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1.
Article de Anglais | IMSEAR | ID: sea-64274

RÉSUMÉ

We report a 5-year-old boy with enterogenous tubular duplication cyst presenting as obstructed inguino-scrotal hernia.


Sujet(s)
Enfant d'âge préscolaire , Kystes/complications , Diagnostic différentiel , Hernie inguinale/diagnostic , Humains , Maladies de l'iléon/complications , Occlusion intestinale/complications , Mâle
2.
J Postgrad Med ; 1997 Jul-Sep; 43(3): 71-2
Article de Anglais | IMSEAR | ID: sea-116099

RÉSUMÉ

Increased participation in sports by the general public leads to increase in sports induced injuries including stress fractures, shin splints, arthritis and host of musculotendenous maladies. We have studied twenty patients referred from sports clinic for bone scanning to evaluate clinically difficult problems. It showed stress fracture in twelve patients, bilateral shin splint in five patients and normal bone scan in three patients. Present study highlights the utility of bone imaging for the diagnosis of various sports injuries in sports medicine.


Sujet(s)
Adulte , Traumatismes sportifs/imagerie diagnostique , Diagnostic différentiel , Fractures de fatigue/imagerie diagnostique , Humains , Tibia
3.
J Postgrad Med ; 1996 Jul-Sep; 42(3): 78-80
Article de Anglais | IMSEAR | ID: sea-115942

RÉSUMÉ

A lumbar hernia which had developed following blunt abdominopelvic trauma is described here. The successful surgical correction is reported.


Sujet(s)
Traumatismes de l'abdomen/complications , Femelle , Fractures osseuses/complications , Hernie/diagnostic , Humains , Région lombosacrale , Adulte d'âge moyen , Os coxal/traumatismes , Plaies non pénétrantes/complications
4.
J Postgrad Med ; 1996 Apr-Jun; 42(2): 50
Article de Anglais | IMSEAR | ID: sea-116882

RÉSUMÉ

The diagnosis and management of a thirty year old male with a hemangiopericytoma of the kidney is reported.


Sujet(s)
Adulte , Hémangiopéricytome/complications , Hématurie/étiologie , Humains , Tumeurs du rein/complications , Mâle
5.
Article de Anglais | IMSEAR | ID: sea-65524

RÉSUMÉ

BACKGROUND: The diagnosis of intraperitoneal abscesses is difficult, resulting in delay in treatment and poor prognosis. Although recent advances in the management have led to significant improvement in prognosis, the choice of therapeutic modality is unclear. AIMS: The role of clinical features and investigations in the diagnosis of intraperitoneal abscesses was studied. The relation of prognosis to delay in diagnosis was also analyzed. Also assessed was the efficacy of various therapeutic modalities. METHODS: Thirty consecutive patients diagnosed to have intraperitoneal abscesses were analyzed. Abscesses were analyzed. Abscesses were divided on the basis of ultrasonography findings into simple and complex (with or without fecal fistula). The following points were evaluated: clinical features, and hematological, biochemical and microbiological reports, imaging findings and the role of therapeutic modalities like percutaneous aspiration (single or multiple), catheter drainage and operative drainage (transperitoneal, extraperitoneal and percutaneous). RESULTS: Clinical features and hematological investigations, though sensitive, were non-specific in diagnosis. Klebsiella was the commonest organism cultured, followed by Proteus, E coli and Pseudomonas. Blood culture was positive in only 6 percent of cases. Real-time ultrasonography had an accuracy of 84%. Contrast X-rays were required in 43% of cases. All the deaths (4 of 30) occurred when the diagnosis and treatment were delayed by more than 4 days. USG-guided aspiration (single and multiple) and USG-guided catheter drainage were effective in simple abscesses but failed in complex abscesses. Transperitoneal operative drainage was successful in 15 of 18 cases (6 of 8 simple abscesses and 9 of 10 complex abscesses). The mortality in patients with simple and complex abscesses was 2 of 17 and 2 of 13 respectively. CONCLUSIONS: Early detection with consequent early treatment is vital for good prognosis of intraperitoneal abscesses. Early diagnosis requires a high degree of clinical suspicion and appropriate use of imaging modalities. USG-guided percutaneous drainage is effective for simple abscesses whereas complex abscesses require operative drainage, sometimes in combination with initial USG-guided drainage.


Sujet(s)
Abcès/classification , Adolescent , Adulte , Sujet âgé , Drainage/instrumentation , Femelle , Humains , Fistule intestinale/complications , Mâle , Adulte d'âge moyen , Maladies du péritoine/classification , Résultat thérapeutique , Échographie interventionnelle
6.
J Postgrad Med ; 1995 Jan-Mar; 41(1): 19-20
Article de Anglais | IMSEAR | ID: sea-115625

RÉSUMÉ

A carcinoma arising within a fibroadenoma is an unusual occurrence, with only a little over 100 reported cases. The purpose of this report is to increase the awareness of this entity and to discourage the practice of rendering a diagnosis on gross examination of the tumor. We are reporting a case with two distinct primary tumors within the same breast, one of which was arising within the fibroadenoma. Only two such cases have been previously reported.


Sujet(s)
Tumeurs du sein/anatomopathologie , Épithélioma in situ/anatomopathologie , Carcinome canalaire du sein/anatomopathologie , Carcinome lobulaire/anatomopathologie , Femelle , Fibroadénome/anatomopathologie , Humains , Mastectomie radicale modifiée , Adulte d'âge moyen , Tumeurs primitives multiples/anatomopathologie
7.
J Postgrad Med ; 1994 Oct-Dec; 40(4): 220-2
Article de Anglais | IMSEAR | ID: sea-116530

RÉSUMÉ

Six male patients (age group: 30-60 years) with aneurysm of the splenic artery presented with massive upper gastrointestinal tract hemorrhage. Five patients presented with hematemesis and one with melena. Chronic pancreatitis was noted in all the patients, four of whom were chronic alcoholics. Endoscopy was not useful in diagnosis. Bleeding through the Ampulla of Vater was seen in the patient with melena. Angiography was diagnostic in all. Pancreatic resection including the aneurysm(2), and bipolar ligation with underrunning of the aneurysm (3) were the operative procedures. Distal pancreatectomy with pancreatogastrostomy was carried out in the patient with hemosuccus pancreaticus. If endoscopy is inconclusive, angiography and early intervention is recommended to reduce the high mortality associated with conservative management.


Sujet(s)
Adulte , Anévrysme/complications , Hémorragie gastro-intestinale/étiologie , Humains , Mâle , Adulte d'âge moyen , Rupture spontanée , Artère splénique
8.
J Postgrad Med ; 1993 Apr-Jun; 39(2): 93-4
Article de Anglais | IMSEAR | ID: sea-116544

RÉSUMÉ

Acute pancreatitis in pregnancy and post-partum period, rarely encountered in surgical practice, can have a lethal effect on the mother and the foetus. We report here a case of a 35 year old tertigravida who presented with high grade fever, abdominal pain with distension, tachycardia and tachypnoea. Chest examination and X-rays were suggestive of pneumonia. The abdomen was tense and tender. Peristalsis was absent. Ultrasound revealed presence of fluid in the abdominal cavity which on paracentesis was found to contain Gram positive cocci. Fluid amylase levels were high. On exploratory laparotomy, haemorrhagic oedematous pancreatitis was noticed. The patient expired on the 2nd post operative day.


Sujet(s)
Maladie aigüe , Adulte , Femelle , Infections bactériennes à Gram positif , Cocci à Gram positif , Humains , Pancréatite/diagnostic , Infection puerpérale
9.
J Postgrad Med ; 1993 Jan-Mar; 39(1): 42-3
Article de Anglais | IMSEAR | ID: sea-116503

RÉSUMÉ

A rare case of gastric lipoma presented to us with hematemesis and symptoms of obstruction. On oesophagoduodenoscopy, a mass projecting in the lumen of stomach was found. Barium meal examination revealed a mass in the antral region suggestive of malignancy. The diagnosis of lipoma was suspected only after exploration. It was confirmed following incision through the serosa. The lipoma was enucleated without any damage to mucosa.


Sujet(s)
Sujet âgé , Sténose du défilé gastrique/étiologie , Hématémèse/étiologie , Humains , Lipome/complications , Mâle , Tumeurs de l'estomac/complications
10.
J Postgrad Med ; 1992 Oct-Dec; 38(4): 202-4, 198
Article de Anglais | IMSEAR | ID: sea-115662

RÉSUMÉ

A case of insulinoma who had episoic bizarre behaviour is presented here. Pre-operative fasting and two hour post-prandial blood sugar values indicated hypoglycemia with inappropriately high insulin levels. USG and CT scan of the abdomen revealed a tumor of head of the pancreas. The tumour was enucleated surgically. Histopathological examination confirmed the origin as islet cells. The post-operative blood sugar and insulin levels were found to be in normal range. Since insulinoma is a rare pancreatic tumor, differential diagnoses along with a brief review of the literature is also presented.


Sujet(s)
Adulte , Glycémie/analyse , Jeûne , Femelle , Hyperglycémie provoquée , Humains , Insuline/sang , Insulinome/sang , Tumeurs du pancréas/sang , Tomodensitométrie
11.
J Postgrad Med ; 1992 Oct-Dec; 38(4): 210-1, 207
Article de Anglais | IMSEAR | ID: sea-117552

RÉSUMÉ

Extrapancreatic gastrinoma is a rare clinical entity encountered in surgical practice. A patient was referred to us who had a history of recurring symptoms of peptic ulcer disease and ulcer perforation located at an unusual site. Serum gastrin levels were abnormally high. Scopy revealed multiple ulcers in the antrum and duodenum. A mass superior to the head of the pancreas was detected on USG, which later on found to be a separate mass on CT scan. The tumour was excised and confirmed on histopathology. Results of conservative surgery were found to be satisfactory.


Sujet(s)
Adolescent , Endoscopie gastrointestinale , Gastrinome/sang , Gastrines/sang , Humains , Mâle , Tumeurs du pancréas/sang , Tomodensitométrie , Vagotomie tronculaire
12.
J Postgrad Med ; 1992 Jan-Mar; 38(1): 36-7
Article de Anglais | IMSEAR | ID: sea-115816

RÉSUMÉ

Fibromatosis of thyroid gland is a rare condition encountered in surgical practice. Clinically presenting as goitre, it is treated with near total thyroidectomy with good results. We had one such case under our care at the K.E.M. Hospital, Bombay. Rarity of this condition prompted us to publish the data, the literature is briefly reviewed.


Sujet(s)
Fibrome/anatomopathologie , Goitre nodulaire/anatomopathologie , Humains , Mâle , Adulte d'âge moyen , Glande thyroide/anatomopathologie , Tumeurs de la thyroïde/anatomopathologie , Thyroïdectomie
13.
Article de Anglais | IMSEAR | ID: sea-64808

RÉSUMÉ

We report four cases in whom post-traumatic or post-surgical biliary leak was detected using dynamic 99mtechnetium-iminodiacetic acid (IDA) cholescintigraphy. This technique is a non-invasive, safe, simple and sensitive method of documenting the presence, location and extent of biliary leaks. Further, it can be repeated and hence, is useful in evaluating the response to treatment. Surgery is indicated when a moderate extravasation of labeled bile suggests that the leak is the chief pathway of bile drainage, with relatively little bile entering the intestine.


Sujet(s)
Adulte , Conduits biliaires/traumatismes , Cholécystectomie/effets indésirables , Humains , Imino-acides/diagnostic , Complications peropératoires , Mâle , Adulte d'âge moyen , Composés organiques du technétium/diagnostic
15.
J Postgrad Med ; 1991 Jan; 37(1): 1-4
Article de Anglais | IMSEAR | ID: sea-117659

RÉSUMÉ

In a prospective controlled trial, 0.25% formalin spray was compared with 2% silver sulfadiazine cream as the local treatment of burns. Formation and separation of eschar, infection and death rates were recorded. In the group receiving formalin, rates of formation and separation of eschar were significantly more (P less than 0.001 and P less than 0.05 resp.) compared to other group. Infection rate and fatality due to infection were also reduced. Other advantages of formalin are ease of application and the low east.


Sujet(s)
Administration par voie topique , Adolescent , Adulte , Aérosols , Asepsie/méthodes , Infections bactériennes/prévention et contrôle , Brûlures/complications , Association thérapeutique , Formaldéhyde/administration et posologie , Humains , Études prospectives , Sulfadiazine d'argent/administration et posologie
16.
J Postgrad Med ; 1990 Oct; 36(4): 181-4
Article de Anglais | IMSEAR | ID: sea-116145

RÉSUMÉ

Pneumatic dilatation is one of the more recent methods in the management of achalasia cardia. Fifty dilatations were done in 42 patients with achalasia cardia over 5 years. There was a significant decrease in the maximum diameter of the oesophagus and a significant increase in diameter in the narrowed lower oesophageal segment in all the patients. Of the patients studied, 95.23% were relieved of their symptoms after only one to two sessions. There were no immediate complications. Out of the 38 patients on long term follow up, 8 (21.05%) had recurrence of symptoms. On repeat dilatations, 4 (50%) of them had good response. Late complication like reflux oesophagitis was observed in only 1 patient over a median follow up period of 22 months. It was thus concluded that pneumatic dilatation is a safe, simple and effective procedure in managing patients with achalasia cardia.


Sujet(s)
Adulte , /instrumentation , Achalasie oesophagienne/diagnostic , Femelle , Études de suivi , Humains , Mâle , Adulte d'âge moyen , Récidive
17.
Article de Anglais | IMSEAR | ID: sea-64117

RÉSUMÉ

A 35 year old man presented with massive lower gastrointestinal hemorrhage due to typhoid enteritis. After confirming the site of bleeding on a selective superior mesenteric angiogram, a vasopressin infusion was given at the rate of 0.2-0.4 units/min initially, followed by tapering doses over 36 hours. Cessation of bleeding was achieved immediately. The patients did not have any complications due to the procedure. Continuous vasopressin infusion is an effective method for the treatment of uncontrolled bleeding from typhoid enteritis.


Sujet(s)
Adulte , Hémorragie gastro-intestinale/traitement médicamenteux , Humains , Perfusions artérielles , Mâle , Fièvre typhoïde/complications , Vasopressines/administration et posologie
18.
Article de Anglais | IMSEAR | ID: sea-64956

RÉSUMÉ

This study was undertaken to ascertain whether clinical and endoscopic factors can predict the outcome in patients with acute upper gastrointestinal hemorrhage. A total of 185 patients admitted with hematemesis over a 4-year period were studied. Clinical evidence of shock and hepatocellular dysfunction and hemoglobin level were noted on admission. Endoscopy was performed within 48 hours of admission to look for the site and number of lesions, and stigmata of hemorrhage. On analysis, age, clinical evidence of shock, hepatic dysfunction and hemoglobin less than 8.0 g/dl (80 g/L) were found to be significant in prediction of risk of further hemorrhage. Similarly age, past history of jaundice, previous bleeding episodes and clinical evidence of hepatic dysfunction were statistically significant predictors of mortality. Bleeding from varices and peptic ulcer was associated with a worse prognosis than acute mucosal lesions. It is concluded that clinical and endoscopic factors can be used to identify a group of patients at high risk of further hemorrhage and mortality.


Sujet(s)
Adolescent , Adulte , Sujet âgé , Enfant , Endoscopie , Hémorragie gastro-intestinale/diagnostic , Humains , Adulte d'âge moyen , Pronostic , Facteurs de risque
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