ABSTRACT
Aorto-enteric fistula, i.e. communication between the aorta and the digestive tract, is a clinical condition that usually appears in patients who have already been submitted to aneurismectomy. Primary fistula, in patients not submitted to surgical treatment, is uncommon. The authors describe a case of primary aorto-enteric fistula which was diagnosed and operated on early, with a favourable outcome. The critical analysis of the authors' experience and the literature data stress that an early diagnosis and suitable therapy can reduce mortality.
Subject(s)
Aortic Diseases/diagnosis , Duodenal Diseases/diagnosis , Intestinal Fistula/diagnosis , Vascular Fistula/diagnosis , Aged , Aorta, Abdominal , Humans , MaleABSTRACT
The management of appendiceal abscesses is still discussed and many different approaches are nowadays adopted. The aim of this study was to analyze retrospectively our experience with this disease to value the results of drainage of the abscess and appendectomy in one stage in presence of appendiceal abscesses. We studied 44 patients consecutively observed in our Department of General Surgery all submitted to drainage of the abscess and appendectomy for acute appendicitis with periappendiceal abscess. Preoperative ultrasonography showed an accuracy of 85.7% in detecting the presence of an abscess. Mean size of the abscesses were 5 cm (from a minimum of 3 cm to a maximum of 9 cm). The mean duration of surgical operation was 48 minutes (min 35'-max 95'), with a mean in-hospital stay of 6.2 days. Morbidity rate was 9% and was due in 75% of cases to wound infection and in 25% of cases to wound dehiscence. Neither major morbidity nor mortality were observed. In consideration of the results the authors conclude that even in presence of an appendiceal abscess, appendectomy with abscess drainage is not only a safe operation with a low morbidity rate but the procedure of choice allowing a significative reduction of hospitalization and health cost.
Subject(s)
Abscess/surgery , Appendectomy , Appendix , Acute Disease , Adult , Appendectomy/methods , Appendicitis/surgery , Cecal Diseases/surgery , Female , Humans , Male , Middle Aged , Postoperative Complications/epidemiology , Retrospective StudiesABSTRACT
The authors report three cases of dermatomyositis, which ha been erroneously diagnosed as "chronic fatigue syndrome" due to the presence of elevated titers of serum anti-Epstein Barr antibodies.
Subject(s)
Dermatomyositis/diagnosis , Fatigue Syndrome, Chronic/diagnosis , Aged , Diagnostic Errors , Female , Humans , Male , Middle AgedABSTRACT
The authors report five cases of dermatomyositis in which positivity for hepatitis C virus was ascertained. A virus-related (ECHO virus, Coxsackie) dermatomyositis is known, but a hepatitis virus C-related dermatomyositis was reported only in one case in a Letter to the Editor of Journal of Rheumatology (1994).