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Avoiding splenectomy in the treatment of children with splenic injury. 避免脾切除术治疗小儿脾损伤。
Acta chirurgica Scandinavica Pub Date : 1990-05-01
K Lännergren, P Tordai, T Linné, U Persson
{"title":"Avoiding splenectomy in the treatment of children with splenic injury.","authors":"K Lännergren,&nbsp;P Tordai,&nbsp;T Linné,&nbsp;U Persson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Ninety-two consecutive patients with traumatic rupture of the spleen were studied. Of the first 46 children (group A), 44 underwent splenectomy. In the subsequent group (group B) non-operative management was successful in 40 of 46 patients, five patients were operated with splenic repair, and one had the spleen removed. All the ruptures were caused by blunt trauma and the severity of the splenic injury was roughly the same in the two groups of patients. A third of the patients in each group had associated injuries, renal injury being the most common intraabdominal lesion. The median hospital stay was 8.0 days (range 5 to 28) in group A and 12.5 days (range 7 to 18) in group B. Among the 40 patients who were treated conservatively, a biphasic course was seen in 23: one or two days after the accident a period of increased pulse rate, fever and increased abdominal tenderness and pain followed, but no evidence for a delayed rupture was found. Our results of conservative treatment of splenic rupture are encouraging and show that non-operative management should be considered in most cases.</p>","PeriodicalId":7005,"journal":{"name":"Acta chirurgica Scandinavica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1990-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13498805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Clinical course and management of suprasphincteric and extrasphincteric fistula-in-ano. 贲门上瘘和贲门外瘘的临床过程与处理。
Acta chirurgica Scandinavica Pub Date : 1990-05-01
S B Fasth, S Nordgren, L Hultén
{"title":"Clinical course and management of suprasphincteric and extrasphincteric fistula-in-ano.","authors":"S B Fasth,&nbsp;S Nordgren,&nbsp;L Hultén","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Over an 8-year period five patients with suprasphincteric fistula and two with extraspincteric fistula a primary transsphincteric track were treated with fistulotomy, using delayed seton technique. In all but one case the fistulas had caused considerable morbidity, involving multiple episodes of abscess drainage and attempts to lay open the track before the correct diagnosis was established. No patient had recurrence of fistula and, despite complete division of the anorectal ring, and sphincter pressures were well maintained and anal continence was unchanged. The results suggest that the delayed seton technique is useful in the treatment of these very rare and complicated fistulas.</p>","PeriodicalId":7005,"journal":{"name":"Acta chirurgica Scandinavica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1990-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13497723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Rupture of a splenic artery aneurysm into the pancreatic duct. Case report. 脾动脉瘤破裂进入胰管。病例报告。
Acta chirurgica Scandinavica Pub Date : 1990-05-01
M Lie, K Ertresvåg, A Skjennald
{"title":"Rupture of a splenic artery aneurysm into the pancreatic duct. Case report.","authors":"M Lie,&nbsp;K Ertresvåg,&nbsp;A Skjennald","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 71-year-old woman was admitted to a local hospital with abdominal pain and repeated haematemeses and melaena. Plain X-ray of the abdomen showed a cystic mass with a calcified wall behind the stomach. No bleeding point in the stomach or duodenum was found at gastroscopy. Over a period of 28 days she had five episodes of gastrointestinal haemorrhage with no drop in blood pressure. She was transferred to the regional hospital 26 days after admission. Angiography showed a splenic artery aneurysm 5 x 10 cm, which at operation was found to have ruptured into the pancreatic duct. The aneurysm, the tail of the pancreas and the spleen were removed, and she made an uneventful recovery.</p>","PeriodicalId":7005,"journal":{"name":"Acta chirurgica Scandinavica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1990-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13497726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Choledochotomy for biliary lithiasis: is routine T-tube drainage necessary? A prospective controlled trial. 胆道切开术治疗胆结石:是否需要常规t管引流?前瞻性对照试验。
Acta chirurgica Scandinavica Pub Date : 1990-05-01
S M Sheen-Chen, F F Chou
{"title":"Choledochotomy for biliary lithiasis: is routine T-tube drainage necessary? A prospective controlled trial.","authors":"S M Sheen-Chen,&nbsp;F F Chou","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Thirty patients with stones in the common bile duct were allocated alternately to have choledocholithotomy carried out with either T-tube drainage or with primary closure. Choledochoscopy was done during every operation, and the patency of the common bile duct tested by perfusion. There were no operative deaths. The length of operation was shorter with primary closure (p less than 0.01) but there were no differences between the groups in operative blood loss, days in hospital after operation, postoperative morbidity and mortality, and final outcome at follow up. There was no change in the incidence of postoperative bacteraemia, the number of adverse reactions, and the incidence of bile peritonitis after removal of the T-tube. Patients who had T-tubes reported greater discomfort and inconvenience than those without, and their treatment cost more. We conclude that primary closure of the common bile duct is a reasonable alternative to T-tube drainage in selected cases.</p>","PeriodicalId":7005,"journal":{"name":"Acta chirurgica Scandinavica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1990-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13342892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Paget's disease of the nipple. A continuing enigma. 乳头佩吉特病一个持续的谜。
Acta chirurgica Scandinavica Pub Date : 1990-05-01
P J Osther, E Balslev, M Blichert-Toft
{"title":"Paget's disease of the nipple. A continuing enigma.","authors":"P J Osther,&nbsp;E Balslev,&nbsp;M Blichert-Toft","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Paget's disease of the nipple, although recognized since 1874, remains in several respects enigmatic. The two main theories of its origin are 1) epidermotropic, i.e. ductal cancer cells migrating to the epidermis of the nipple, and 2) in situ appearance of malignant keratinocytes expressing the multicentricity of breast cancer. The literature is reviewed. Clinical, histologic (including classification), histochemical and electron microscopy observations and diagnostic considerations are discussed. Diagnosis is often delayed, with adverse consequences for treatment. The nipple lesions may be accompanied by ductal carcinoma of local or more extensive in situ type, or invasive tumour. Lymph-node metastasis seems to be the most important prognostic factor. The merits of radical vs. modified radical mastectomy and local excision, with or without adjuvant radiotherapy, are considered. Major studies of breast-conserving management of Paget's disease of the nipple are in progress.</p>","PeriodicalId":7005,"journal":{"name":"Acta chirurgica Scandinavica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1990-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13315043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Zollinger-Ellison syndrome due to gastrin-secreting ovarian cystadenocarcinoma. Case report. 胃泌素性卵巢囊腺癌引起的左林格-埃里森综合征。病例报告。
Acta chirurgica Scandinavica Pub Date : 1990-05-01
D Boixeda, A Lopez-San Roman, J M Pascasio, J C Erdozain, F Perez-Hernandez, M Garcia-Villanueva, F Hernandez-Ranz
{"title":"Zollinger-Ellison syndrome due to gastrin-secreting ovarian cystadenocarcinoma. Case report.","authors":"D Boixeda,&nbsp;A Lopez-San Roman,&nbsp;J M Pascasio,&nbsp;J C Erdozain,&nbsp;F Perez-Hernandez,&nbsp;M Garcia-Villanueva,&nbsp;F Hernandez-Ranz","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Zollinger-Ellison syndrome in a 76-year-old woman is reported. The source of the hypergastrinemia proved to be an ovarian cystadenocarcinoma. Resection was performed and the diagnosis was confirmed histologically, immunohistochemically and by determination of gastrin in tumor tissue and in serum. The long-term result was good.</p>","PeriodicalId":7005,"journal":{"name":"Acta chirurgica Scandinavica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1990-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13497725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Atherosclerotic occlusive disease after radiation for pelvic malignancies. 盆腔恶性肿瘤放疗后动脉粥样硬化闭塞性疾病。
Acta chirurgica Scandinavica Pub Date : 1990-05-01
F Pettersson, J Swedenborg
{"title":"Atherosclerotic occlusive disease after radiation for pelvic malignancies.","authors":"F Pettersson,&nbsp;J Swedenborg","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>We have studied 15 women who were previously treated by irradiation for pelvic malignancies and who all developed symptoms of arterial occlusive disease of the iliac arteries and the distal aorta. Risk factors were evaluated in a case control study in which each patient was compared with three individually matched controls who were treated during the same period for the same type of cancer and who did not develop arterial occlusions. We conclude that smoking habits as well as treatment by irradiation are strong predictors of the development of atherosclerotic occlusive disease. Side effects of irradiation occur in the arteries more often in patients who have also radiation reactions in other organs--for example, the bowel and bladder. Irradiation acts in combination with other atherogenic factors and this should be kept in mind when radiation treatment is planned for patients with a high risk of developing atherosclerosis.</p>","PeriodicalId":7005,"journal":{"name":"Acta chirurgica Scandinavica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1990-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13498806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Repeated bowel resections for eosinophilic gastroenteritis with obstruction and perforation. Case report. 嗜酸性胃肠炎伴梗阻穿孔反复肠切除术。病例报告。
Acta chirurgica Scandinavica Pub Date : 1990-04-01
C S Wang, S Hsueh, L Y Shih, M F Chen
{"title":"Repeated bowel resections for eosinophilic gastroenteritis with obstruction and perforation. Case report.","authors":"C S Wang,&nbsp;S Hsueh,&nbsp;L Y Shih,&nbsp;M F Chen","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>A 60-year-old man underwent two operations in 10 months for eosinophilic gastroenteritis. Segmental resection of the jejunum was initially carried out for the obstructing lesion. A second jejunal resection was required for perforation 10 months later in spite of treatment with steroids.</p>","PeriodicalId":7005,"journal":{"name":"Acta chirurgica Scandinavica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1990-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13498803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Progress symposium: Pancreatic pain--causes, diagnosis, and treatment. 进展专题讨论会:胰腺疼痛——原因、诊断和治疗。
Acta chirurgica Scandinavica Pub Date : 1990-04-01
{"title":"Progress symposium: Pancreatic pain--causes, diagnosis, and treatment.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":7005,"journal":{"name":"Acta chirurgica Scandinavica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1990-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13498161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Relationship between pancreatic function and pain in chronic pancreatitis. 慢性胰腺炎胰腺功能与疼痛的关系。
Acta chirurgica Scandinavica Pub Date : 1990-04-01
P Malfertheiner, O Pieramico, M Büchler, H Ditschuneit
{"title":"Relationship between pancreatic function and pain in chronic pancreatitis.","authors":"P Malfertheiner,&nbsp;O Pieramico,&nbsp;M Büchler,&nbsp;H Ditschuneit","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The association between pain and exocrine pancreatic function was re-evaluated in 56 patients with chronic pancreatitis to see if residual function of the gland may evoke outflow obstruction resulting in pain. No significant differences were found in the degrees of pancreatic dysfunction among three groups with different degrees of pain (no pain, n = 7; moderate pain, n = 21; and severe pain, n = 28), but patients with more impairment of exocrine pancretic function tended to have less pain. In patients with no pain the mean (SD) peak serum concentration of fluorescein was 2.0 (0.2) micrograms/l, in those with moderate pain it was 2.6 (0.1), and in those with severe pain it was 3.4 (0.1). No significant differences were found between the degree of pain and the duration of the disease, which was 5.5 (0.3) years in the group with no pain, 3.5 (0.2) in patients with moderate pain, and 3.8 (0.1) in those with severe pain. We conclude that outflow obstruction may affect some patients, but is not the only cause of pain. Patients with severe pancreatic dysfunction and steatorrhoea often present with pain, so either obstruction of the residual secretions, or inflammatory activity impinging on nerve endings in fibrotic tissue, may also cause pain. The causes vary, and there is often more than one, so optimal management implies thorough investigation of each patient and long term follow up.</p>","PeriodicalId":7005,"journal":{"name":"Acta chirurgica Scandinavica","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"1990-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"13498795","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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