Gut
-
Serum bile acid classes have been studied in 15 patients with primary biliary cirrhosis in five patients with cholestasis, and in five patients who had cirrhosis without cholestatic features. Conjugated monohydroxy bile acids (12-35% serum total bile acids) were found in eight of 11 sera from patients with primary biliary cirrhosis, in sera from four patients with cholestasis but not in any of the five patients with cirrhosis. ⋯ Decreases in serum total bile acid concentrations were observed which were accompanied by small increases in the trihydroxy/dihydroxy ratio and also in the G/T ratio in six of the seven patients. No association was found between the concentration of any particular conjugated or free bile acid and the presence or absence of pruritus.
-
Randomized Controlled Trial Comparative Study Clinical Trial Controlled Clinical Trial
A comparative study of conventional premedication (pethidine, promethazine, and atropine) and neuroleptanalgesia (droperidol and phenoperidine) for peroral endoscopy.
A double blind comparison of conventional premedication (pethidine, promethazine, and atropine) and neuroleptanalgesia (droperidol and phenoperidine) failed to demonstrate any difference in either the comfort of the patient or ease of instrumentation in 70 upper gastrointestinal tract endoscopies. Further trials are needed before conventional premedication is abandoned.
-
The results of medical treatment in 113 patients with chronic ulceration of the angulus and vertical part of the stomach are reported. The ulcers failed to heal in 38% and healed but recurred in 22%. The ulcers healed and, except for minor recurrences in a few, remained healed for five years in 40%. ⋯ If such cases had been excluded from the present series the success rate would have risen to 64%. Patients with ulcers in these two categories should be referred for surgery. It is suggested that a trial of medical treatment is justifiable in most other cases, surgery being reserved for its failures.
-
This paper records an incidence of 10.4% of aneurysm of the splenic artery in 250 consecutive routine post-mortem examinations. Medial degeneration seemed to be the commonest cause of such aneurysms and although a number were associated with other intraabdominal pathology, including portal hypertension, the association may be fortuitous and not causal.