RESUMO
One hundred and thirty-eight patients with abdominal aortic aneurysms were treated by aneurysmorrhaphy over an eleven-year period. Six patients, all male and aged 60 - 74 years, were found to have developed primary aorteonteric fistulae. Four patients presented with bleeding into the gastrointestinal tract in association with a tender abdominal swelling. In the other two cases, the aneurysm was discovered at emergency laparatomy for gastrointestinal haemorrhage. The presence of the fistula was confirmed at operation in five patients and at autopsy in one. Two patients died, one from a massive gastrointestinal haemorrhage to surgery, the other from sepsis complicated by adult respiratory distress syndrome and renal failure following operation (AU)
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Idoso , Fístula Intestinal/etiologia , Fístula Intestinal/cirurgia , Aneurisma da Aorta Abdominal/complicações , Hemorragia Gastrointestinal/etiologiaRESUMO
Two successfully treated cases of benign colovesical fistula are presented. The condition should be suspected whenever patients with colorectal disease develop urinary symptoms. Fllexible colonoscopy and lateral abdominal X-ray should be the initial investigations; but barium enema, cystoscopy and, rarely, CT scan may be necessary to confirm the presence of a colovesical fistula. Patients should be managed conservatively during the acute phase, and then be treated definitively by a single-stage bowel resection. Simple closure or resection and closure is used for the bladder defect. (AU)
Assuntos
Humanos , Pessoa de Meia-Idade , Masculino , Fístula Intestinal/cirurgia , Fístula da Bexiga Urinária/cirurgia , Doenças do Colo/cirurgia , Doenças do Colo/diagnóstico , Fístula da Bexiga Urinária/diagnóstico , Fístula Intestinal/diagnóstico , Divertículo do Colo/complicaçõesRESUMO
Gallstone ileus is a rare cause of mechanical bowel obstruction. The attendant lack of awareness by the clinician will not only result in the diagnosis being made intraoperatively but will also affect the adequacy of the preoperative preparation of these ill patients. These patients are often elderly, septic and have significant concomitant medical illnesses. Recently two patients with gallstone ileus were managed with enterolithotomy and primary repair of the cholecyst-duodenal fistula at the University Hospital of the West Indies, Jamaica. Their clinical presentations and progress are described along with a review of the classical clinical course, radiological features, and operative choices available. (AU)