Assuntos
Neoplasias da Mama , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/terapia , Terapia Combinada , Feminino , Humanos , Masculino , TexasRESUMO
The present paper describes the presentation and management of 9 patients who developed dilatation in the colon during the course of spontaneous ischaemic colitis. The length of history varied from 16 hours to 6 weeks. The patients usually had diarrhoea and abdominal pain but no bleeding and posed a difficult diagnostic problem. At laparotomy, three distinct types of colonic dilatation were recognised. Dilatation of non-diseased colon proximal to localised ischaemic segments occurred in 2 patients, 3 patients exhibited dilatation of obviously gangrenous colon, 4 patients showed dilatation of ischaemic but possibly viable colon, yet in 1 of these, multiple sealed perforations were present. Resection of the obvious or possibly gangrenous colon was the treatment used but in the 2 patients with dilatation due to stricture, transverse colostomy alone was employed.
Assuntos
Colo/irrigação sanguínea , Doenças do Colo/etiologia , Isquemia/complicações , Adulto , Idoso , Colo/patologia , Colo/cirurgia , Doenças do Colo/patologia , Doenças do Colo/cirurgia , Dilatação Patológica/etiologia , Dilatação Patológica/patologia , Feminino , Humanos , Isquemia/patologia , Masculino , Pessoa de Meia-IdadeRESUMO
A survey has been performed of the mortality and morbidity of anterior lesser curve seromyotomy with posterior truncal vagotomy in the elective treatment of chronic duodenal ulcer. There was one death in a series of 605 patients due to a myocardial infarction, an operative mortality of 0.16 per cent. There was no case of ischaemic necrosis of the lesser curvature or fundus of the stomach. Eleven patients had symptoms of delayed gastric emptying (1.7 per cent) and seven of these underwent a drainage procedure (1.3 per cent). Postoperative dumping did not occur, significant diarrhoea was present in two patients (0.33 per cent). This operation is relatively simple, quick and extremely safe to perform. It is suggested that the more widespread use of this type of elective surgery for duodenal ulcer might reduce the mortality from the condition.
Assuntos
Úlcera Duodenal/cirurgia , Membrana Serosa/cirurgia , Estômago/cirurgia , Vagotomia/mortalidade , Doença Crônica , Úlcera Duodenal/mortalidade , Humanos , Métodos , Complicações Pós-OperatóriasRESUMO
In a prospective, randomized trial metronidazole was found to be significantly better than povidone-iodine in reducing the incidence of wound infection after appendicectomy (P less than 0.005). The metronidazole was given as a established 7-day course. Over 65 per cent of the wound infections presented after the patients had been discharged from hospital.