RESUMEN
Gastric antral vascular ectasia (GAVE), recently described in literature, is an important cause of gastric bleeding. A case of great gastrectasia with vascular ectasia in an elderly male patient is reported. The lesion was characterized by great linear and brush folds along the antrum and body of the stomach, Endoscopically, this folds seems like the watermelon streakings. It could be an acquired lesion probably linked to traumatism on gastric mucosa.
Asunto(s)
Ectasia Vascular Antral Gástrica/patología , Anciano , Resultado Fatal , Ectasia Vascular Antral Gástrica/complicaciones , Humanos , Masculino , Infarto del Miocardio/complicacionesAsunto(s)
Apendicitis , Apendicectomía/métodos , Apendicitis/diagnóstico , Apendicitis/epidemiología , Predicción , HumanosRESUMEN
BACKGROUND: Intraoperative duplex examination can be used during carotid surgery to identify small technical defects (like anastomotic stenosis, intimal flaps or subintimal wall dissections) that cannot be easily found by palpatory manoeuvres. The objective of this clinical study is to correlate intraoperative duplex findings with early postoperative complications and with duplex data obtained during follow-up. METHODS: From January 1993 to January 1996 we compared early and late postoperative complications that occurred after carotid surgery in two groups of patients: a group of 120 patients undergone intraoperative duplex compared with a group of 100 patients not undergone intraoperative ultrasound. RESULTS: The percentages of early and late postoperative complications which occurred in the first group were respectively 7.5% and 4.2% contrary to 10% and 7% occurred in the control group. CONCLUSIONS: Duplex constitutes a selective intraoperative method for carotid surgery, easy to use, enable to identify and immediately correct technical defects.
Asunto(s)
Estenosis Carotídea/cirugía , Endarterectomía Carotidea , Monitoreo Intraoperatorio/métodos , Ultrasonografía Doppler Dúplex , Anciano , Anciano de 80 o más Años , Angiografía , Arteria Carótida Interna/diagnóstico por imagen , Arteria Carótida Interna/cirugía , Estenosis Carotídea/diagnóstico por imagen , Femenino , Estudios de Seguimiento , Humanos , Complicaciones Intraoperatorias/prevención & control , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/prevención & control , Estudios Retrospectivos , Prevención SecundariaRESUMEN
BACKGROUND: We report one case of symptomatic aneurysm of infrarenal abdominal aorta in a patient symptomatic for acute abdomen. METHODS: The patient was accepted at the Emergency Care Unit and the routine admission tests were taken. US of the abdomen revealed a <
Asunto(s)
Aneurisma de la Aorta Abdominal/complicaciones , Situs Inversus/complicaciones , Abdomen Agudo/etiología , Anciano , Aneurisma de la Aorta Abdominal/diagnóstico , Aneurisma de la Aorta Abdominal/cirugía , Femenino , HumanosRESUMEN
Morgagni-Larrey's hernias are congenital diaphragmatic hernias, rarely observed and generally identified accidentally due to the lack of symptoms. The authors report a case of intestinal occlusion secondary to Morgagni-Larrey herniation in an adult recently observed and underline the aetiopathogenic aspects, the diagnostic tools and the clinical pattern. They suggest to consider surgical repair as a choice of treatment, also for asymptomatic patients.
Asunto(s)
Hernia Diafragmática/complicaciones , Hernias Diafragmáticas Congénitas , Obstrucción Intestinal/etiología , Adulto , Humanos , MasculinoRESUMEN
Hartmann's procedure has progressively changed its indications in the last years; nowadays they are reduced by the increasing of anesthesiology and the introduction of stapler devices. The introduction of staplers makes reconstructive operation easier and it contributes to a sensible increasing of reversal percentage after Hartmann's procedure. Video-assisted techniques make Hartmann's procedure possible for older patients with high-risk of post-operative general complications. The authors describe the results obtained with traditional and video-assisted reversal Hartmann's procedure, comparing with data from Literature.
Asunto(s)
Colon/cirugía , Recto/cirugía , Anciano , Anciano de 80 o más Años , Colostomía , Procedimientos Quirúrgicos del Sistema Digestivo/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Reoperación , Dehiscencia de la Herida Operatoria/prevención & controlRESUMEN
This paper reports the results of a trial, comparing the use of disposable skin staplers with conventional nylon or silk sutures in skin closure. This study began in 1986; 7274 patients undergoing elective and emergency operations were controlled during the postoperative period, 3 and 6 months after surgery. It was shown that skin clips instead of sutures decrease the operative time, produce wound healing with a good cosmetic results, and above all a significant lowering of the wound infection rate.
Asunto(s)
Procedimientos Quirúrgicos Dermatologicos , Engrapadoras Quirúrgicas , Urgencias Médicas , Estudios de Evaluación como Asunto , Estudios de Seguimiento , Humanos , Proteínas de Insectos , Nylons , Seda , Infección de la Herida Quirúrgica/prevención & control , Suturas , Textiles , Factores de Tiempo , Cicatrización de HeridasRESUMEN
Adenomyomatosis is a rare affection of the gallbladder and it's infrequently reported in the Literature. Having observed eighteen cases of adenomyomatosis of the gallbladder in the last five years and considering the difficulties in making an early diagnosis of gallbladder cancer, the authors suggest the importance of cholecystectomy in this pathology.
Asunto(s)
Adenomioma/cirugía , Colecistectomía , Neoplasias de la Vesícula Biliar/cirugía , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
A case of cavernous-capillary intramuscular haemangioma is reported. The tumour was characterized histologically by a proliferation of capillaries, cavernous blood spaces, along with arterial and venous blood vessels, intermingled with striated muscle fibres and fat tissue. The complex mixture of vessels and the circumscribed margins of the tumour could support a congenital origin.
Asunto(s)
Neoplasias de Cabeza y Cuello/patología , Hemangioma Cavernoso/patología , Músculos del Cuello/patología , Neoplasias de los Tejidos Blandos/patología , Actinas/análisis , Adulto , Biomarcadores de Tumor/análisis , Diagnóstico Diferencial , Femenino , Neoplasias de Cabeza y Cuello/química , Neoplasias de Cabeza y Cuello/diagnóstico , Neoplasias de Cabeza y Cuello/diagnóstico por imagen , Hemangioma Cavernoso/química , Hemangioma Cavernoso/diagnóstico , Hemangioma Cavernoso/diagnóstico por imagen , Humanos , Cuello/irrigación sanguínea , Proteínas de Neoplasias/análisis , Neoplasias de los Tejidos Blandos/química , Neoplasias de los Tejidos Blandos/diagnóstico , Neoplasias de los Tejidos Blandos/diagnóstico por imagen , Neoplasias de la Tiroides/diagnóstico , Ultrasonografía , Vimentina/análisisRESUMEN
Colonscopy is a standard diagnostic and therapeutic procedure that has its own morbidity. Colonic perforation is the dangerous complication of this procedure. Successful management of perforation by conservative or surgical treatment remains controversial. We report two cases, recently observed, of patients with colonic perforation occurring during therapeutic colonscopy treated with minimally invasive technique.
Asunto(s)
Colon/lesiones , Colon/cirugía , Colonoscopía/efectos adversos , Perforación Intestinal/etiología , Perforación Intestinal/cirugía , Laparoscopía , Anciano , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The authors report their experience on cervical anastomosis dehiscence in patients who had total esophagectomy and esophagogastroplasty for esophageal neoplasms. They describe, accurately and step by step, the plastic reconstructive technique (by using a vascularized transposed cutaneous flap), used to treat a symptomatic cervical fistula which occurred in 3 of the 24 patients who had esophagectomy and cervical-esophagogastroplasty. This kind of treatment led to complete healing of the fistulas, without clinical and radiological signs of fistula recurrence in all the patients treated.
Asunto(s)
Fístula Cutánea/cirugía , Esofagoplastia/efectos adversos , Gastroplastia/efectos adversos , Anastomosis Quirúrgica/efectos adversos , Fístula Cutánea/etiología , Humanos , CuelloRESUMEN
The Authors report a case of acute abdominal syndrome, caused by primary torsion of the greater omentum. They describe the still unknown aetiopathogenetic factors, pointing out the problems of preoperative diagnosis.
Asunto(s)
Epiplón , Enfermedades Peritoneales , Diagnóstico Diferencial , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Peritoneales/diagnóstico , Enfermedades Peritoneales/cirugía , Pronóstico , Anomalía TorsionalRESUMEN
Deep venous thrombosis is a quite frequent pathology with a high degree of morbidity and death-rate. Two are the main problems of this disease: the risk of pulmonary embolism and outcome of a post-thrombotic syndrome, leading patients to infirmity. The patients max exposed to the risk of deep venous thrombosis are the surgical ones: the authors, with a retrospective study on 480 surgical patients, examine the risk factors mostly related with the onset of deep venous thrombosis. At the end they refer about connection between the risk factors studied and the clinical display of in surgical patients.
Asunto(s)
Complicaciones Posoperatorias/epidemiología , Tromboflebitis/epidemiología , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de RiesgoRESUMEN
Up until now the problem of surgical infections has been one of the most important which surgeons must confront daily. In 1989 our Institute began programs for control and surveillance of surgical infections; these include, among others, the use of chemo-antibiotic prophylaxis protocols applied to all of the patients hospitalized for surgery. The authors report two years application of three protocols of chemo-antibiotic prophylaxis related to 1722 patients, in which we pointed out the passage from 27.6% of infected cases in the control group to 10.2% infected cases in one of the groups subject to prophylaxis. In these cases the antibiotic prophylaxis also acted reducing in a spectacular manner the incidence of clinically not significant infections.
Asunto(s)
Antibacterianos/uso terapéutico , Premedicación , Infección de la Herida Quirúrgica/prevención & control , Antibacterianos/administración & dosificación , Humanos , Italia/epidemiología , Infección de la Herida Quirúrgica/epidemiología , Factores de TiempoRESUMEN
Coarctation of abdominal aorta constitutes a rare group of vascular abnormalities, including segmental stenoses and extended hypoplasia below the restriction. Usually hypertension is the only clinical evidence. The natural history of the surgically untreated disease foresees a decline of life expectancy; while surgical operation permit an almost complete "restitutio ad integrum". The Authors report a case of coarctation of the abdominal aorta come to their observation whose particularly was determined by the absence of high blood pressure, the aortic stenoses being located under the renal arteries.
Asunto(s)
Coartación Aórtica , Aorta Abdominal , Coartación Aórtica/diagnóstico , Coartación Aórtica/cirugía , Femenino , Humanos , Persona de Mediana EdadRESUMEN
Modern technology has recently provided us with new resorbable suture material for use also in vascular surgery. Clinical use of these sutures has been impeded however by not little mistrust and by old dogmas without a rational experimental basis. We have therefore begun studies of two slowly resorbable materials, polyglactin 910 and polyglycolic acid, in comparison with two classic nonreabsorbable materials, nylon and polypropylene, used in experimental model of end-to-end anastomosis rats'infrarenal aorta, following up the healing process and its evolution after an interval. The results are discussed in relation to data collected from current literature.
Asunto(s)
Microcirugia/métodos , Técnicas de Sutura , Suturas , Procedimientos Quirúrgicos Vasculares/métodos , Absorción , Animales , Vasos Sanguíneos/ultraestructura , Estudios de Evaluación como Asunto , Masculino , Nylons , Poliglactina 910 , Ácido Poliglicólico , Polipropilenos , Ratas , Ratas EndogámicasRESUMEN
Twenty patients (42-80 years old of whom 9 women) affected by instrumentally ascertained pancreatic cancer (7 cases were operated on) were studied. In all of them the following coagulation indices (fibrinopeptide A, FpA; beta-thromboglobulin, BTG; platelet factor IV, PF4; fibrinogen degradation products, XDP) and tumor markers (gastrointestinal cancer associated antigen, GICA; tissue polypeptide antigen, TPA; carcinoembryonic antigen, CEA; alpha-fetoprotein, or AFP) were assessed at the time of diagnosis, and 10 and 30 days after diagnosis, to test whether and which of the above parameters are more sensitive for entertaining the underlying affection. In both operated and nonoperated patients FpA was shown to be the most sensitive index. Lesser sensitivity was shown by XDP, GICA, and BTG. AFP proved to be quite useless as its serum levels constantly fell within the normal range.
Asunto(s)
Biomarcadores de Tumor/análisis , Factores de Coagulación Sanguínea/análisis , Neoplasias Pancreáticas/diagnóstico , Adulto , Anciano , Antígenos de Neoplasias/análisis , Productos de Degradación de Fibrina-Fibrinógeno/análisis , Fibrinopéptido A/análisis , Humanos , Persona de Mediana Edad , Neoplasias Pancreáticas/cirugía , Péptidos/análisis , Factor Plaquetario 4/análisis , Antígeno Polipéptido de Tejido , alfa-Fetoproteínas/análisis , beta-Tromboglobulina/análisisRESUMEN
Progress in the management of complex vascular injuries of the limbs has not eliminated the necessity for amputations. Physicians' failure to suspect vascular injury on admission in traumatized patients causes delay in the diagnosis and management of arterial injury that ultimately leads to limb loss. High index of suspicion, early recognition by clinical evaluation, routine use of Doppler flowmeter and broad indication of preoperative angiography result in prompt repair of these lesions in the majority of cases. In managing the lower popliteal or trifurcation vessels, distal radial and ulnar artery as well as nerve injuries, the Authors believe microsurgical techniques should always be employed.
Asunto(s)
Vasos Sanguíneos/lesiones , Extremidades/irrigación sanguínea , Procedimientos Quirúrgicos Vasculares , Accidentes de Trabajo , Accidentes de Tránsito , Adolescente , Adulto , Anciano , Arterias/lesiones , Arterias/cirugía , Femenino , Humanos , Masculino , Microcirugia , Persona de Mediana EdadRESUMEN
Nineteen patients with total gastrectomy for neoplastic diseases were followed up from twelve to thirty months. Three different surgical reconstructive procedures were employed. Results are discussed and compared with those of the recent literature.