ABSTRACT
Vehicle collisions represent more than 75% of mechanism of blunt abdominal trauma. In spite of the incomparable improvement of car safety devices, recent studies pointed out that the air bags might cause injuries, specially when it is not associated with seatbelt. In fact, some studies pointed out that crash victims using air bags alone have increased injury severity, hospitalisations, thoracoabdominal procedure, and rehabilitation. Some of the most frequently injured organs reported from air bag deployment are the liver (38%), the spleen (23%) and digestive system (17%). Injury of the hollow viscera are far less common. In particular, blunt abdominal trauma resulting in small bowel perforation is an infrequent lesion. These injuries are difficult to diagnose because specific signs are poor and a delay in treatment increases mortality and morbidity of the patients. We describe a case of thoracoabdominal trauma that occurred during a head-on collision after an air bag deployment without seatbelt use.
Subject(s)
Abdominal Injuries/etiology , Air Bags/adverse effects , Intestinal Perforation/etiology , Jejunum/injuries , Ribs/injuries , Sternum/injuries , Wounds, Nonpenetrating/etiology , Abdominal Injuries/surgery , Accidents, Traffic , Adult , Humans , Intestinal Perforation/surgery , Intestine, Small/injuries , Jejunum/surgery , Male , Ribs/surgery , Sternum/surgery , Thoracic Injuries/etiology , Treatment Outcome , Wounds, Nonpenetrating/surgeryABSTRACT
The haemoperitoneum and bowel haematoma are complications of the oral anticoagulant treatment. The abdominal pain in patient under oral anticoagulant drugs represents a diagnostic problem; apart of the acute abdomen, we also have to consider unusual haemorrhagic lesion, rare in patients without coagulation problems. The early diagnosis of the complication in the patients permits a conservative treatment with excellent prognosis, instead of performing surgical operations in subjects with frequent comorbidities. We report a case of haemoperitoneum and intramural bowel haematoma in a patient with altered laboratory parameters and haemodynamic instability that required an urgent surgical procedure.
Subject(s)
Acenocoumarol/adverse effects , Anticoagulants/adverse effects , Hematoma/chemically induced , Hemoperitoneum/chemically induced , Jejunal Diseases/chemically induced , Aged , Angina Pectoris/drug therapy , Hematoma/surgery , Hemoperitoneum/surgery , Humans , Jejunal Diseases/surgery , Male , Treatment OutcomeSubject(s)
Medical Oncology , Neoplasms/diagnosis , Neoplasms/therapy , Africa , Developing Countries , HumansABSTRACT
The peritoneal papillary serous carcinoma (PPSC) is a rare tumor more frequently revealed in female. The onset mean age is 56 years. It implicate peritoneum, ovary's surface and pelvis. The histology of this disease is similar to papillary serous carcinoma ovary (PSCO). The PPSC histogenesis is probably correlated to coelomatic embryonal epithelium. Clinical characteristics are abdominal swelling, constipation, nausea, emesis, inappetence, feel unwell, lose weight. The cytoreductive surgery and the cisplatinum chemotherapy, and other treatments like immunotherapy and radiotherapy, increase the PSCP patient survival. A case of a 51 years old patient with previous surgery for breast cancer is here described. She show some of the yet described clinical findings. At the surgery we found the typically serous peritoneal localizations. We performed a debulking, and the patient died 14 months after the operation due to the disease progression.
Subject(s)
Breast Neoplasms/surgery , Cystadenocarcinoma, Papillary/surgery , Peritoneal Neoplasms/surgery , Cystadenocarcinoma, Papillary/diagnosis , Fatal Outcome , Female , Humans , Middle Aged , Peritoneal Neoplasms/diagnosisABSTRACT
The increasing of HIV infection in young women as well as prolonged survival let us to register an important rising of breast cancers in such type of patients. The Authors report the case of a 48 year old HIV-positive woman, who underwent surgery because of the histological positivity for cancer of the right breast. It was decided to perform a quadrantectomy and reconstruction with implant, because of the absence of immunodepression. The Authors discuss about indications for reconstructive surgery in seropositive women with breast cancer.
Subject(s)
Breast Neoplasms/surgery , HIV Seropositivity/complications , Breast Neoplasms/complications , Female , Humans , Mammaplasty , Middle AgedABSTRACT
Recent technological advances have led to an increasing ability to detect isolated or groups of tumour cells in blood, lymph nodes or bone marrow in patients with different tumour types. However, the clinical evidence of these advances is unclear. The detection and the characterisation of circulating breast cancer cells and the eventually micrometastasis represent an important prognostic factor with therapeutic implications. The number of neoplastic cells being very small, these are not easily detected by using only cytomorphology, possibly associated to immunocytochemistry. In the last decade many studies have been directed in order to identify new assays. In the present review the Authors summarize advantages and disadvantages about two different technical approaches: molecular and immunomagnetic selection with cellular enrichment and immunocytochemistry.
Subject(s)
Breast Neoplasms/pathology , Immunomagnetic Separation , Neoplastic Cells, Circulating/pathology , Breast Neoplasms/surgery , Humans , Immunohistochemistry , Molecular BiologyABSTRACT
Plastic and oncological breast surgery have to be considered as two aspects of the same treatment. The term "oncoplastic surgery" refers to the use of plastic surgery techniques in breast cancer surgery, in order to avoid and to correct the adverse aesthetic findings. The care of cosmetic sequelae of breast cancer surgery has reached an important therapeutic role for psychological consequences of disease and because of the higher patients expectations of a good aesthetic result. Considering the concept of oncoplastic surgery, since 1999 the authors began to use a periareolar approach in the breast conserving therapy (BCT), associated to axillary dissection performed through the same periareolar incision. This technique is not different from the traditional quadrantectomy in the extension of the glandular resection, while the skin may be preserved in according to the conventional protocols of BCT. Oncological and aesthetic results have proved to be safe and satisfactory.
Subject(s)
Lymph Node Excision/methods , Mastectomy, Segmental/methods , Surgery, Plastic , Axilla , Esthetics , Female , Humans , Nipples/surgery , Patient Acceptance of Health CareABSTRACT
Plastic and oncological breast surgery are becoming more and more closer as one surgical treatment. The term "oncoplastic surgery" refers to the use of plastic surgery techniques in breast cancer surgery, in order to avoid and to correct the adverse aesthetic findings. The care of cosmetic sequelae of breast cancer surgery has reached an important therapeutic role for psychological consequences of disease and because of the higher patients expectations of a good aesthetic result. Considering the concept of oncoplastic surgery, since 1999 the Authors began to use a periareloar approach in the breast conserving therapy (BCT), associated to axillary dissection performed through the same periareolar incision. This technique, original from the oncological point of view, is not different from the traditional quadrantectomy in the extension of the glandular resection, while the skin may be preserved in according to the conventional protocols of BCT. Oncological and aesthetic results have proved to be safe and satisfactory.