Causes of lower gastrointestinal haemorrhage.
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Biomedical subjects
Publications and source records attributed to W G Everett.
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The records of 74 patients who had loop colostomies closed at Addenbrooke's Hospital between 1970 and 1975 were studied retrospectively. One death from a pulmonary embolus occurred and the incidence of fistula from the site of closure was found to be 5.4 per cent. A number of differing factors were assessed. Closure 6 weeks after the colostomy's formation and preoperative antibiotic (antimicrobial) bowel preparation appeared to be factors associated with a favourable outcome. On the other hand, an initial operation for carcinoma and closure less than 6 weeks after the colostomy's formation were factors related to a less favourable outcome.
Fluorescein angiograms were performed in 90 patients the first and sixth week after removal of non-traumatic cataracts by phacoemulsification. The incidence of macular edema was found to be one half that reported in the literature for a comparable group of patients following intracapsular cataract extraction. The difference in incidence of macular edema between the phacoemulsification and the intracapsular groups seems dependent on the presence of the posterior capsule and perhaps the small size of the phacoincision. One of 21 maculas with angiographic evidence of edema developed clinical cystoid macular edema.
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A case of Zollinger-Ellison syndrome complicated by a gastroduodenal fistula is described in a 42-year-old man. So far as the authors know, this is the first report of this complication in gastrinoma.
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A case of duplication of the rectum is presented and the literature reviewed.
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A review of 1,107 cases of cataract extraction by phacoemulsification is presented. The incidence of retinal detachment in this group was found to be 1,7%. This incidence of retinal detachment following phacoemulsification appears to be favorable compared to that following conventional cataract extraction. It is hoped that this report will encourage others to study this important subject.
It is hoped that the results of surgery for retinal detachment after surgery for congenital cataract, when discission and aspiration or phacoemulsification under the microscope are used, will approach the present reattachment rate that has been achieved with improved examination, instrumentation, and surgical technique in cases of senile retinal detachment. Further studies of the role of retinal pathology as lattice degeneration, vitreous pathology, and the place for prophylactic cryotherapy all must be reevaluated. In summary, the low incidence of retinal detachment following the extraction of congenital cataracts as seen in major retinal referral centers suggests that the risks of detachment are not as high as previously reported, that the cure rate approaches that of senile aphakic detachment; therefore early operative intervention to prevent amblyopia, nystagmus, and strabismus is indicated.
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In a randomized prospective clinical trial and layer and two layer techniques have been compared in 92 patients undergoing colorectal anastomosis. The results were assessed radiologically by barium studies on the tenth postoperative day. There was no significant difference in the incidence of anastomotic breakdown with either technique when the anastomosis was performed above the pelvic peritoneal reflection. When the anastomosis was situated below the pelvic peritoneum the incidence of dehiscence was significantly greater when a two layer technique was used.