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3.
World J Emerg Surg ; 11: 25, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27307785

RESUMO

Acute calculus cholecystitis is a very common disease with several area of uncertainty. The World Society of Emergency Surgery developed extensive guidelines in order to cover grey areas. The diagnostic criteria, the antimicrobial therapy, the evaluation of associated common bile duct stones, the identification of "high risk" patients, the surgical timing, the type of surgery, and the alternatives to surgery are discussed. Moreover the algorithm is proposed: as soon as diagnosis is made and after the evaluation of choledocholitiasis risk, laparoscopic cholecystectomy should be offered to all patients exception of those with high risk of morbidity or mortality. These Guidelines must be considered as an adjunctive tool for decision but they are not substitute of the clinical judgement for the individual patient.

4.
Scand J Surg ; 93(1): 11-4, 2004.
Artigo em Inglês | MEDLINE | ID: mdl-15116813

RESUMO

Our objective in this review is to describe the unique features of bombing injury and to outline some special elements of their management. This is to allow the timely improvement and adjustment of existing mass casualty protocols. Forensic studies, detonation and explosion, mechanisms of injury in explosion and their bodily effects, chemical effects of the explosive, site of the explosion and the wounding potential, the Multidimensional Injury Pattern, diagnostic evaluation of Multidimensional Injury Pattern, and surgical and treatment dilemmas associated with it are described and discussed.


Assuntos
Traumatismos por Explosões/patologia , Explosões , Terrorismo , Traumatismos por Explosões/cirurgia , Humanos
5.
Surg Gynecol Obstet ; 159(3): 249-52, 1984 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-6433496

RESUMO

Air embolism--the most dangerous complication of central venous catheterization--may occur in several ways. The most frequent is from disconnection of the catheter from the related intravenous tubing. An embolism may present with a sucking sound, tachypnea, air hunger, wheezing, hypotension and a "mill wheel" murmur. A later manifestation is severe pulmonary edema. In a review of 24 patients, the mortality was 50 per cent. Among the survivors, five (42 per cent) had neurologic damage. Immediate treatment includes placing the patient in the left lateral and Trendelenberg positions, administration of oxygen and aspiration of air from the heart. Cardiac massage and emergency cardiopulmonary bypass may be necessary. Most instances can be prevented by inserting the cannula with the patient in the Trendelenberg position, occluding the cannula hub except briefly while the catheter is inserted, fixation of the catheter hub to its connections and occlusive dressing over the track after removal of the catheter.


Assuntos
Cateterismo/efeitos adversos , Embolia Aérea/etiologia , Adulto , Cateterismo Cardíaco/efeitos adversos , Cateterismo Cardíaco/métodos , Cateterismo/instrumentação , Pressão Venosa Central , Embolia Aérea/diagnóstico , Embolia Aérea/terapia , Feminino , Humanos , Masculino , Oxigênio/uso terapêutico , Nutrição Parenteral Total/efeitos adversos , Nutrição Parenteral Total/métodos , Sucção
6.
J Pediatr Surg ; 18(5): 621-2, 1983 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-6644508

RESUMO

This is a report of the first known case of congenital tracheoesophageal fistula in father and son.


Assuntos
Atresia Esofágica/genética , Adulto , Pré-Escolar , Atresia Esofágica/complicações , Humanos , Masculino , Fístula Traqueoesofágica/complicações
7.
Surgery ; 92(4): 758-64, 1982 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-7123496

RESUMO

The management of intermediate severity duodenal injuries remains a controversial issue. This report details our experience with 34 patients who underwent operations for duodenal trauma in the past 3 years. Seventy-two percent had penetrating injuries. Seven patients (28%) were managed with by duodenorrhaphy and Penrose drainage, nine (36%) with duodenal diversion (pyloric exclusion with gastrojejunostomy), two (8%) with resection and anastomosis, and one (4%) with pancreaticoduodenectomy. A comparison with a previous report from our institution. in 1978 discloses (1) more severe injuries in the current series, (2) more frequent use of duodenal diversion with a corresponding decreased use of tube decompression, (3) increased nutritional support, and (4) fewer complications. Based on this experience we advocate the use of duodenal diversion and needle catheter jejunostomy for intermediate severity duodenal wounds.


Assuntos
Duodeno/lesões , Ferimentos não Penetrantes/cirurgia , Ferimentos Penetrantes/cirurgia , Adolescente , Adulto , Drenagem , Duodeno/cirurgia , Feminino , Humanos , Jejuno/cirurgia , Masculino , Pessoa de Meia-Idade , Pâncreas/cirurgia , Estômago/cirurgia , Ferimentos por Arma de Fogo/cirurgia , Ferimentos Perfurantes/cirurgia
8.
Arch Surg ; 117(5): 722-8, 1982 May.
Artigo em Inglês | MEDLINE | ID: mdl-6803739

RESUMO

Forty-four patients were operated on for pancreatic trauma during the past three years. Twenty-one patients (48%) were treated by drainage alone, nine (21%) by distal resection, eight (19%) by duodenal diversion, and one (2%) by pancreatoduodenectomy. Active sump drainage was used in 27 patients (71%) and early enteral feeding by needle catheter jejunostomy in 24 (63%) postoperatively. Of the 38 patients who survived the initial operation, two (5%) died postoperatively. Pancreas-related complications occurred in 13 patients (34%). Comparison with earlier findings from our institution reveals (1) more frequent use of active sump drainage, (2) continued use of distal resection for suspected ductal injuries of the body or tail, (3) earlier postoperative nutrition by needle catheter jejunostomy, and (4) increased use of duodenal diversion for concurrent pancreatic and duodenal trauma.


Assuntos
Pâncreas/lesões , Traumatismos Abdominais/complicações , Adolescente , Adulto , Idoso , Drenagem , Duodeno/cirurgia , Nutrição Enteral , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Pâncreas/cirurgia , Cuidados Pós-Operatórios , Complicações Pós-Operatórias
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