Browsing by Author "Keet, A. D."
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- ItemThe anatomical extent of the pyloric sphincteric cylinder, the pyloric mucosal zone and the pyloric antrum(Health & Medical Publishing Group, 1982-8) Keet, A. D.The anatomy of the pyloric sphincteric cylinder is discussed. The pyloric ring is not a separate anatomical structure, but is an inherent part of the cylinder. Contraction of the cylinder narrows the diameter of the pyloric ring, and thus of the pyloric aperture. The extent of the sphincteric cylinder is determined on radiographs. It is seen to be 3-5 cm in length when fully contracted. Anatomical features of the pyloric mucosal zone are reviewed. On the aboral side both the cylinder and the mucosal zone end at the ring. The entire cylinder is lined by pyloric mucosa, but the mucosal zone extends orally beyond the confines of the cylinder. In gastric ulcer it may extend much further up the stomach. In contrast to the cylinder, the greatest length of the mucosal zone is on the lesser curvature. The sphincteric cylinder and the pyloric mucosal zone are clearly defined anatomically. The term 'pyloric antrum', in contrast, has been used in many different senses.
- ItemDubbele pilorus en piloroduodenale fistels : twee gevalbeskrywings met bespreking(Health & Medical Publishing Group, 1984) Keet, A. D.; Bezuidenhout, D. J. J.Congenital double pylorus is extremely rare; only 2 cases have been found in the English and French literature. Acquired double pylorus occurs more often; up to 1982, 66 cases had been reported. During 6,810 consecutive barium meal examinations over a period of 2 years, we diagnosed the condition in 5 patients. Two came to operation, at which the diagnosis was confirmed. These 2 cases are described. Acquired double pylorus is in reality a short pyloroduodenal fistula situated next to the pylorus, usually on the lesser curvature side. In the majority of cases it results from a pyloric ulcer penetrating into the duodenum. In a minority of cases the primary lesion is a duodenal ulcer penetrating into the pyloric area. Cases initially present with peptic ulcer symptoms. With the formation of the fistula, symptoms may disappear. Some authorities consider this to indicate spontaneous cure of the ulcer, thus obviating the need for further medical or surgical treatment. In the present 2 cases there was no remission of symptoms. None of the cases has been associated with malignant disease. It is thought that the condition may be recognized more often in future.
- ItemHerpesvirus hominis oesophagitis and oesophageal stricture(Health & Medical Publishing Group, 1980) Heydenrych, J. J.; Keet, A. D.; Mare, J. B.; Becker, W. B.The literature on herpetic involvement of the esophagus is reviewed and a case is described in which the presumptive clinical diagnosis of primary Herpesvirus hominis stomatitis and oesophagitis and subsequently esophageal strictures was made. The differential diagnosis of an esophageal lesion and its treatment are discussed.
- ItemA new, tubeless radiological test for duodenogastric reflux(Health & Medical Publishing Group, 1982) Keet, A. D.As a modification of the double-contrast barium meal, a tubeless radiological test for duodenogastric reflux, not involving the administration of any pharmacologically active substances, is described. The procedure minimizes the possible occurrence of artefacts. It allows for the examination of duodenogastric reflux in relation to both duodenal and pyloric motility. Previously much emphasis has been laid on the role of duodenal contraction waves, but the results show that the dynamic state of the pyloric sphincteric cylinder may be of greater importance, as reflux only occurred while this structure was relaxed or partially contracted. The test can be used on a routine basis in pathological conditions (such as gastric ulceration) and may help to clarify some of the controversial aspects of duodenogastric reflux. The findings in 14 normal controls and in 100 patients are described.