Angiodysplasia in transposed colon.
A 40-year-old man with a history of colonic transposition for lye stricture at 10 years of age presented with upper gastrointestinal tract bleeding due to angiodysplasia in a transposed right colon.
Adult↗
Biomedical subjects
S S Hans
Publications and source records attributed to S S Hans.
Role of oxygen free radical scavengers in preservation of intestinal villi in the presence of ischemia.
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Animals↗
Venous patch grafts and carotid endarterectomy. A critical appraisal.
Seventy-eight patients underwent 83 carotid endarterectomies (CEAs) with vein patch grafts from 1980 to 1985. A technically satisfactory endarterectomy was confirmed by completion arteriogram in all instances. Indications for venous patch graft included a diameter of the internal carotid artery of less than 3.0 mm (49 patients); an internal carotid artery diameter of less than 3.5 mm, with contralateral internal carotid artery occlusion (nine patients); unexpected stenosis detected by completion arteriogram (six patients); a reexploration for neurologic deficit following conventional CEA (three patients); and irregular surface or edges of the endarterectomy site or high extension of a plaque (16 patients). Late follow-up arteriograms (66 studies) after a mean two-year interval revealed three instances (4.5%) of recurrent asymptomatic stenosis. Four patients (6%) developed late occlusions; three were asymptomatic and one was associated with major stroke 2 1/2 years later. One patient (1.5%) developed a false aneurysm. One patient experienced a postoperative transient ischemic attack. There was no operative mortality. Six patients died in the late follow-up period. The venous patch graft ensured immediate patency of the internal carotid artery but failed to prevent recurrent stenosis or occlusion in internal carotid arteries less than 3.0 mm in diameter.
Aged↗
Intraoperative carotid arteriography. A comparison of two techniques.
Routine intraoperative completion carotid arteriography was performed in 225 patients from January 1980 to December 1985 to detect technical problems. In the first 100 patients, standard common carotid artery puncture was used. In the last 125 patients, catheter technique through the superior thyroid artery was compared with the needle technique to evaluate quality of images, completeness of the study, number of exposures required, and complications from these two techniques. The needle technique resulted in complete visualization of the extracranial and intracranial circulations in 94 patients (94 percent). The catheter technique was similarly successful in 123 of 125 patients (98 percent). The proportions of complete visualization were not statistically different in the two groups (p = 0.16). Six patients (6 percent) in the needle technique group and three patients (2 percent) in the catheter technique group required multiple exposures. When the complications incurred by the two techniques were compared, there was no statistical difference between the two techniques (p = 0.39). Two complications occurred in the needle technique group (2 percent), one resulting in dissection and the other, extravasation. There were no complications in the catheter technique group. Due to technical ease of performance, the catheter technique is preferred, although statistical data did not reveal superiority of one technique over the other.
Carotid Arteries↗
Resection of extracranial carotid artery aneurysm and correction of kink.
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Carotid Artery Diseases↗
Distal anastomotic obstruction with patent infrainguinal bypass.
Hemodynamic graft failure due to distal anastomotic obstruction was observed in 13 patients following femoropopliteal-tibial graft. The majority of such grafts (10 out of 13) had been performed with reversed saphenous vein. Graft patency was confirmed by arteriography in all cases, with retrograde flow in the majority of cases. Jump graft to a more distal site was performed in nine patients. Two early major amputations (within 30 days) and two late major amputations (30 days to 1 year) resulted. Return of ischemic symptoms, diminution of graft or distal pulses, and decrease in ankle pressures is an indication for arteriography. Undetected hemodynamic graft failure leads to thrombosis of the graft necessitating far more complicated operative procedures.
Femoral Artery↗
Anterolateral left gastric (coronary) vein: an anatomical variant.
The authors report a case of left gastric (coronary) vein that terminated on the anterior aspect of the portal vein 3.0 cm above the upper border of the duodenum after running anterolaterally. Preoperative arteriography helped to localize the vein, and allowed a safe portacaval shunt to be performed. The radiologic and surgical significance of this anomaly is discussed.
Adult↗
Safer intraoperative carotid arteriography.
A new technique of intraoperative carotid arteriography after endarterectomy is described. Placement under direct vision of a plastic angiocatheter through the superior thyroid artery into the lumen of the common carotid artery facilitates arteriography without the potential complications of puncture of the common carotid artery wall.
Carotid Arteries↗
Accelerated renovascular hypertension following intra-aortic balloon counter-pulsation.
A 62-year-old man developed high serum renin arterial hypertension following thoraco-abdominal dissection which resulted from insertion of an intra-aortic balloon pump (IABP). Nephrectomy resulted in cure of medically unmanageable hypertension.
Assisted Circulation↗
Hypercalcemic crisis due to unsuspected parathyroid adenoma in a patient with advanced breast carcinoma.
Primary hyperparathyroidism was found to be responsible for hypercalcemic crisis in a 73-year-old woman who had undergone mastectomy for advanced breast carcinoma. Medical management followed by removal of a large parathyroid adenoma resulted in gradual recovery and normocalcemia documented over a period of 2 years.
Adenoma↗
Uncommon presentations of venous disease.
Venous disease can manifest itself in unusual ways; three uncommon venous disease states are described, together with discussions of their treatment. The cases include an iliac compression syndrome, incipient venous gangrene of an upper limb associated with polycythemia and congestive cardiac failure, and venous edema of a lower limb as a sequel to previous radical pelvic surgery.
Adolescent↗
Saccular atherosclerotic aneurysm of the superior mesenteric artery.
We report on the successful surgical resection of an aneurysm of the superior mesenteric artery. The saccular nature of the aneurysm and evidence of celiac axis occlusion in this patient posed an additional challenge in the successful surgical treatment.
Adult↗
Eosinophilic granulomas of the gastrointestinal tract.
Three patients with eosinophilic infiltration of the stomach and one with eosinophilic granulomatous polyp of the ileum are described. We believe that eosinophilic granulomatous lesions of the gastrointestinal tract comprise a distinct clinical and pathologic entity which should be considered in the differential diagnosis of obstructing or ulcerating lesions.
Adult↗
Carcinoma arising in thyroglossal duct remnants.
Papillary adenocarcinoma arising in a thyroglossal cyst is described in a 38-year-old man to make a total of 83 cases in the literature. Most cases appear to be benign thyroglossal duct cysts. The malignant nature of the lesion was recognized only after the permanent pathology sections were reviewed. Paillary carcinoma was the most common type of carcinoma arising in thyroglossal duct remnants. Local resection by the Sistrunk method is the standard treatment when the malignancy has not extended beyond the confines of the cyst. The differentiation between a carcinoma arising in a thyroglossal duct remnant and a metastatic papillary carcinoma from an occult primary in the main thyroid gland is discussed.
Adenocarcinoma, Papillary↗
Post-thyroidectomy hypoparathyroidism.
The incidence of hypoparathyroidism following thyroid surgery in the series reported was 7.8 per cent. Temporary hypoparathyroidism was present in 15 patients (4.6%) and permanent hypoparathyroidism in 10 (3.2%). Persistently low levels of serum calcium and high levels of serum phosphorus at six to 10 weeks after thyroid operation in patients with temporary hypoparathyroidism, with no tendency toward normalization, suggests permanent hypoparathyroidism. Serum calcium below 5 mg per cent suggests permanent hypoparathyroidism.
Calcium↗
Double inferior vena cava and abdominal aortic aneurysm.
Duplicated inferior vena cava was found unexpectedly at the time of resection of abdominal aortic aneurysm. Resection of the aneurysm and preservation of duplicated vena cava was performed. Technical difficulties and embryology of this anomaly are discussed.
Aorta, Abdominal↗
Subclavian-external carotid bypass.
Subclavian to external carotid artery bypass was performed to improve collateral flow to the brain in three patients with symptomatic cerebral ischemia from common-internal carotid occlusion. Stenosis of the contralateral carotid in the neck or intracranial internal carotid arteries was also present. There was significant neurological improvement without complications in the three operations. Saphenous vein was used for the bypass and graft patency was confirmed by intra or postoperative arteriography in all cases.
Aged↗