balance.

Adult↗
PubMed1975

The surgical implication of broncholithiasis.

A calcified hilar or mediastinal lymph node can compress or erode the tracheobronchial tree and cause a variety of problems, including the "spitting of stones," hemoptysis, pneumonia, atelectasis, and bronchoesophageal fistula. From 1955 to 1975, 43 patients were evaluated for broncholithiasis. Nonsurgical management was carried out in 10 patients, whereas the remaining 33 underwent thoracotomy for the pathological process. Five patients had bronchoesophageal fistula as a result of the broncholith. Segmentectomy was the surgical resective procedure most commonly used. Conservation of pulmonary tissue is recommended when dealing with this problem. Surgical complications were minimal and no deaths occurred. The surgeon must be versatile in his technical approach and be prepared to carry out bronchoplastic procedures when indicated. A clinical awareness of the symptomatology of broncholithiasis leads the examiner to carry out the appropriate diagnostic studies of laminagraphy, bronchoscopy, bronchography, and esophagography. Early diagnosis and treatment will prevent the severe complications that can occur from continued observation.

Adult↗