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At least 1,261 records · Page 70Linked to original sources
PubMed2006

Biliary-colonic fistula: a case report and literature review.

We report the occurrence of common bile duct obstruction and biliary-colonic fistula after open cholecystectomy. Although it is a very unusual complication after cholecystectomy, biliary-colonic fistula should be part of the differential diagnosis for patients presenting with sepsis after open or laparoscopic cholecystectomy. After confirmation and characterization of the injury by endoscopic retrograde cholangiopancreatography and cholangiogram, assessment for undrained collections by computed tomography scan, control of sepsis and coagulopathy, and nutritional support, surgical repair was undertaken. The patient underwent fistula take-down between the common bile duct and the colon at the hepatic flexure, primary closure of the colon enterotomy, and a Roux-en-Y end-to-side hepaticojejunostomy at the confluence of the right and left hepatic ducts. Recovery was uneventful and the patient was doing well at the 6-month follow-up. Surgical repair should be undertaken by surgeons with extensive experience in hepatobiliary reconstruction.

Biliary Fistula↗
PubMed1991

Complications of biopsy of the cervical lymph node.

The incidence of injury to the accessory nerve after biopsy of the cervical lymph nodes is difficult to ascertain. The deficits in trapezius muscle function can result in marked disability to the patient. We have presented the results of surgical exploration and repair in eight patients with injury to the accessory nerve during biopsy of the cervical lymph node. External and internal fascicular neurolysis and fascicle suturing when indicated were performed. Four patients received significant improvement in accessory nerve function and four had no improvement. Our findings agree with those reported in the literature that early recognition of accessory nerve dysfunction after biopsy of the posterior cervical lymph node with appropriate surgical therapy can yield excellent results in trapezius muscle function.

Accessory Nerve Injuries↗
PubMed1990

Effect of brucellosis vaccination and dehorning on transmission of bovine leukemia virus in heifers on a California dairy.

Brucellosis vaccination and dehorning were examined for an association with bovine leukemia virus (BLV) infection in heifers on a California dairy between April 1984 and June 1987. Between December 1985 and June 1986, weaned heifers were dehorned using the gouge method at the time of brucellosis vaccination. Using logistic regression, the estimated probability for a nondehorned heifer to seroconvert within three months after brucellosis vaccination (0.08) was significantly less than that for heifers dehorned after a noninfected heifer (0.46) or than that for heifers dehorned after an infected heifer (0.85) (p = 0.039 and p less than 0.001, respectively). To evaluate risk of transmission by brucellosis vaccination, which was usually done within one month postweaning, cumulative proportions of heifers remaining uninfected were computed among heifers that did not seroconvert three months after dehorning. Because results of a Cox model analysis indicated that groups of heifers were 6.6 times more at risk of becoming infected if placed in pens holding gouge-dehorned heifers (where prevalence varied between 50 and 70%) (p less than 0.001) than other groups placed in pens without gouge-dehorned heifers (where prevalence varied between 10 and 30%), cumulative proportions of heifers remaining uninfected were computed for each type of group. The cumulative proportion of heifers remaining uninfected from weaning to first calving was 0.60 for the high prevalence group and 0.96 for the low prevalence group. No change in slope of cumulative proportions was observed before and after one month postweaning, suggesting that brucellosis vaccination was not an effective means of transmission.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

Primary jejunal osteosarcoma associated with a surgical sponge in a dog.

Primary jejunal osteosarcoma was diagnosed in association with a surgical sponge in a dog. The tumor was biologically aggressive, resulting in widespread metastasis throughout the abdomen within 2 months of surgical resection. Microscopic examination of the resected osteosarcoma revealed strands of gauze material throughout the tumor mass. It was theorized that the presence of a sponge foreign body may have resulted in malignant transformation of adjacent tissues similar to what has been reported to occur after internal fixation of some long-bone fractures.

Animals↗
PubMed1978

Hospital diseases.

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Hospitalization↗
PubMedDate not supplied

Etiology and management of aorto-femoral bypass graft failure.

Over a nine-year period 1973 to 1982, 364 aorto-bifemoral bypass grafts were inserted for aorto-iliac occlusive disease and 45 graft failures were encountered. Twelve patients developed acute graft occlusion, occurring less than 30 days postoperatively (Group I). These failures were almost all due to technical problems, the most common cause was elevation of an intimal flap following local endarterectomy. Five patients (Group II) developed recurrent symptoms without actual thrombosis or occlusion of the graft, but were associated with neointimal hyperplasia at the distal anastomosis and evidence of distal atherosclerosis. Twenty-eight patients were late failures (Group III). These patients thrombosed their grafts more than 30 days postoperatively. Four patients thrombosed both limbs of the graft at separate intervals. Nineteen patients were found to have progressive atherosclerosis affecting their run-off vessels. Six patients were found to have stenosis limited to the distal anastomosis. False aneurysm, kinking of the graft, and proximal suture line stenosis were felt to be determining factors in 3 other incidences of graft failure. The most common treatment in Group I was thrombectomy and securing of the raised intimal flap. The patients in Group II were treated with local endarterectomy and patch angioplasty. Of the patients in Group III, the most common inflow procedure was thrombectomy, carried out in 17 cases. In Group III, 13 of 28 patients underwent profundaplasty to improve outflow. The importance of pre and postoperative angiography in defining the etiology of graft failure is stressed. It is important to rule out problems with the proximal anastomosis. Once inflow has been established, angiography should ensure that an adequate outflow procedure has been performed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗