Irving B. Brick

Sources of upper gastrointestinal hemorrhage in cirrhotic patients with esophageal varices.

WHEN the patient who is hospitalized because of massive hemorrhage from the upper gastrointestinal tract is found to have the clinical signs of portal cirrhosis, the diagnosis of bleeding esophagea...

Liver Histology in Six Asymptomatic Siblings in a Family with Hemochromatosis; Genetic Implications

Summary 1.Six siblings of a patient with hemochromatosis have been investigated to determine early manifestations of the disease. 2.Liver biopsies in these asymptomatic siblings revealed iron deposition in all, with fully developed hemochromatosis in 1 male sibling, and additional histologic changes in the liver biopsy in 2 other males. 3.A review of previous family studies shows a sparsity of studies similar to the present one in which liver biopsies were obtained in asymptomatic siblings. The importance of this diagnostic technique in assessing the genetic manifestations of the disease is discussed. 4.Although it has been stated in the past that in this disease there has usually been incomplete penetrance with variable expressivity, study of this family demonstrates complete penetrance from a genetic point of view.

Gastrointestinal Hemorrhage (Excluding Peptic Ulcer and Esophageal Varices)

Miscellaneous Conditions Mallory-Weiss Syndrome Decker, Zamcheck and Mallory122 reviewed this form of gastrointestinal bleeding, which is due to erosions or lacerations in the long axis of the stom...

Esophageal varices without hemorrhage in cirrhosis; a proper indication for shunting procedures.

AMONG the first 50 surgical portal decompressions carried out for the treatment of esophageal varices at three university-affiliated hospitals in Washington, 18 patients were operated on in the abs...

Effect of sodium carboxymethylcellulose on the blood cells.

1. A large daily dose of sodium carboxymethylcellulose was given to a group of patients for a six month period. 2. Careful study of the effect on the blood cell constituents was made. 3. No significant effect on the blood cell constituents could be ascertained as resulting from the administration of sodium carboxymethylcellulose. Bone marrow was also unaltered in a small group of patients in which such study was done. 4. Many of the patients tolerated much larger doses than are ordinarily used therapeutically without ill effect.

Critique on sequelae of viral hepatitis

In summary, this critique has attempted to review the evidence of the occurrence of sequelae of acute viral hepatitis. Chronic disability does occur for periods of time not yet clearly defined as to duration and may occur as a continuation of the acute attack or after presumable recovery from the acute attack. The prognosis can not be definitely answered at present. The percentage of acute cases having chronic disability is small, but no definite numbers can be stated with assurance. That a still smaller group of the acute cases may terminate in cirrhosis seems supported by adequate evidence. Whether the group having chronic disability (the chronic hepatitis syndrome) or what percentage of it goes on to cirrhosis can not be answered at present.

Elevated Diaphragm From Hematoma

To the Editor.— We wish to add another entity to the differential diagnosis of an elevated hemidiaphragm. Report of a Case.— A 37-year-old white man was admitted to Georgetown University Hospital for evaluation of hepatomegaly. There was a 15-year history of heavy alcohol intake. On admission, the hematocrit value was 46.5%, and the x-ray film of the chest was normal (Fig 1). A liver biopsy performed on the second hospital day was consistent with Laennecs cirrhosis. Later that day, the patient complained of right-sided pleuritic pain in the chest. The hematocrit value had fallen to 37.5% while the x-ray film of the chest showed elevation of the right hemidiaphragm with basilar discoid atalectasis (Fig 2). The fall in hematocrit value was attributed to hemorrhage from the liver biopsy. Although no further diagnostic studies were done, it was assumed that the elevation of the right diaphragm was secondary to hematoma formation