RESUMO
PURPOSE: The purpose of this study was to debate the epidemiologic and clinical features of primitive biliary peritonitis (PBP) as much as a rare pathology; and especially to obtain a more comprehensive view of factors associated with a severe prognosis. METHOD: It is a retrospective survey of 15 patients, collected from 2000 to 2003. Only primitive biliary peritonitis has been included. RESULT: It is a series of 15 patients, 6 men and 9 women, with a mean age of 62 years. Biliary lithiasis was incriminated in 14 cases. Clinical picture was an acute peritonitis in every case. Six patients were operated on by median incision, the others by costal one. The death rate is of 26,6%, all death were a direct complication of PBP. Factors associated with a higher mortality are an IGS II score superior or equal than 31 and a number of organ failures superior or equal to 3. CONCLUSION: PBP is a rare and severe pathology that concerns aged women. Biliary lithiasis is the main etiology. Treatment is essentially surgical, in association with active per-operative resuscitation.
Assuntos
Bile , Peritonite , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Peritonite/diagnóstico , Peritonite/cirurgia , Estudos RetrospectivosRESUMO
The traumatic rupture of the aortic isthmus is one of the worst complication due to high speed motor vehicle accidents. When death is not the immediate consequence of this lesion, the initial clinical signs are not very clear. The present article demonstrates the case of a 23-year-old patient, victim of a car accident. A traumatic aortic rupture was actually diagnosed after the unusual discovery of a mesenteric infarct. In this case report, the mesenteric infarct mechanism can be controversed, and an emphasis should be put on an early aortic lesion diagnosis and repair in order to avoid any ischaemic complications.