RESUMO
The authors consider the various causes of ascites and they also develop the concept of refractory ascites. They consider the various possibilities of medical and dietary therapy whose failure constitutes the basis for a surgical approach. In the latter case it is being considered the Peritoneo Venous Shunt (PVS) that employs different types of valves. In the light of their personal experience, matured over a period of 15 years, in which 75 valves were positioned in 64 patients and precisely: 55 valves of Le Veen, 15 Hakim and 5 Denver, it is emphasized that the best results, as for as mortality and morbidity goes, were obtained through careful attention in the preoperative stage and during surgery itself with the privileged use of a Le Veen's valve. For such motives, since in a high percentage of these patients there persists a poor prognosis a year away from the onset of refractory ascites, a PVS seems proposable anyway and even though this will not alter the pathological outcome, there's a clear improvement in the quality of life without precluding any other surgical approach. Finally, the authors outline the possibilities offered by the Transjugular Intrahepatic Portosystemic Shunt (TIPS), as a new original approach for the resolution of refractory ascites.
Assuntos
Ascite/cirurgia , Derivação Peritoneovenosa , Adulto , Idoso , Idoso de 80 Anos ou mais , Ascite/etiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Derivação Peritoneovenosa/efeitos adversosRESUMO
Authors have studied the incidence of septic complications due to subclavian vein catheterization, According to literature, have considered that this is generally connected to the operating ability. Septic contamination, though of high incidence, only exceptionally is reason of a septic clinical condition.
Assuntos
Cateterismo/efeitos adversos , Sepse/etiologia , Veia Subclávia , Antibacterianos/uso terapêutico , Técnicas Bacteriológicas , Candida/isolamento & purificação , Humanos , Staphylococcus/isolamento & purificação , Streptococcus/isolamento & purificaçãoRESUMO
Following a brief review of the literature dealing with the rarity of this disease, and the diagnostic progress made to date, the surgical techniques applicable to the various locations of the neoplasia are described. Personal experience with 8 insuloma patients is reported.
Assuntos
Adenoma de Células das Ilhotas Pancreáticas/cirurgia , Insulinoma/cirurgia , Neoplasias Pancreáticas/cirurgia , Adenoma/cirurgia , Carcinoma/cirurgia , Feminino , Humanos , Insulinoma/mortalidade , Masculino , Métodos , Pancreatectomia , Neoplasias Pancreáticas/mortalidadeRESUMO
Serological tests used in pancreatic diseases, especially isoamylase analysis and trypsin radioimmunoassay are presented. The results show that these markers are helpful in the diagnosis of chronic pancreatic diseases.
Assuntos
Amilases/sangue , Isoenzimas/sangue , Pancreatopatias/diagnóstico , Tripsinogênio/imunologia , Adolescente , Criança , Pré-Escolar , Doença Crônica , Fibrose Cística/sangue , Humanos , Lactente , Lipase/sangue , Pancreatopatias/sangueRESUMO
TPA and CEA were both assayed in a population of 352 diseases of the gastroenteric tract and control subjects. The results show that TPA though sensitive has no predictive value or specificity comparable to CEA. However should specific tumour markers prove negative TPA may be an extremely useful aid in monitoring patients with gastrointestinal neoplasias.
Assuntos
Antígeno Carcinoembrionário/imunologia , Gastroenteropatias/imunologia , Neoplasias Gastrointestinais/imunologia , Peptídeos/imunologia , Antígenos de Superfície , Diagnóstico Diferencial , Gastroenteropatias/diagnóstico , Neoplasias Gastrointestinais/diagnóstico , Humanos , Antígeno Polipeptídico TecidualRESUMO
We present a case report about a patient affected by an "insular" thyroid carcinoma, a poorly differentiated carcinoma, situated morphologically and biologically in an intermediate position between the well-differentiated (papillary and follicular) and the totally undifferentiated thyroid tumors. We believe that its separation from other types of thyroid cancer will lead to a more accurate estimate of its prognosis and a more aggressive therapeutic approach.
Assuntos
Adenocarcinoma/patologia , Recidiva Local de Neoplasia/patologia , Neoplasias da Glândula Tireoide/patologia , Idoso , Idoso de 80 Anos ou mais , Feminino , HumanosRESUMO
The Authors report a case of rhabdomyosarcoma observed in a 17-year-old boy. They emphasize that this rare form has an extremely rapid evolution, and in this case was also in an unusual site and of abnormal size. The difficulty of an early diagnosis and the impossibility of radical surgery are also underlined.