RESUMEN
The purpose of this work is a critical revision of spleen traumatism treatment. We have examined 46 patients which we treated by total splenectomy. We examined the recent literature on spleen functions and we tried to punctualize the newest methods for conservative treatment of the spleen.
Asunto(s)
Esplenectomía/métodos , Rotura del Bazo/cirugía , Adolescente , Adulto , Anciano , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Esplenectomía/efectos adversos , Rotura del Bazo/complicaciones , Rotura del Bazo/diagnóstico , Rotura del Bazo/patologíaRESUMEN
Hepatic traumas are one of the most common sequelae of abdominal injuries. The Authors report 24 cases of hepatic traumas about a casuistry of 104 patients, that, in the decade '74-'84, had an abdominal traumatism. The quality of injuries, the therapeutic actions, and results are described.
Asunto(s)
Hígado/lesiones , Adolescente , Adulto , Angiografía , Femenino , Hemoperitoneo/etiología , Hemoperitoneo/cirugía , Humanos , Hígado/cirugía , Masculino , Persona de Mediana Edad , UltrasonografíaRESUMEN
The authors relate about 107 cases of multiple injuries observed from 1975 to 1984. The causes of trauma, the different injuries caused by trauma, the association of different injuries intra and extra abdominal are examined; the diagnostic procedure, the results obtained, mortality, complications. The studied patients are divided on the basis of the trauma occurred. These data support the position that, in patients with severe multiple injuries, certain criteria, as rapidly increasing abdominal distension or uncorrectable hypotension and isolated rigidity of abdominal wall, eliminate the need for diagnostic examinations and make these procedures unwise waste of valuable time.
Asunto(s)
Traumatismos Abdominales/cirugía , Traumatismos Abdominales/diagnóstico , Traumatismos Abdominales/epidemiología , Accidentes de Trabajo , Accidentes de Tránsito , Adolescente , Adulto , Anciano , Niño , Preescolar , Diagnóstico Diferencial , Femenino , Hemoperitoneo/etiología , Hemoperitoneo/cirugía , Humanos , Masculino , Persona de Mediana Edad , Heridas no Penetrantes , Heridas PenetrantesRESUMEN
The Authors have developed a retrospective study of 45 patients, suffering from acute pancreatitis and hospitalized at a general surgery Departement during a period of two years. The purpose of the study was to evaluate the validity of the classification of acute pancreatitis in three degrees (slight, moderate, serious), suggested by Hollender to prognostic and therapeutic aims.
Asunto(s)
Pancreatitis/terapia , Enfermedad Aguda , Adulto , Anciano , Antibacterianos/uso terapéutico , Aprotinina/uso terapéutico , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pancreatitis/diagnóstico , Pancreatitis/cirugía , Nutrición Parenteral Total , Pronóstico , Estudios RetrospectivosRESUMEN
The authors refer their experience in the treatment of the acute pancreatitis by total parenteral nutrition. The study has been carried on twelve patients selected on the basis of prognostic factors of gravity by Ranson. The total parenteral nutrition proved to be useful as a therapy of support, causing the functional rest of the gland and assuring to the patient a caloric and proteic contribution strict necessary to overcome the serious hypercatabolic state which is determined.
Asunto(s)
Pancreatitis/terapia , Nutrición Parenteral Total , Enfermedad Aguda , Adulto , Anciano , Estudios de Evaluación como Asunto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pancreatitis/etiología , Estudios RetrospectivosRESUMEN
Following a number of remarks on the desirability of introducing into the practice of bronchopulmonary cancer surgery certain immunological ideas, a monitoring programme to be adopted in candidates for lung exeresis and for their subsequent monitoring is presented. The data to emerge thus far may be correlated fairly precisely with the prognosis and from this point of view their use in the selection of patients to be operated might be hypothesised.
Asunto(s)
Neoplasias de los Bronquios/cirugía , Neoplasias Pulmonares/cirugía , Neumonectomía , Anticuerpos Antineoplásicos , Formación de Anticuerpos , Linfocitos B/inmunología , Humanos , Activación de Linfocitos , Linfocitos T/inmunologíaRESUMEN
Three typical cases of segmental portal hypertension due to occlusion of the splenic vein are reported. This syndrome may be asymptomatic for a very long time and then present suddenly in the form of a serious picture of high digestive haemorrhage due to rupture of the varices of the fundus of the stomach as a result of hypertrophized submucous collateral drainage circulation. Useful for diagnosis are oesophagogastroduodenoscopy, which points to stomach varices, and splenoportography or superselective arteriography of the splenic artery with venous phase, which highlight pathognomonic dilatation and tortuosity of the gastroepiploic veins. Surgical exploration typically shows: presence of large epipolic vessels, splenomegaly, absence of changes in the liver and in the portal and mesenteric circulation. Resolutive treatment of choice is splenectomy.
Asunto(s)
Hipertensión Portal/etiología , Vena Esplénica , Tromboflebitis/complicaciones , Adulto , Femenino , Hemorragia Gastrointestinal/etiología , Humanos , Masculino , Rotura , Esplenectomía , Estómago/irrigación sanguínea , Tromboflebitis/diagnóstico , Tromboflebitis/cirugía , Várices/complicacionesRESUMEN
The physiopathological premisses of portosystemic anastomosis and the modern approach to this question are explained. Stress is laid on the general and haemodynamic advantages offered by selective shunts and 6 cases (4 distal splenorenal and 2 coronarocava shunts) are presented. As yet the postoperative period is not long enough to enable a final judgement to be formed. However, it can be stated that the success of this form of management is primarily determined by the proper choice of candidates, i.e. patients with non-decompensated initial cirrhosis and unimpaired portal hepatic flow.