RESUMEN
Gas gangrene of the abdominal wall after appendicectomy is reported. Discussion evokes etiology and literature review. Penicillin, large excision of necrotic tissues and hyperbaric oxygenotherapy are the basis of the treatment.
Asunto(s)
Apendicectomía , Apendicitis/complicaciones , Gangrena Gaseosa/etiología , Músculos Abdominales , Gangrena Gaseosa/terapia , Humanos , Masculino , Persona de Mediana Edad , Complicaciones PosoperatoriasRESUMEN
The authors analyze the surgical indications and procedures for cases of chronic pancreatites. There were but few cases and the procedures were chosen for minimal harm ; there were : 4 external marsupialisations, 1 resection of a true cyst, 5 cystoanastomoses, 2 biliary bypasses, 4 left pancreatectomies. Postoperative courses were normal in 12 patients; 2 had recurrent pancreatitis because of alcoholism. Our attitude towards chronic pancreatic lesions is thus as follows: 1. Cautions and reserved indications. 2. Ad minima procedures.
Asunto(s)
Enfermedades Pancreáticas/cirugía , Adulto , Anciano , Enfermedad Crónica , Femenino , Humanos , Masculino , Métodos , Persona de Mediana Edad , Quiste Pancreático/cirugía , Enfermedades Pancreáticas/etiología , RecurrenciaRESUMEN
From a series of 58 cholecystectomies for chronic cholecystitis or for asymptomatic cholelithiasis, the authors have retrieved: 1) gall microbial contamination in 15,5% of the samples under study; 2) a complicated evolution--according to criteria defined for this research--of the operative wounds in 37,5% of the cases with positive gall cultures, and in 11% when the gall was sterile. It is the authors' opinion that cholecystectomy shows an actual septic risk, even in a non-acute clinical stage.
Asunto(s)
Bilis/microbiología , Colecistectomía/efectos adversos , Infección de la Herida Quirúrgica/microbiología , Adulto , Anciano , Colecistitis/cirugía , Colelitiasis/cirugía , Enfermedad Crónica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios ProspectivosRESUMEN
The authors report 7 cases of isolated injuries of the gallbladder, in closed abdominal trauma. The literature indicates the frequency to lie between one and five percent. The postprandial period and fasting alcohol levels, responsible for the distention of the gallbladder, are mostly the cause of such lesions. Four groups of injuries are described: 1) laceration 2) avulsion 3) simple contusion 4) traumatic cholecystitis Early diagnosis of such injuries is difficult as abdominal signs are poor and little specific; the authors note the value of peritoneal puncture and lavage. The treatment of gallbladder trauma is always surgical, cholecystectomy giving the best results; raphy and cholecystostomy are second choice treatments. The prognosis is usually favorable, even if surgery is delayed, and depends essentially on the nature of associated extra-abdominal injuries.