Portal biliopathy.

In patients with portal hypertension, particularly with extrahepatic portal vein obstruction, portal biliopathy producing biliary ductal and gallbladder wall abnormalities are common. Portal cavernoma formation, choledochal varices and ischemic injury of the bile duct have been implicated as causes of these morphological alterations. While a majority of the patients are asymptomatic, some present with a raised alkaline phosphatase level, abdominal pain, fever and cholangitis.

Safety of an ofloxacin-based antitubercular regimen for the treatment of tuberculosis in patients with underlying chronic liver disease: a preliminary report.

Background And Aims: Hepatotoxicity is a major side-effect of antitubercular drugs (ATD). As these drugs are metabolized in the liver, there is a theoretical risk of increased hepatotoxicity in patients with underlying chronic liver disease (CLD). Ofloxacin has antitubercular activity and has exclusive renal clearance.

Comparison of truncal hair distribution in alcoholic liver disease and alcohol-related chronic pancreatitis.

The present study shows that scanty hair distribution over the trunk is a specific finding in patients with alcoholic liver disease (ALD), and is not seen in alcoholic pancreatitis. This observation not only provides a useful clinical marker of individuals at increased risk of developing alcohol-related liver disease, but from the pathogenetic viewpoint, it suggests that at the tissue level, the male sex hormones protect the liver against ethanol-related damage.

Intrapericardial teratoma masquerading as pyopericardium.

A 10-year-old boy was admitted with cardiac tamponade. Initial pericardiocentasis yielded pus. A subxiphoid tube-pericardiostomy was done and thick, purulent material was drained out.

Coagulation profile and platelet function in patients with extrahepatic portal vein obstruction and non-cirrhotic portal fibrosis.

Background And Aims: Coagulation disorders commonly develop in patients with cirrhosis of the liver. They have also been reported in patients with non-cirrhotic portal fibrosis (NCPF) and extra-hepatic portal venous obstruction (EHPVO); the two conditions with portal hypertension and near-normal liver functions. The spectrum and prevalence of coagulation abnormalities and their association with the pathogenesis of these diseases and with hypersplenism was prospectively studied.

Evolution of strategies in the non-pharmacologic management of atrial fibrillation: a review.

Atrial fibrillation is the commonest amongst all sustained cardiac dysrhythmias. Besides in its idiopathic form seen in the elderly, it may co-exist with other cardiac disorders, especially rheumatic valvular heart disease. No pharmacotherapeutic combination has yet succeeded in comprehensively addressing the three detrimental sequelae of atrial fibrillation viz, the subjective discomfort of an irregular heartbeat, compromised cardiac haemodynamics caused by the loss of synchronous atrioventricular contraction, and the stasis of blood flow in the left atrium threatening thrombo-embolism.

Gastric outlet obstruction in carcinoma gall bladder.

Background: Gastric outlet obstruction is occasionally reported to occur in advanced gall bladder malignancy and may require palliative surgery. A review of 39 patients who required gastroenterostomy for symptomatic or incipient gastric outlet obstruction in carcinoma gall bladder is presented.

Methods: This retrospective review included 24 women and 15 men over nine years who underwent gastrojejunostomy for locally advanced neoplasms of the gall bladder.

Bile duct obstruction due to portal biliopathy in extrahepatic portal hypertension: surgical management.

Background: Varices can develop in and around the bile duct in the presence of portal hypertension, especially when it is caused by extrahepatic portal vein thrombosis. The term 'portal biliopathy' is used to describe changes in the bile duct due to these varices, which may cause bile duct obstruction. This paper reviews experience of the surgical management of patients with symptomatic portal biliopathy.

Segment III cholangiojejunostomy for carcinoma of the gallbladder.

Jaundice in patients of advanced carcinoma of the gallbladder requires palliation for the distressing symptoms of pruritus and cholangitis. Intrahepatic segment III duct cholangiojejunostomy is a means for alleviating the obstruction with malignant porta block. The authors reviewed their experience with this procedure in 48 patients of carcinoma of the gallbladder.

Surgical management of pancreatic necrosis presenting with locoregional complications.

Background: Local complications of pancreatic necrosis may occur after surgery, but when they occur spontaneously render surgical treatment more hazardous and impair prognosis.

Methods: A retrospective review was carried out of 83 patients who underwent surgery for pancreatic necrosis from 1988 to 1995, to determine the incidence, type, treatment and outcome of locoregional complications caused by pancreatic necrosis associated with acute pancreatitis.

Results: Seventeen patients (20 per cent) were identified to have intra-abdominal complications with pancreatic necrosis either before operation or at the time of surgery.

Reoperative surgery for choledochal cysts.

Background: Complications often follow if a choledochal cyst is treated simply by drainage, either internal or external. This study reviews 17 patients who had had previous cystoenterostomy (n = 9) or external drainage (n = 8) and who required reoperation and cyst excision.

Methods: The study was a retrospective review including ten women and seven men managed over 9 years.

Current trends in the diagnosis and management of cystic hydatid disease of the liver.

Cystic hydatid disease caused by Echinococcus granulosus most commonly involves the liver. Recent years have seen many changes in modalities of diagnosis and treatment of cystic disease in the liver. Currently used methods of immunodiagnosis, newer radiological modes of imaging, emerging non-surgical techniques of management and the impact of minimal access surgery in this disease are highlighted in the present review.

Internal pancreatic fistulae with serous effusions in chronic pancreatitis.

Background: Serous effusions in chronic pancreatitis are infrequent but persistent. These occur usually as a consequence of internal pancreatic fistulae and commonly involve the pleural cavity or peritoneum.

Methods: To assess strategies in operative management, the records of 12 patients who underwent surgery for internal pancreatic fistula with underlying chronic pancreatitis were reviewed retrospectively.

Percutaneous transluminal angioplasty in Takayasu arteritis.

Percutaneous transluminal balloon angioplasty (PTBA) was performed in 87 patients for 111 stenotic lesions due to Takayasu arteritis. Of the lesions attempted for dilatation, 35 were in the aorta, 64 in renal arteries, 9 in subclavian, and 3 in common iliac arteries. The stenosis of aorta could be successfully dilated in 33 of 35 (94.

Use of human colostrum in the management of chronic infantile diarrhoea due to enteropathogenic E. coli infection with associated intestinal parasite infestations and undernutrition.

This study reports the management of infants with chronic diarrhoea by colostrum feeding. Eight children with chronic diarrhoea, ranging from 9 months to 3 years of age and all from low socio-economic families, formed the basis of this study. They were undernourished and marasmic.

Raised stool and serum IgA levels in undernourished infants with chronic diarrhoea and associated parasitic infestations.

Sixty children with chronic diarrhoea, age ranging from 9 months to 3 years and 15 normal healthy children of same age group, all belonging to the low socio-economic families formed the basis of this study. Fifty-six out of these 60 children were undernourished and were marasmic. Stool examination showed enteropathogenic E.

Computer assisted analysis of wound infection in neurosurgery.

The effect of 10 variables on the development of postoperative infection in 536 clean elective neurosurgery patients was calculated using correlational, regression and discriminant analyses. The time of shaving the operation site, type of theatre ventilation and duration of operation were found to have a highly significant effect on the infection rate. The influence of season and age of patient was not evident on simple analysis, but both were found to be significant factors using regression analysis.