Helicobacter pylori Before and After Gastric Reduction for Morbid Obesity.

Nine patients with morbid obesity were evaluated for the presence of Helicobacter pylon (Hp) before gastric reduction, and all were negative. Fifteen patients, Including those nine, were evaluated for the presence of Hp in antral and 'channel' region biopsies by culture and urease test after gastric reduction. Hp-negative patients totaled 73.

Carotid endarterectomy under local anesthesia supplemented with neuroleptic analgesia.

Surgical treatment of the carotid artery is being performed increasingly under local rather than general anesthesia. The advantage of local anesthesia is that neurologic function can be continuously assessed while the carotid arteries are cross-clamped, and unnecessary shunting can, thus, be avoided, with resulting sedation, analgesia, alpha blockade and blood pressure stability. The main objection to the use of local anesthesia is the anxiety of the patient.

Transcatheter occlusion of inferior mesenteric arteriovenous fistula: a case report.

Transcatheter embolization of the inferior mesenteric artery with steel coils was performed for the control of massive lower gastrointestinal bleeding and sepsis. The bleeding and sepsis was caused by a very large arteriovenous fistula of the inferior mesenteric vessels. This iatrogenic lesion developed and became symptomatic just 5 weeks after an anterior resection of the rectum was performed.

Vertical banded gastroplasty for the treatment of morbid obesity.

We report the technique and results of vertical banded gastroplasty in 86 morbidly obese patients. At 12 months, the patients had lost a mean of 57% of their excess body weight; 36 months, they had lost 70%. The most severe early complication was perforation of the esophagus.

Selective operative cholangiography.

This is a study of 505 patients who underwent surgical treatment of the gallbladder. Of this group, 343 were operated upon without operative cholangiography with an incidence of retained stones of 0.03 per cent.

The everted rectal stump technique for the application of the distal pursestring suture in the construction of stapled anastomoses.

The everted rectal stump technique for the application of the distal pursestring suture was used successfully in three patients to perform a low stapled reconstructive anastomosis in the treatment of carcinoma of the rectum. Two of the patients were Dukes' Stage B and one patient was classified as Dukes' Stage C. The postoperative course was uneventful.

Pseudoaneurysm of the dorsalis pedis artery.

Two cases of post-traumatic pseudoaneurysm of the dorsalis pedis artery are presented. Both were managed by resection and vascular reconstruction with a successful result. It is suggested that this, rather than resection and ligation, is the preferred treatment in these cases.

Coumadin-induced skin necrosis.

Two women developed coumadin-induced skin necrosis. A 16-year-old woman sustained necrosis on the leg after a single dose of the drug, and a 59-year-old woman developed gangrene of most of her left breast.

Surgical treatment of primary hyperhidrosis. A report of 42 cases.

Forty-two patients suffering from primary hyperhidrosis underwent upper dorsal sympathectomy using the supraclavicular approach. The postoperative course and results were devoid of complications. All the patients except one were satisfied with the results of surgery, which greatly improved the quality of their lives.

Carbon dioxide laser in the treatment of high anal fistula.

Three high anal fistulas were treated with a carbon dioxide laser beam. The laser vaporizes the tissue and, because of the accurate focus of the apparatus, causes no damage around the path of the beam. This method was used to core out the fistula tract, and resulted in good healing.

Cloacogenic carcinoma of the anus.

A case is presented of transitional-cell cloacogenic carcinoma -- a rare variant of anal canal malignancy that occurred in a 58-year-old woman. The characteristics of this tumor are discussed, and her prognosis after abdominoperineal resection and posterior colpectomy seems good.

Angiodysplasia as a cause of colonic bleeding in the elderly.

Angiodysplasia is being recognized as a major causal factor of colonic haemorrhage in the elderly. Superior mesenteric arteriography in an 86-year-old lady with recurrent haemorrhage revealed the lesion. Confirmation of the diagnosis was made possible by the injection of contrast material into the blood vessels of the removed intestine and subsequent histological examination.