Limited operation for bleeding or perforated gastric ulcer in high risk patients.

Twenty-four high risk patients underwent limited operation for bleeding (15) or perforated (9) gastric ulcers. Limited operation is defined as local ulcer management (oversewing or excision of bleeding ulcer and suture closure of perforated ulcer) with (8) or without (16) complementary vagotomy and pyloroplasty. Sixteen patients had serious coexistent disease and eight were physiologically unstable because of continued bleeding or peritonitis.

Colonic diverticular disease in patients 40 years old or younger.

Diverticular disease in patients 40 years of age or younger has been described as rare but virulent. Previous studies, based on age, on diverticular disease are often confusing because of inexact definitions of the disease status. With these criticisms in mind, the authors studied 322 clinical records on patients admitted with a diagnosis of colonic diverticulosis or diverticulitis to the University of New Mexico Hospital and the Lovelace Medical Center.

Morbidity and mortality of ostomy closure.

Ostomy closure following the Hartmann procedure is perceived to be associated with higher morbidity and mortality rates than is ostomy closure following divided colostomy, loop colostomy, and divided ileostomy-colostomy so that ostomy closure after Hartmann procedure may be denied to certain patients. To test that perception, the charts of 59 patients undergoing a Hartmann procedure and 43 patients having ostomy closure after divided colostomy, loop colostomy, or divided ileostomy-colostomy were reviewed. Ostomy closure after Hartmann procedure was accomplished in 46 patients.

Revision and closure of the colostomy.

Reoperative stomal surgery includes the correction of complications and closure of a colostomy. Necrosis, retraction, and stenosis are the most frequently occurring complications and are simply corrected by straightforward techniques. Prolapse of the colostomy and parastomal hernia occur less frequently.