RESUMO
Primary localization of hydatidosis in the musculoskeletal system is a quite rare occurrence. We report a case of a 67 year old man with an infestation of the coracobrachialis muscle. We discuss several instrumental and serologic diagnosis methods and the hypothesis of a primary muscular localization.
Assuntos
Braço/parasitologia , Equinococose/diagnóstico , Músculo Esquelético/parasitologia , Idoso , Humanos , MasculinoRESUMO
For about ten years repair of inguinal or abdominal hernias using prosthetic materials has been in routine use in general surgery. Various experimental and clinical observations of surgical physiopathology have been proved that the most important cause of recidivation is abnormal tension between diastasis tissues. From the beginning of 1991, in the Surgical Department of "Clinica S. Anna" in Pomezia (Rome), we have been using tension free technique. Goretex was preferred versus other prosthetic devices because of our experience in vascular surgery. Hundred-fifteen operations have been carried out; 23 for ventral hernias, 92 for inguinal and femoral hernias. The age of patients varied from 18 to 69 years. Localization of inguinal hernias was indirect in 48 cases, direct in 16 an associated in 13; 9 were recidive and 3 bilateral, 3 femoral hernias. Abdominal wall hernias consisted of 12 epigastric localizations, 8 hypogastric and 3 pararectal. All cases of abdominal and bilateral hernias were operated under general anesthesia with orotracheal intubation. Inguinal hernias were treated with local (pubivacaine 0.5%, 1:2 with physiologic solution) or spinal anesthesia, except for 2 cases operated in total anesthesia. As regards surgical technique, the objective pursued was that of filling up the parietal defect with a patch of the same form fixed with a non absorbable suture in Goretex 2/0. The peritoneum was not opened in abdominal hernias, if not necessary, because prosthetic devices must not touch directly the small and large bowel; patches have been positioned between the peritoneum and transversalis aponeurosis. For inguinal hernias Rives' technique was used. Goretex patches were cut with "no-touch" technique.(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Hérnia Femoral/cirurgia , Hérnia Inguinal/cirurgia , Hérnia Ventral/cirurgia , Politetrafluoretileno , Próteses e Implantes , Adolescente , Adulto , Idoso , Humanos , Pessoa de Meia-Idade , Recidiva , Telas CirúrgicasRESUMO
Laparoscopic surgery represents a real innovation with respect to the traditional laparotomic way of access, owing to its undeniable advantages, both intraoperative and postoperative. This new technique reduces the complications connected with the surgical wound and with forced allerement. Therefore it allows the patient's fast recovery. Laparoscopic surgery application ground get's wider and wider every day: in fact, the authors report two medical cases, one of elective surgery (treatment of a hidatid cyst of the liver) and the other in emergency surgery (peritonitis due to perforated duodenal ulcer), both obtaining a positive result about the clinical and the postoperative timing of recovery.