Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 17 de 17
Filtrar
Más filtros











Intervalo de año de publicación
1.
Bol. Asoc. Méd. P. R ; Bol. Asoc. Méd. P. R;90(7/12): 121-125, Jul.-Dec. 1998.
Artículo en Inglés | LILACS | ID: lil-411365

RESUMEN

Three patients with the abdominal compartment syndrome are presented and discussed. In one of the patients the condition was induced in an endocrine fashion, since trauma was sustained exclusively by the middle third of the left leg. The development of the syndrome as a remote effect of local trauma has never been reported previously. In all three instances only insignificant amounts of intraperitoneal fluid was found and the increase in abdominal pressure was due to severe edema of the mesentery and retroperitoneum. Since the condition is highly lethal, early diagnosis is imperative, and this starts by carrying a high index of suspicion. Measurement of the intraperitoneal pressure easily confirms this diagnosis. It is emphasized that measurements at various sites, like bladder and stomach, in each patient is essential to confirm the diagnosis, since one of the sites may be rendered unreliable due to intraperitoneal processes impinging on the affected site and affecting its distensibility


Asunto(s)
Humanos , Masculino , Adulto , Persona de Mediana Edad , Abdomen , Síndromes Compartimentales , Abdomen Agudo/etiología , Absceso Abdominal/complicaciones , Apendicitis/complicaciones , Insuficiencia Multiorgánica/etiología , Fracturas de la Tibia/complicaciones , Fracturas del Fémur/complicaciones , Peritonitis/complicaciones , Síndromes Compartimentales/diagnóstico , Síndromes Compartimentales/etiología , Traumatismo Múltiple/complicaciones , Traumatismos Abdominales/complicaciones , Traumatismos Torácicos/complicaciones
2.
Bol. Asoc. Méd. P. R ; Bol. Asoc. Méd. P. R;90(7/12): 117-120, Jul.-Dec. 1998.
Artículo en Inglés | LILACS | ID: lil-411366

RESUMEN

A right lumbar approach to the duodenum was developed to perform transduodenal sphinctero-plasty for the treatment of retained common bile duct stones. With experience, the procedure was reduced to a mininvasive approach. Nine patients with symptomatic choledocal stones were subjected to translumbar transduodenal sphincteroplasty. Eventually it became obvious that limited dissection was equally effective in exposure of pertinent anatomical structures and ease of performance. Four patients were intervened using the mini-invasive approach. In one instance the procedure was combined with laparoscopic cholecystectomy and cholangiogram. There was no mortality or morbidity and there was universal clearance of the common bile duct


Asunto(s)
Humanos , Masculino , Femenino , Adolescente , Adulto , Persona de Mediana Edad , Cálculos Biliares/cirugía , Procedimientos Quirúrgicos Mínimamente Invasivos , Esfinterotomía Transduodenal , Colangiografía , Colecistectomía Laparoscópica
3.
Bol Asoc Med P R ; 90(7-12): 117-20, 1998.
Artículo en Inglés | MEDLINE | ID: mdl-10224683

RESUMEN

A right lumbar approach to the duodenum was developed to perform transduodenal sphinctero-plasty for the treatment of retained common bile duct stones. With experience, the procedure was reduced to a mininvasive approach. Nine patients with symptomatic choledocal stones were subjected to translumbar transduodenal sphincteroplasty. Eventually it became obvious that limited dissection was equally effective in exposure of pertinent anatomical structures and ease of performance. Four patients were intervened using the mini-invasive approach. In one instance the procedure was combined with laparoscopic cholecystectomy and cholangiogram. There was no mortality or morbidity and there was universal clearance of the common bile duct.


Asunto(s)
Cálculos Biliares/cirugía , Procedimientos Quirúrgicos Mínimamente Invasivos , Esfinterotomía Transduodenal , Adolescente , Adulto , Colangiografía , Colecistectomía Laparoscópica , Femenino , Humanos , Masculino , Persona de Mediana Edad
4.
Bol Asoc Med P R ; 90(7-12): 121-5, 1998.
Artículo en Inglés | MEDLINE | ID: mdl-10224684

RESUMEN

Three patients with the abdominal compartment syndrome are presented and discussed. In one of the patients the condition was induced in an endocrine fashion, since trauma was sustained exclusively by the middle third of the left leg. The development of the syndrome as a remote effect of local trauma has never been reported previously. In all three instances only insignificant amounts of intraperitoneal fluid was found and the increase in abdominal pressure was due to severe edema of the mesentery and retroperitoneum. Since the condition is highly lethal, early diagnosis is imperative, and this starts by carrying a high index of suspicion. Measurement of the intraperitoneal pressure easily confirms this diagnosis. It is emphasized that measurements at various sites, like bladder and stomach, in each patient is essential to confirm the diagnosis, since one of the sites may be rendered unreliable due to intraperitoneal processes impinging on the affected site and affecting its distensibility.


Asunto(s)
Abdomen , Síndromes Compartimentales , Abdomen Agudo/etiología , Absceso Abdominal/complicaciones , Traumatismos Abdominales/complicaciones , Adulto , Apendicitis/complicaciones , Síndromes Compartimentales/diagnóstico , Síndromes Compartimentales/etiología , Fracturas del Fémur/complicaciones , Humanos , Masculino , Persona de Mediana Edad , Insuficiencia Multiorgánica/etiología , Traumatismo Múltiple/complicaciones , Peritonitis/complicaciones , Traumatismos Torácicos/complicaciones , Fracturas de la Tibia/complicaciones
5.
Bol. Asoc. Méd. P. R ; Bol. Asoc. Méd. P. R;88(10/12): 92-93, Oct.-Dec. 1996.
Artículo en Inglés | LILACS | ID: lil-411518

RESUMEN

Transduodenal sphincteroplasty is a safe, effective, reliable procedure in the treatment of choledocholithiasis. The fact that it can be practiced without radiographic surveillance makes it uniquely applicable during pregnancy. There are no reports applying this mode of treatment to the pregnant woman with choledocholithiasis


Asunto(s)
Humanos , Femenino , Embarazo , Adulto , Cálculos Biliares/cirugía , Complicaciones del Embarazo/cirugía , Esfínter de la Ampolla Hepatopancreática , Dilatación , Duodenostomía , Complicaciones Posoperatorias , Suturas
6.
Bol. Asoc. Méd. P. R ; Bol. Asoc. Méd. P. R;88(10/12): 89-91, Oct.-Dec. 1996.
Artículo en Inglés | LILACS | ID: lil-411519

RESUMEN

Seven patients with peptic ulcer disease had severe scarring of the duodenum, making its closure at the time of gastrectomy difficult. They were managed intraoperatively with proximal duodeno-jejunostomy as a means to avoid the catastrophic complication of disruption of the duodenal stump closure with its consequent peritonitis. The jejunum used for this anastomosis was an extension of the long limb of a Roux en Y which is brought up to perform the gastrojejunostomy. The end to end duodeno-jejunostomy is performed proximal to a side to side gastrojejunostomy, hence the name, proximal duodeno Jejunostomy. These seven patients had no unexpected immediate postoperative complications during the thirty days following surgery and were all discharged from the hospital well. During the same three and a half year period twenty five other patients were submitted to gastrectomy and had two duodenal stump leaks after conventional closures. One patient died and the other survived after prolonged intensive care stay. These differences were not statistically significant. These duodenojejunostomies are non-functional anastomoses and should consequently stricture, but in one patient it remained open and he developed bile reflux gastritis in spite of the Roux en Y gastrojejunostomy constructed to avoid this complication. These anastomoses should be constructed as stenotic as possible


Asunto(s)
Humanos , Masculino , Adulto , Persona de Mediana Edad , Duodeno , Duodeno/cirugía , Yeyuno/cirugía , Úlcera Duodenal/cirugía , Anastomosis en-Y de Roux , Duodenostomía , Estudio de Evaluación , Complicaciones Posoperatorias
7.
Bol Asoc Med P R ; 88(10-12): 89-91, 1996.
Artículo en Inglés | MEDLINE | ID: mdl-8976068

RESUMEN

Seven patients with peptic ulcer disease had severe scarring of the duodenum, making its closure at the time of gastrectomy difficult. They were managed intraoperatively with proximal duodeno-jejunostomy as a means to avoid the catastrophic complication of disruption of the duodenal stump closure with its consequent peritonitis. The jejunum used for this anastomosis was an extension of the long limb of a Roux en Y which is brought up to perform the gastrojejunostomy. The end to end duodeno-jejunostomy is performed proximal to a side to side gastrojejunostomy, hence the name, proximal duodeno Jejunostomy. These seven patients had no unexpected immediate postoperative complications during the thirty days following surgery and were all discharged from the hospital well. During the same three and a half year period twenty five other patients were submitted to gastrectomy and had two duodenal stump leaks after conventional closures. One patient died and the other survived after prolonged intensive care stay. These differences were not statistically significant. These duodenojejunostomies are non-functional anastomoses and should consequently stricture, but in one patient it remained open and he developed bile reflux gastritis in spite of the Roux en Y gastrojejunostomy constructed to avoid this complication. These anastomoses should be constructed as stenotic as possible.


Asunto(s)
Úlcera Duodenal/cirugía , Duodeno/cirugía , Yeyuno/cirugía , Adulto , Anciano , Anastomosis en-Y de Roux , Duodenostomía , Estudios de Evaluación como Asunto , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias
8.
Bol Asoc Med P R ; 88(10-12): 92-3, 1996.
Artículo en Inglés | MEDLINE | ID: mdl-8976069

RESUMEN

Transduodenal sphincteroplasty is a safe, effective, reliable procedure in the treatment of choledocholithiasis. The fact that it can be practiced without radiographic surveillance makes it uniquely applicable during pregnancy. There are no reports applying this mode of treatment to the pregnant woman with choledocholithiasis.


Asunto(s)
Cálculos Biliares/cirugía , Complicaciones del Embarazo/cirugía , Esfínter de la Ampolla Hepatopancreática , Adulto , Dilatación , Duodenostomía , Femenino , Humanos , Complicaciones Posoperatorias , Embarazo , Suturas
9.
Bol. Asoc. Méd. P. R ; Bol. Asoc. Méd. P. R;88(7/9): 55-56, Jul.-Sept. 1996.
Artículo en Inglés | LILACS | ID: lil-411527

RESUMEN

Chronic sporotrichosis granuloma of the skin is usually the result of non compliance with oral iodine therapy for whatever reason. Excision of the lesion, local iodine application with povidone iodide for six days and delayed primary skin grafting is presented as a quick, effective and acceptable alternative, if oral treatment is not tolerated. The ineffectiveness of local excision and grafting without adequate iodine therapy is demonstrated by this case


Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Esporotricosis/terapia , Granuloma/terapia , Yoduros/administración & dosificación , Administración Oral , Administración Tópica , Terapia Combinada , Esporotricosis/tratamiento farmacológico , Esporotricosis/cirugía , Granuloma/tratamiento farmacológico , Granuloma/cirugía , Yoduro de Potasio/administración & dosificación , Yoduro de Potasio/efectos adversos , Recurrencia
10.
Bol Asoc Med P R ; 88(7-9): 55-6, 1996.
Artículo en Inglés | MEDLINE | ID: mdl-8962526

RESUMEN

Chronic sporotrichosis granuloma of the skin is usually the result of non compliance with oral iodine therapy for whatever reason. Excision of the lesion, local iodine application with povidone iodide for six days and delayed primary skin grafting is presented as a quick, effective and acceptable alternative, if oral treatment is not tolerated. The ineffectiveness of local excision and grafting without adequate iodine therapy is demonstrated by this case.


Asunto(s)
Granuloma/terapia , Yoduros/administración & dosificación , Esporotricosis/terapia , Administración Oral , Administración Tópica , Terapia Combinada , Granuloma/tratamiento farmacológico , Granuloma/cirugía , Humanos , Masculino , Persona de Mediana Edad , Yoduro de Potasio/administración & dosificación , Yoduro de Potasio/efectos adversos , Recurrencia , Esporotricosis/tratamiento farmacológico , Esporotricosis/cirugía
11.
Ann Thorac Surg ; 48(3): 356-8, 1989 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-2774718

RESUMEN

Three patients with Barrett's esophagus and strictures between the middle and distal thirds of the esophagus, of 5 to 26 years duration at the time of the plasty, were treated with an infradiaphragmatic Nissen fundoplication and gastric vascular pedicle patch esophagoplasty, based on the right gastroepiploic vessels. Follow-up for 2 patients has been 6 and 7 years; both patients are asymptomatic except for periodic mild dysphagia in 1. The third patient developed cancer after 1 symptom-free year, and had esophagectomy with colon interposition. The results of this operation justify its use in recalcitrant lower intrathoracic esophageal strictures that do not respond to antireflux operation or dilation.


Asunto(s)
Estenosis Esofágica/cirugía , Esofagoplastia/métodos , Colgajos Quirúrgicos , Esófago de Barrett/complicaciones , Niño , Estenosis Esofágica/complicaciones , Estenosis Esofágica/diagnóstico por imagen , Esófago/diagnóstico por imagen , Femenino , Humanos , Masculino , Persona de Mediana Edad , Radiografía
12.
Bol Asoc Med P R ; 81(8): 308-10, 1989 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-2765046

RESUMEN

The case analysis of five patients with post-ampullary adenocarcinoma of the duodenum showed this to be a tumor which favors local extension into surrounding organs, instead of lymphatic or hepatic metastasis. This justifies and aggressive resectional approach to treatment, pancreaticoduodenectomy being the basic operation to be applied. Proximity to the superior mesenteric vessels involving them in four out of five of our tumors, is the major anatomic limiting factor. Leaving vascular control for the end of the excision and perfusing them to maintain viability of the gut until a comfortable vascular anastomosis can be constructed, should solve the problem. Misdiagnosis proved to be a prominent source of error, causing delays and inappropriate therapy. The Cancer Registry of Puerto Rico has documented an incidence of carcinoma of the duodenum similar to that of the ampulla of Vater. This fact demands the same care in the conduct of diagnostic procedures of the distal duodenum as is customary in the visualization of the ampulla.


Asunto(s)
Adenocarcinoma/cirugía , Neoplasias Duodenales/cirugía , Adenocarcinoma/diagnóstico , Adenocarcinoma/patología , Adulto , Anciano , Neoplasias Duodenales/diagnóstico , Neoplasias Duodenales/patología , Femenino , Humanos , Complicaciones Intraoperatorias/mortalidad , Masculino , Arterias Mesentéricas/lesiones , Arterias Mesentéricas/cirugía , Persona de Mediana Edad , Invasividad Neoplásica , Puerto Rico , Estudios Retrospectivos
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA