ABSTRACT
Ultrasonography has been popular for the diagnosis of gallbladder diseases since the mid-1970s. Although this technique has replaced oral cholecystography (OCG) for the diagnosis of cholecystolithiasis, it has not gained popularity in the diagnosis of adenomyomatosis of the gallbladder (AMMG). We examined 141 patients with clinically suspected gallbladder disease. Ultrasonography (previously done by a radiologist) had produced no positive findings. On ultrasonographic re-evaluation by the same radiologist, but in the presence of a surgeon from our study group, 64 cases of AMMG were detected. OCG revealed the diagnosis of AMMG in 13 other cases. In the study group there were no false-positive results. However, the false-negative rate of sonography in diagnosing AMMG was 16.9%. Thus, in our opinion ultrasonography is a worthwhile technique in diagnosing AMMG done by a surgeon.
Subject(s)
Gallbladder Diseases/diagnosis , Ultrasonography , Adult , Aged , Female , Gallbladder/pathology , Humans , Hyperplasia , Male , Middle AgedABSTRACT
Treatment was applied to 279 cases of gastric carcinoma at the authors' hospital, within a period of six years. Fourteen of these patients (five per cent) had received surgical treatment for peptic ulcer, between seven and 44 years back (23.6 years on average). Bilateral truncular vagotomy and pyloroplasty had been applied as primary operation to 6.9 per cent. The remaining 93.1 per cent had undergone either exclusive gastrojejunostomy or, in addition, partial gastrectomy. Partial or residual resection of the stomach could be performed on six patients only.
Subject(s)
Adenocarcinoma/surgery , Gastroenterostomy , Postoperative Complications/surgery , Stomach Neoplasms/surgery , Adult , Aged , Esophagus/surgery , Female , Follow-Up Studies , Gastrectomy , Humans , Jejunum/surgery , Male , Middle AgedABSTRACT
VARY operations were performed at the authors' hospital on 25 patients for duodenal ulcer and on two patients for gastric ulcer, between May 1984 and January 1987. A postoperative complication was recorded from one patient only, that is bleeding of the anastomosis on the first postoperative day. All patients underwent follow-up X-ray, one month after surgery. Stomach voiding was found to be delayed in 55.6 per cent of all cases. Normally functioning anastomosis and intact gastric mucosa were gastroscopically recorded from all patients. Bile reflux did not occur at all. Slight diarrhoea was found in 18.5 per cent of the patients, while 14.8 per cent reported minimal epigastric dullness. Hence, all 27 patients were rated Visick I.
Subject(s)
Duodenal Ulcer/surgery , Stomach Ulcer/surgery , Adult , Anastomosis, Roux-en-Y , Female , Humans , Jejunum/surgery , Male , Middle Aged , Peptic Ulcer Hemorrhage/surgery , Postoperative Complications/etiology , Pyloric Antrum/surgery , Vagotomy, TruncalABSTRACT
Traffic accidents are increasingly responsible for mortality in childhood in Turkey. Between 1982 and 1984, 197 children were admitted for contused abdominal injuries to the surgical casualty ward at the School of Medicine of Istanbul University. Most of these children had been involved in traffic accidents, and peritoneal lavage was applied to all of them. The diagnosis on admission was confirmed by laparotomy in 90 per cent of all cases. 20 children died (10.1 per cent). Uncontrollable abdominal bleeding was the cause of ten deaths and massive brain lesion of another six.
Subject(s)
Abdominal Injuries/surgery , Wounds, Nonpenetrating/surgery , Abdominal Injuries/diagnosis , Adolescent , Child , Child, Preschool , Diagnosis, Differential , Female , Humans , Infant , Male , Therapeutic Irrigation , Wounds, Nonpenetrating/diagnosisABSTRACT
Operations were performed on 327 patients for blunt abdominal trauma at the casualty ward of the Istanbul University Hospital, over the past three years. Isolated injuries to small intestines were recorded by laparotomy from 22 of these cases. Peritoneal lavage was applied to 18 patients. Only one patient was operated on with 24-hour delay because of false negative result of lavage. Six of the above 22 patients died (27.2 per cent) despite early surgical action. Five of these six had been admitted to the casualty ward with hypovolaemic shock as well as head and extremity injuries after a traffic accident.
Subject(s)
Abdominal Injuries/surgery , Intestine, Small/injuries , Wounds, Nonpenetrating/surgery , Abdominal Injuries/diagnosis , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Wounds, Nonpenetrating/diagnosisSubject(s)
Common Bile Duct/surgery , Gallstones/surgery , Adult , Aged , Cholecystectomy , Drainage , Female , Humans , Male , Middle Aged , Suture TechniquesABSTRACT
Infra-umbilical abdominal section concomitant with peritoneal lavage was applied to 74 patients with pelvic fracture and has proved to be helpful in early diagnosis of intra-abdominal organ injuries. However, the percentage of falsely positive results was found to be as high as 17.3 per cent, in the context of pelvic fractures. This has been attributable to the fact that the pelvic floor is likely to be elevated by the haematoma caused by a pelvic fracture, and the syringe may thus get accidentally into the haematoma.
Subject(s)
Fractures, Bone/surgery , Pelvic Bones/injuries , Humans , Postoperative Complications/mortality , Prognosis , Therapeutic IrrigationABSTRACT
A selective approach is taken, as a matter of principle, to cases of abdominal injuries at the Traumatological Department of the Faculty of Medicine at Instanbul University. Surgical treatment was applied to 378 in 2,968 hospitalised patients for contused or penetrating abdominal injuries, in 1983 and 1984. The rate of negative laparotomy was as low as 7.3 per cent owing to routine peritoneal flushing. However, laparotomy has been preferred and resulted in a negative laparotomy rate of 21 per cent, since problems are quite often faced in the diagnosis of stab injuries.
Subject(s)
Abdominal Injuries/surgery , Wounds, Gunshot/surgery , Wounds, Stab/surgery , Abdomen, Acute/surgery , Adolescent , Adult , Aged , Child , Child, Preschool , Hemorrhage/surgery , Humans , Middle Aged , Wounds, Nonpenetrating/surgerySubject(s)
Spleen/injuries , Adolescent , Adult , Aged , Child , Child, Preschool , Humans , Infant , Middle Aged , Retrospective Studies , Rupture, Spontaneous , Spleen/surgery , Splenic Rupture/etiology , Splenic Rupture/mortality , Turkey , Wounds, Nonpenetrating/etiology , Wounds, Penetrating/etiologySubject(s)
Spleen/injuries , Wounds and Injuries/classification , Accidents , Accidents, Traffic , Child , Female , Humans , Male , Middle Aged , Prognosis , Wounds and Injuries/therapyABSTRACT
In 59 splenic injuries, with 2 of them being caused by penetrating abdominal trauma, and 57 caused by blunt abdominal trauma the feasibility of splenorrhaphy instead of splenectomy was evaluated. In 22 cases out of a total of 59 splenic tissue preventing intervention like splenorrhaphy and partial splenectomy could be practiced.
Subject(s)
Spleen/injuries , Wounds, Nonpenetrating/surgery , Wounds, Penetrating/surgery , Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Male , Middle Aged , Splenectomy/methods , Splenic Rupture/surgery , Surgical Wound Infection/etiologyABSTRACT
In our country the number of abdominal traumata is steadily increasing. Mostly they are caused by traffic accidents in the overcrowded cities. In this retrospective study we analyse all our cases of the last 4 years, which were admitted to our clinic. Only in rare cases diagnosis could be made immediately on the basis of clinical symptoms. The decision to operate or not could only be taken after diagnostic irrigation of the abdominal cavity. In this way early diagnosis could also be made in doubtful cases and the patients operated in time.