Abdominal Exploratory Surgery Research Articles

War Injuries of the Ureter

During the 18 months of war in Croatia, from 1991 until 1992, 4,425 wounded patients were treated at Clinical Hospital Osijek. Urogenital injuries were present in 115 treated patients (2.6%), and among them ureteral injuries were present in 11 patients (9.5%). The ureteral injuries were discovered by chance during exploratory abdominal surgery performed for other accompanying injuries. Ureteroureteral anastomosis was done in three cases. In three cases ureterocystoneostomy was performed. Exploration only was performed in three cases and nephrectomy was performed in two cases. It is important to emphasize that in three cases with contusions of the ureter wall that were not surgically reconstructed, the final result was ureteral stenosis. Moreover, in one case the final result was complete obliteration of the ureteral lumen.

Urinary eosinophil-derived neurotoxin in Churg-Strauss syndrome

J A LLERGY C LIN I MMUNOL 1995;96:261-4.

Fatal encephalitis caused byOchroconis gallopavumin a domestic cat (Felis domesticus)

Ochroconis gallopavum was identified as the causal agent of fatal encephalitis in a young, short-hair, domestic cat. The cat initially developed an ulcerated mass on the left side of the tongue and signs of pain in the abdomen. The tongue lesion was surgically removed and exploratory abdominal surgery revealed abnormalities suggestive of pancreatitis and peritonitis. During the month after surgery, the cat's health declined, manifested by sluggishness, loss of appetite and abnormal behaviour. Following a final rapid deterioration, the cat became non-responsive and was euthanized. Histologic examination of the brain, lung and mediastinal lymph node lesions revealed large numbers of pigmented, septate, branched, hyphal elements with swollen intercalary and terminal vesicles, and short chains of moniliform hyphal cells. Cultures of the mediastinal lymph nodes yielded a dematiaceous, thermotolerant fungus that was identified as O. gallopavum. This report describes the first well-documented infection in a cat caused by O. gallopavum.

Adenomatous polyps of the duodenum in cats: 18 cases (1985-1990)

Summary: Medical records were reviewed for 18 cats with adenomatous polyps of the proximal portion of the duodenum. Cats of Asian ancestry were over represented (8/18), and male castrated cats were common (15/18). The median age was 11.8 years. Common clinical signs were acute and chronic vomiting and hematemesis. Nine cats were anemic. Contrast radiography was performed in 12 cats, and a mass of the proximal portion of the duodenum was identified in 10 cats. Endoscopy was used to confirm existence of the mass in 3 cats. Complete excision of the duodenal mass was performed in 17 cats. One cat died before abdominal exploratory surgery, and a duodenal adenomatous polyp was identified at necropsy. Fifteen cats survived the immediate postoperative period, with 13 of 15 having complete resolution of clinical signs. Five cats had concurrent disease, which caused 4 of them to die between 3 and 26 months after surgery. Redevelopment of adenomatous polyps was not detected in any cat during the follow-up period of 1 to 49 months. Results of the study indicated that benign, adenomatous polyps of the duodenum in cats can be safely excised and that the prognosis for return to normal function is excellent.

Leiomyosarcoma of the Jejunum in a Budgerigar

Exploratory abdominal surgery in a budgerigar with a history of lethargy, feather fluffing, and melena revealed a neoplastic mass associated with the jejunal muscularis. Histologically, the nonencapsulated cellular mass was composed of sheets of spindle-shaped cells with pleomorphic nuclei, numerous and bizarre mitotic figures, and admixed anaplastic sarcomatous and giant cells. Special stains confirmed the cell of origin as the leiomyocyte. These characteristics warranted a diagnosis of jejunal leiomyosarcoma, previously unreported in the budgerigar.

Intraoperative abdominal ultrasonography: initial experience with a dedicated high-resolution operative transducer.

A dedicated 8-MHz intraoperative scanning probe was used in 42 patients who underwent exploratory abdominal surgery. A variety of pathologic processes involving the liver, pancreas, bowel, and biliary and genitourinary systems were evaluated. Sonographic studies were evaluated to determine if they added new information (20 patients, 47.6 per cent), confirmed known information (20 patients, 47.6 per cent), or provided false information (two patients, 4.8 per cent). Preliminary experience with a specially developed transducer suggests that its design avoids many of the difficulties encountered with other transducers employed for this technique. Intraoperative sonography has, in many instances, the potential to simplify surgery, shorten operating time, and modify the type of surgical procedure performed.

Treatment of cryptorchidism: Long-term prospective study

We have presented preliminary findings on a long-term prospective study designed to (1) assess timing of orchiopexy, (2) eliminate unnecessary abdominal exploratory surgery, and (3) determine efficacy of orchiopexy on subsequent fertility and on malignant degeneration. Some suggestions for the management of this common congenital defect can be provided, but long-term results are lacking. A significant drop-out rate from this prospective study is expected with time; therefore, large patient numbers are needed to draw any valid conclusions at the time of postpubertal reassessment.

Indications for exploratory surgery.

Generally, the chief indication for exploratory abdominal surgery is an increasing amount of abdominal pain accompanied by loss of weight or changes in eating habits. Roentgenographic studies and clinical symptoms sometimes are misleading and result in erroneous diagnoses of abdominal conditions.Surgical exploration frequently reveals unsuspected diverticula, benign lesions simulating malignant ones, scirrhous carcinoma, ulcers, or various biliary disorders.Abdominal exploration is accompanied by minimal risk. In the author's experience, this procedure has revealed the presence of a lesion in 50 per cent of cases.