RESUMO
Fourteen patients with pharyngo-esophageal foreign bodies are reported. The esophagus was normal in 7 cases, two foreign bodies were ejected spontaneously, one was extracted by endoscopy, two by cervicotomy, one by thoracotomy, and one by cervicothoracotomy. It is rare for dental prostheses to be swallowed, but mention is made of a patient who swallowed a live fish accidentally, and developed cervical emphysema. In 7 cases the foreign body was retained by an esophageal stenosis following previous caustic burns. It was removed by thoracotomy in one case, gastrostomy in 3 cases, colo-esophagoplasty in 2 cases, and by relief of an esophagocolic stenosis in the last case. Long-term results were excellent except for one early postoperative death due to a cerebrosvascular accident, and another from bronchopneumonia at a later stage. Therapy varies according to the condition of the esophagus, the site of the foreign body, and the time when the patient is hospitalized.
Assuntos
Esôfago/cirurgia , Corpos Estranhos/cirurgia , Adulto , Idoso , Feminino , Humanos , Masculino , Métodos , Pessoa de Meia-IdadeAssuntos
Circulação Hepática , Sistema Porta , Fluxo Sanguíneo Regional , Animais , Isótopos do Cromo , Cães , Hemodinâmica , Isótopos de Fósforo , CintilografiaRESUMO
The authors present a case with peritonitis following rupture of a splenic abscess in a female aged 18 years. Peritonitis developed in three stages. The diagnosis before surgery was of pelvic peritonitis. Bacteriologic examination revealed the presence of B. colli. Splenectomy was followed by complete recovery of the patient. The site of the primary infection could not be determined. The authors stress the usefulness of exploration of the splenic lodge in the so-called "primary" generalized peritonitis, in pelvic peritonitis or in all cases when the origin of the peritoneal infection is not known.
Assuntos
Abscesso/complicações , Peritonite/etiologia , Esplenopatias/complicações , Ruptura Esplênica/etiologia , Adolescente , Feminino , Humanos , Ruptura Espontânea , Esplenectomia , Ruptura Esplênica/cirurgiaRESUMO
Based on the experience accumulated in the treatment of 35 cases of iterative occlusions through adherences and perivisceritis the authors present the advantages and the disadvantages of the different operatory techniques employed (total or partial Noble procedure, Raymond technique, Child-Phillips method, C. Andreolu and I. Vintila procedures). The various factors are stressed (such as local and general conditions of the patients) that preside over the selection of the operative procedure.
Assuntos
Obstrução Intestinal/cirurgia , Adulto , Idoso , Humanos , Obstrução Intestinal/etiologia , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Recidiva , Aderências Teciduais/complicações , Aderências Teciduais/cirurgiaRESUMO
The authors present 83 cases of associated ulcer and cirrhosis, evaluating the frequency of this complication in relation with the total number of ulcers hospitalized over a determined time. The percentage of this association was of 1,6 of the total number of patients with ulcers, and of 10,2 of the total number of patients with cirrhosis. The major complications of this association were hemorrhage and perforation, both in an identical percentage (38). In the case of hemorrhage the authors recommend extirpation of the ulcer. In situ hemostasis should be avoided, when possible because the risk of continued hemorrhage is greater than that of gastric resection. When hemorrhage is due to ruptured oesophageal varicosities endocardial transgastric ligature is recommended by the abdominal route, according to the Skinner-Suteu procedure. In perforated ulcers excision is recommended, associated with pyloroplastia and vagotomy.
Assuntos
Cirrose Hepática/complicações , Úlcera Péptica Hemorrágica/cirurgia , Úlcera Péptica Perfurada/cirurgia , Veia Ázigos/cirurgia , Colecistectomia , Gastrectomia , Humanos , Cirrose Hepática/cirurgia , Veia Porta/cirurgia , Piloro/cirurgia , Esplenectomia , VagotomiaRESUMO
The authors present 15 cases of patients with pharyngo-oesophageal foreign bodies, of which 6 occurred in subjects with a normal, healthy oesophagus. In two cases the foreign bodies were eliminated spontaneously, one was extracted by endoscopy, two through cervicotomy and one through thoracotomy. The author stress the fact that dental prostheses are very rarely swallowed, and the deglutition of a live fish is mentioned --. In 7 patients the foreign body became struck in an old post-caustic oesophageal stenosis. In one of these patients the foreign body was extracted by thoracotomy, in 3 cases gastrostomy was performed, in 2 cases colo-oesophagoplasty was necessary and in one case the oeso-colic stenosis was recalibrated. The late results were excellent, excepting one case when the patient died a short time after surgery through a cerebral vascular accident. The therapeutic attitude was differentiated in relation with the condition of the oesophagus, the site of the foreign body and the time of hospitalization.