Abstract:
:A review of 228 cholecystectomies done over a two-year period revealed 15 cases (6.6%) in which gallstones were absent. These 15 patients were all characterized by colicky abdominal pain in the right upper quadrant, with a mean duration of eight months. Ultrasonographic examination was falsely positive for gallstones in one third (5/15) of the patients, and further diagnostic evaluation in the remaining two thirds (10/15) failed to define a clear-cut surgical problem. All 15 patients ultimately had operation on the basis of symptoms. Every patient reported resolution of preoperative symptoms at short-term follow-up (four to eight weeks). Seven patients available for long-term follow-up (ten to 27 months) reported complete symptomatic resolution. The postoperative outcome failed to correlate reliably with gallbladder histology, bile cultures, and results of diagnostic testing. There was no mortality, and morbidity was limited to three patients. This series confirms previous reports of a small set of relatively young, healthy patients having chronic disabling symptoms of gallbladder disease in the absence of gallstones. Our results suggest that the most reliable factor predicting a successful outcome of cholecystectomy in these patients was the presence of severe biliary colic.
journal_name
South Med Jjournal_title
Southern medical journalauthors
Frykberg ER,Duong TC,LaRosa JJ,Etienne HBdoi
10.1097/00007611-198811000-00005subject
Has Abstractpub_date
1988-11-01 00:00:00pages
1353-7issue
11eissn
0038-4348issn
1541-8243journal_volume
81pub_type
杂志文章,评审abstract::Medical inpatients in inner-city hospitals have both potentially lead-related disorders and potential lead exposure. To see whether there is substantial unexpected lead intoxication in this population, we did a cross-sectional study of 117 consecutively admitted patients to a general medical ward of an inner-city univ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199605000-00003
更新日期:1996-05-01 00:00:00
abstract::Most regions of the United States are served by poison control centers that provide 24-hour toxicologic guidance resulting in the home management of most poison exposures. It has been suggested that without public access to a poison control hotline the majority of poison-exposed patients would seek medical care in eme...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1991-06-01 00:00:00
abstract::We have described a family with X-linked myotubular myopathy that was clinically manifest in the neonatal period and compared it with the clinical picture and course of the disease in similar reported cases. Clinical expression of the disease in the newborn period is not always lethal. Despite a fatal outcome in the f...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198409000-00035
更新日期:1984-09-01 00:00:00
abstract:OBJECTIVES:To compare grayscale and color Doppler ultrasound (CDUS) findings to that of multidetector computed tomography (MDCT) portography in the evaluation of portal hypertension in children. METHODS:Thirty children (mean age, 11.4 years) with definitive clinical and laboratory diagnoses of portal hypertension were...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e31823cfae2
更新日期:2012-01-01 00:00:00
abstract::To make informed career decisions, physicians must acquire a basic knowledge in medical management and health care economics as they evaluate the potential survival and growth of a primary care practice. Health care providers considering a specific community and local leaders and hospital administrators attempting to ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199404000-00006
更新日期:1994-04-01 00:00:00
abstract::Anorexia nervosa and bulimia are two of the four eating disorders that appear to be increasingly prevalent. Each has its own diagnostic criteria and medical hazards, though certain features are shared. It is important for internists to be aware of these disorders, since their management is best accomplished by a team ...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:
更新日期:1986-07-01 00:00:00
abstract::Retinal detachment complicating proliferative diabetic retinopathy is being recognized with increasing frequency. Although one type of detachment is tractional and requires vitrectomy for hopeful repair, the other variety of detachment is rhegmatogenous. The rhegmatogenous form of retinal detachment does not generally...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/00007611-197810000-00007
更新日期:1978-10-01 00:00:00
abstract::Sarcoidosis rarely involves the genitourinary system or the spinal cord. This report describes a case of sarcoidosis with a scrotal mass, a mass compressing the spinal cord, and lesions in the liver and spleen. This case illustrates an uncommon manifestation of sarcoidosis, which may mimic disseminated testicular canc...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/01.SMJ.0000163306.54629.35
更新日期:2005-09-01 00:00:00
abstract::Fixation of femur fractures in children and adolescents is becoming widely accepted because of the lower chance of iatrogenic infection and prohibitive cost of in-hospital traction and spica cast care. Interlocking nails, which have dramatically improved adult femur fracture care, have posed problems, such as injury t...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199707000-00008
更新日期:1997-07-01 00:00:00
abstract::Giant cell arteritis has been thought to occur only in white patients. There have been several recent reports of this disorder to blacks, however, and this case of biopsy-proven giant cell arteritis in a black patient indicates the diagnosis should be considered in any elderly patient with typical symptoms regardless ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197909000-00045
更新日期:1979-09-01 00:00:00
abstract::Perioperative consultations may play a major role in the care of surgical patients in an era of prospective payments. Since insurance reimbursement policy favors limitations in the number of consultants on a case, general medicine ("holistic") consultation services may become preferred perioperative consultants in the...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198903000-00004
更新日期:1989-03-01 00:00:00
abstract::The frequency with which house staff noticed their patients to be anemic, the frequency with which they tried to find out why the patients were anemic, and the diagnostic accuracy of such endeavors were measured. Next, an intervention was conducted in which the teams were lectured on the subject of anemia, given readi...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199102000-00022
更新日期:1991-02-01 00:00:00
abstract::The diagnosis of intestinal obstruction is readily made when a patient presents with typical history and signs, and when plain films of the abdomen display characteristic findings. Some patients, however, constitute diagnostic problems because abdominal roentgenograms are still equivocal, even after repetition in four...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197912000-00008
更新日期:1979-12-01 00:00:00
abstract::Documented fetal inactivity is strongly suggestive of fetal jeopardy, but the significance of excessive activity over a prolonged period has not been reported. Using data gathered from fetal movement charts recorded by 931 patients, fetal hyperactivity was defined statistically as 40 or more movements perceived per ho...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198302000-00005
更新日期:1983-02-01 00:00:00
abstract::A case of pneumococcal endocarditis in an infant is reported together with a review of seven cases previously described in the literature. The prominent presenting symptoms of this usually fatal disease consisted of tachycardia, tachypnea, and cardiomegaly. A new murmur was heard in six of the eight patients. Fever wa...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-197904000-00021
更新日期:1979-04-01 00:00:00
abstract::We describe a 47-year-old man with shoulder pain, multiple bony lesions, and a 1-cm lesion in the spleen. T-1 facetectomy revealed a poorly differentiated malignant neoplasm. Several months after chemotherapy, multiple splenic lesions were found by computed tomography and liver-spleen scan. A splenectomy showed a mali...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199508000-00020
更新日期:1995-08-01 00:00:00
abstract::We have reported a case of reversible acute renal transplant failure due to the Page kidney phenomenon, which followed routine diagnostic needle biopsy. Duplex Doppler ultrasonography differentiated between allograft rejection and graft failure due to perirenal and mechanical abnormalities. Renal transplant failure ma...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199305000-00019
更新日期:1993-05-01 00:00:00
abstract:BACKGROUND:Smokeless tobacco (ST) use is associated with significant health risks and is increasing in prevalence in the United States. This study examined the prevalence of ST use among patients seen in two family practice centers and the documentation of that ST use in the medical record. METHODS:A survey of 209 pat...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199712000-00012
更新日期:1997-12-01 00:00:00
abstract::We have reported a case of suppurative pylephlebitis in an elderly, debilitated patient. The infection was caused by toothpick perforation of and migration from the gastrointestinal tract. The patient had risk factors for foreign body ingestion, including poor dentition, aphasia caused by a previous cerebrovascular ac...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198803000-00034
更新日期:1988-03-01 00:00:00
abstract::To study the role of formula as a cause of rickets, we randomly assigned 46 very-low-birth-weight (VLBW) infants (less than or equal to 1,500 gm) to one of three groups receiving either Isomil, a soy isolate formula, Similac with Iron, a common milk-based formula, or Similac 24 LBW, a hypercaloric milk-based formula d...
journal_title:Southern medical journal
pub_type: 临床试验,杂志文章
doi:10.1097/00007611-198401000-00005
更新日期:1984-01-01 00:00:00
abstract::We have described a 38-year-old woman with a lesion of the cervix found on routine physical examination. The lesion proved to be a primary leiomyosarcoma of the cervix. Despite radiation therapy, surgery, and chemotherapy, the tumor recurred and grew relentlessly. She is alive with disease at two years seven months af...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-198104000-00042
更新日期:1981-04-01 00:00:00
abstract::Coronary heart disease remains the major cause of mortality and morbidity in the United States and other western countries despite major advances in its treatment. During the last decades, many markers of coronary artery disease have been found which help predict future risk of cardiovascular events. High-sensitivity ...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/SMJ.0b013e31816c0195
更新日期:2008-05-01 00:00:00
abstract::We report the case of an 18-year old man with hemolytic-uremic syndrome (HUS) having a classic clinical presentation and diagnostic renal pathology without evidence of microangiopathic hemolytic anemia (MAHA) by peripheral blood smear. Indirect evidence of hemolysis was suggested by mild anemia, elevation of serum lac...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199603000-00018
更新日期:1996-03-01 00:00:00
abstract::Early gradual ambulation is currently recommended for patients with acute low back pain if results of neurologic examination are normal. Bed rest for up to 2 days is considered optimal. To assess management practices, we retrospectively reviewed the medical records of individuals with acute back pain treated at three ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:1991-05-01 00:00:00
abstract:BACKGROUND:Human immunodeficiency virus (HIV) seroprevalence surveys help determine the extent of HIV and the need for routine HIV counseling and testing. We sought to describe trends in five south Georgia hospitals and compare two protocols for conducting anonymous HIV surveys. METHODS:From 1993 to 1997, each hospita...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:
更新日期:2001-04-01 00:00:00
abstract:BACKGROUND:Echocardiographic demonstration of valvular infection now ranks with positive blood cultures as one of the two major clinical criteria for diagnosis of infective endocarditis (IE), according to new, more accurate guidelines for diagnosis. Because early detection of IE and its complications is essential for d...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:
更新日期:1999-08-01 00:00:00
abstract:OBJECTIVES:Anemia, either chronic or newly developed in the hospital as a result of underlying disease and/or phlebotomy, is seen commonly among general medical inpatients, and its impact on the quality and efficiency of care is unknown. METHODS:This study investigated the relation among hemoglobin level, length of st...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/SMJ.0b013e318290f930
更新日期:2013-05-01 00:00:00
abstract:OBJECTIVES:In 2014, 726 bicyclists were killed and an additional 50,000 were injured in crashes with motor vehicles. The number of cyclists in the United States is increasing, and as a result there has been a call for more bike lanes. We examined the difference in the severity of injury of bicyclists involved in motor ...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.14423/SMJ.0000000000000665
更新日期:2017-07-01 00:00:00
abstract::We report a case of perforated solitary jejunal diverticulum in an 80-year-old woman. Jejunal diverticulosis occurs in 0.07% to 2.0% of the population. Jejunal diverticulitis with perforation is rare and is associated with high mortality. Treatment is surgical resection of the involved segment. Several theories to exp...
journal_title:Southern medical journal
pub_type: 杂志文章
doi:10.1097/00007611-199505000-00013
更新日期:1995-05-01 00:00:00
abstract::Disorders of the foregut are an increasingly common cause of symptoms in Western populations. This review summarizes recent advances in the understanding and treatment of gastroesophageal reflux disease, dyspepsia and celiac disease. ...
journal_title:Southern medical journal
pub_type: 杂志文章,评审
doi:10.1097/01.smj.0000242808.91797.3d
更新日期:2007-03-01 00:00:00