RESUMO
Boerhaave's syndrome is a rare and severe syndrome, with a mortality rate around 40%. The Authors report a case recently observed and through a Literature review stress the importance of an early diagnosis and quick surgical treatment as far as quoad vitam prognosis is concerned.
Assuntos
Doenças do Esôfago , Doenças do Esôfago/diagnóstico , Doenças do Esôfago/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Ruptura Espontânea , Síndrome , Tomografia Computadorizada por Raios XRESUMO
Acute arterial obstruction of the limbs represents one of the most frequent events in Emergency Surgery. In 95% of the cases, the cause has to be searched in embolus parting from the heart in patients with rheumatic or fibrillary disease. Currently the two therapeutic methods used for peripheral arterial obstruction are thrombolytic therapy and surgical dysobstruction using Fogarty's catheter. The Authors compare the two methods on the basis of their experience in 129 cases underlying how the thrombolytic therapy (Urokinase, Streptokinase) should be instituted in the early hours from presentation of symptoms, otherwise, the possibility of revascularization will heavily drop. Better results are obtained by positioning a catheter under radiologic guide for intra-arterial infusion. The Authors also believe that up-to-date the surgical approach with Fogarty's catheter represents one of the best procedures, either for its feasibility of for the costs of the thrombolytic therapy. Furthermore, the thrombolysis may be not complete, and account for possible haemorrhagic complications.
Assuntos
Embolia/terapia , Perna (Membro)/irrigação sanguínea , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Embolectomia , Embolia/tratamento farmacológico , Embolia/cirurgia , Feminino , Fibrinolíticos/administração & dosagem , Humanos , Masculino , Ativadores de Plasminogênio/administração & dosagem , Estreptoquinase/administração & dosagem , Terapia Trombolítica , Ativador de Plasminogênio Tipo Uroquinase/administração & dosagemRESUMO
The Authors, after a Literature review on endovascular invasive procedures used for inferior limbs obstructive arteriopathy, describe the use of a new device for mechanical endarterectomy. Through the latest acquired experience the importance of dissecting progressively the single layers of the atheroma plaque without arriving to a complete denudation of the arterial wall, so avoiding the risk of myointimal hyperplasia reactions, is outlined. The possibility of using endoarterial stents in case of more indaginous recanalization is also stressed.
Assuntos
Angioplastia com Balão/instrumentação , Endarterectomia/instrumentação , Microcirurgia/instrumentação , Stents , Arteriopatias Oclusivas/cirurgia , Arteriosclerose/cirurgia , Prótese Vascular , Cadáver , Humanos , Perna (Membro)/irrigação sanguínea , PolitetrafluoretilenoRESUMO
The Authors report the case of a male patient, 52 year old, suffering from retroperitoneal leiomyosarcoma, submitted to multiple operations in the space of about seven years, for the presence of liver metastases and local relapses; the good general health state, the moderate grade of the neoplasm and the disease's fair interval free, have justified the therapeutic attitude adopted; the patient at present enjoys good health.