RESUMEN
A significant percentage of surgery performed for complications of gastroesophageal reflux at a major medical center has been performed for problems related to prior surgery. Our patients who required remedial surgery fell into three categories. Those with recurrent reflux generally fared well. Patients with dysphagia, gastric stasis, or both presented difficult problems. The key to success for these patients lies in choosing the operation best suited to the anatomic and physiologic situation as defined by preoperative contrast studies, pH monitoring, endoscopy, and selective gastric emptying studies.
Asunto(s)
Fundus Gástrico/cirugía , Reflujo Gastroesofágico/cirugía , Adulto , Estudios de Evaluación como Asunto , Femenino , Estudios de Seguimiento , Humanos , Masculino , Métodos , Complicaciones Posoperatorias/cirugía , ReoperaciónRESUMEN
Three cases of hepatoblastoma that were deemed unresectable, both by angiographic study and exploration, became resectable following combined therapy of dactinomycin, vincristine, and irradiation.
Asunto(s)
Carcinoma Hepatocelular/terapia , Neoplasias Hepáticas/terapia , Hígado/cirugía , Antineoplásicos/uso terapéutico , Carcinoma Hepatocelular/diagnóstico por imagen , Niño , Quimioterapia Combinada , Femenino , Humanos , Lactante , Recién Nacido , Hígado/patología , Neoplasias Hepáticas/diagnóstico por imagen , Masculino , Radiografía , Cintigrafía , RadioterapiaRESUMEN
Spigelian hernia may be a more common clinical entity than previously recognized or reported. We report seven cases, four diagnosed and treated in the past 12 months at a large military hospital. Diagnosis can be difficult because of failure to consider it, incomplete understanding of the anatomy, and the nonpalpable intraparietal nature of the hernia. A careful history and physical examination are essential. Any patient with persistent localized pain in the proper anatomic location--just lateral to the outer border of the rectus muscle and usually below the umbilicus--warrants surgical exploration.