RESUMO
Endoscopic management of post cholecystectomy biliary leak is described in a 56-year-old patient who developed a cystic duct leak following open cholecystectomy.
Assuntos
Doenças Biliares/terapia , Colangiopancreatografia Retrógrada Endoscópica/métodos , Colecistectomia/efeitos adversos , Stents , Doenças Biliares/etiologia , Colelitíase/cirurgia , Drenagem/instrumentação , Drenagem/métodos , Humanos , Pessoa de Meia-IdadeRESUMO
Endoscopic management of post cholecystectomy biliary leak is described in a 56-year-old patient who developed a cystic duct leak following open cholecystectomy
Assuntos
Humanos , Pessoa de Meia-Idade , Stents , Colecistectomia/efeitos adversos , Doenças Biliares/terapia , Colangiopancreatografia Retrógrada Endoscópica/métodos , Colelitíase/cirurgia , Doenças Biliares/etiologia , Drenagem/instrumentação , Drenagem/métodosAssuntos
Anti-Helmínticos/uso terapêutico , Ivermectina/uso terapêutico , Mansonelose/tratamento farmacológico , Adulto , Idoso , Idoso de 80 Anos ou mais , Anti-Helmínticos/efeitos adversos , Método Duplo-Cego , Feminino , Humanos , Ivermectina/efeitos adversos , Masculino , Pessoa de Meia-Idade , Parasitemia/tratamento farmacológico , Recidiva , Resultado do Tratamento , Trinidad e TobagoRESUMO
We describe a female diabetic patient who presented with features suggestive of hepatobiliary disease and who exhibited clinical signs of fulminant hepatic failure. Identification and drainage of a right perinephric abscess resulted in prompt resolution of both the physical signs and biochemical indices of liver disease. Infection remote from the hepatobiliary tree can mimic fulminant hepatic failure, and recognition of this unusual presentation of infection is important if dangerous delay in diagnosis and treatment is to be avoided.
Assuntos
Abscesso/diagnóstico , Encefalopatia Hepática/diagnóstico , Nefropatias/diagnóstico , Adulto , Feminino , HumanosRESUMO
We describe a female diabetic patient who presented with features suggestive of hepatobiliary disease and who exhibited clinical signs of fulminant hepatic failure. Identification and drainage of a right perinephric abscess resulted in prompt resolution of both the physical signs and biochemical indices of liver disease. Infection remote from the hepatobiliary tree can mimic fulminant hepatic failure, and recognition of this unusual presentation of infection is important if dangerous delay in diagnosis and treatment is to avioded.
Assuntos
Humanos , Adulto , Feminino , Encefalopatia Hepática/etiologia , Abscesso/microbiologia , Nefropatias/microbiologia , Encefalopatia Hepática/tratamento farmacológico , Diabetes Mellitus/complicações , Diagnóstico Diferencial , Icterícia/etiologiaRESUMO
Drainage in thyroid surgery has been a routine but empirical practice with no scientific evidence to support its benefit. The largest series to date of non-drainage in thyroid surgery is presented, comprising 260 patients over a 15-year period. No case selection for non-drainage was employed. Two hundred and fifty-nine cases were not drained and included toxic goitres, and bilateral and redo procedures. There was one thyroid storm and two cases of subcutaneous fluid collection, treated by needle aspiration. No cases of recurrent laryngeal nerve injury, airway obstruction or death were recorded. This study strongly demonstrates the safety of non-drainage in routine thyroid surgery.
Assuntos
Doenças da Glândula Tireoide/cirurgia , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia , Humanos , Estudos Prospectivos , Fatores de TempoRESUMO
Drainage in thyroid surgery has been a routine but empirical practice with no scientific evidence to support its benefit. The largest series to date of non-drainage in thyroid surgery is presented, comprising 260 patients over a 15-year period. No case selection for non-drainage was employed. Two hundred and fifty-nine cases were not drained and included toxic goitres, and bilteral and redo procedures. There was one thyroid storm and two cases of subcutaneous fluid collection, treated by needle aspiration. No cases of recurrent laryngeal nerve injury, airway obstruction or death were recorded. This study strongly demonstrates the safety of non-drainage in routine thyroid surgery (AU)
Assuntos
Humanos , Tireoidectomia , Drenagem , Nervos Laríngeos/anormalidades , Nervos Laríngeos/lesões , Nervos Laríngeos/cirurgia , Região do CaribeRESUMO
A 32 year old female, para 2 + 0 presented with a hard lump in the scar of a lower midline incision. She had had a myomectomy 2 years previously and subsequently noticed the lump 3 months later. Her only complaints were urinary frequency during menstruation and the suprapubic mass. Surgery was performed for what was initially thought to be a desmoid tumour. At surgery the uterus was found to be lying in the subcutaneous position with no peritoneal sac. The uterus was dissected free of the sheath and reduced into the pelvis, uneventfully. This rare occurrence of a subcutaneous non-gravid uterus in the absence of a hernial sac is reported and its clinical features and possible preventative measures are discussed.
Assuntos
Miométrio/cirurgia , Complicações Pós-Operatórias , Doenças Uterinas/etiologia , Músculos Abdominais , Adulto , Feminino , Hérnia , Humanos , Menstruação , Micção , Doenças Uterinas/cirurgiaRESUMO
Advanced Trauma Life Support (ATLS) training of medical staff did not improve outcome of the trauma victim. Potential benefit of this course may have been masked by weak links in the trauma care chain such as pre-hospital care and in hospital investigative and therapeutic facilities.
Assuntos
Acidentes de Trânsito/mortalidade , Serviços Médicos de Emergência , Corpo Clínico/educação , Educação Médica Continuada , Humanos , Fatores de Tempo , Trinidad e TobagoRESUMO
A severely pre-eclampic patient developed peripartum cardiomyopathy and bilateral femoral emboli. Medical therapy for cardiac failure was commenced prior to delivery by Caesarean Section. Bilateral femoral embolectomy was performed on the sixth postpartum day.
Assuntos
Embolia/etiologia , Artéria Femoral , Insuficiência Cardíaca/complicações , Complicações Cardiovasculares na Gravidez , Transtornos Puerperais/etiologia , Adulto , Cesárea , Embolia/cirurgia , Feminino , Insuficiência Cardíaca/tratamento farmacológico , Humanos , Pré-Eclâmpsia/complicações , Gravidez , Complicações Cardiovasculares na Gravidez/tratamento farmacológico , Terceiro Trimestre da GravidezRESUMO
Advanced Trauma Life Support (ATLS) training of medical staff did not improve outcome of the trauma victim. Potential benefit of this course may have been masked by weak links in the trauma care chain such as pre-hospital care and in hospital investigative and therapeutic facilities.
Assuntos
Traumatologia/educação , Acidentes de Trânsito/mortalidade , Educação Médica Continuada , Cuidados para Prolongar a Vida , Trinidad e Tobago , Serviços Médicos de EmergênciaRESUMO
A severely pre-eclamptic patient developed peripartum cardiomyopathy and bilateral femmoral emboli. Medical therapy for cardiac failure was commenced prior to delivery by Caesarean Section. Bilateral femoral embolectomy was performed on the sixth postpartum day.
Assuntos
Pré-Eclâmpsia/complicações , Complicações Cardiovasculares na Gravidez , Embolia/cirurgia , Artéria Femoral/cirurgia , Insuficiência Cardíaca/tratamento farmacológico , Transtornos Puerperais , CesáreaRESUMO
Thirty-two consecutive cases of left-sided colonic obstruction are presented. Thirty cases were managed by primary resection and anastomosis without colostomy. No anastomotic leakage occurred. This procedure allowed significant conservation of material and personnel resources, with minimal patient morbidity.
Assuntos
Doenças do Colo/cirurgia , Obstrução Intestinal/cirurgia , Anastomose Cirúrgica , Doenças do Colo/mortalidade , Colostomia , Países em Desenvolvimento , Humanos , Obstrução Intestinal/mortalidadeRESUMO
Thirty-two consecutive cases of left-sided colonic obstruction are presented. Thirty cases were managed by primary resection and anastomosis without colostmy. No anastomotic leakage occurred. This procedure allowed significant conservation of material and personnel resources with minimal patient morbidity (AU)