RESUMO
Cholangiography carried out in laparoscopic surgery is a diagnostic exam considered by many authors to be very important for the anatomy and the research pre-existent pathologies of the biliary tree. Such are the effective advantages that many Schools suggest it be carried out any case as the risks, the costs and the results do not influence or alter the result of surgical treatment and moreover, its continuous use improves the positive results. The simple execution of cholangiography, allowed also by the presence of suitable forceps, makes this exam practicable at any moment and easily coupled to other diagnostic and therapeutic methods executable during the proper times of laparoscopic surgery.
Assuntos
Colangiografia , Laparoscopia , Colangiografia/métodos , Colangiopancreatografia Retrógrada Endoscópica , Colelitíase/cirurgia , Contraindicações , Estudos de Avaliação como Assunto , Humanos , Período IntraoperatórioRESUMO
The authors discuss the possibility of changing out laparoscopic cholecystectomy during the first clinical manifestation of acute cholecystitis. The international published series report similar results to those found with the laparotomic operation. There is no common operating conduct either or regards surgical technique or the diagnosis of possible pathologies of biliary ducts. It is shown the effective improvement of the pain, the lowest complications and the duration of the postoperative course which, especially in old patients, results considerably diminished with consequent advantage for them.
Assuntos
Colecistectomia Laparoscópica , Colecistite/cirurgia , Doença Aguda , Fatores Etários , Idoso , Colecistectomia , Colecistite/diagnóstico , Estudos de Avaliação como Assunto , Humanos , LaparotomiaRESUMO
The authors report their experience concerning the outpatient echo Doppler mapping of peripheral venous circulation in the lower limbs. Out of a total of 240 patients examined, 190 showed monolateral venous insufficiency and 50 bilateral. These results were correlated to the age of the patients and showed that saphenous pathology tended to affect the entire vein in elderly patients, whereas only partial damage was observed in young patients. Varices seemed to appear with the first signs of the insufficiency of collateral veins before signs of saphenous insufficiency became manifest.
Assuntos
Ultrassonografia Doppler , Varizes/classificação , Varizes/diagnóstico por imagem , Adolescente , Adulto , Idoso , Hemodinâmica , Humanos , Pessoa de Meia-Idade , Varizes/fisiopatologiaRESUMO
Laparoscopic deroofing of the solitary non parasitic cysts of the liver is a safe and effective procedure. This technique allows a wide access for surgical treatment of cysts localized in segments II, III, IVb, V, and VIII of the liver. On the contrary, the posterior segments, VI and VII, and the segment IVa, are difficult to approach laparoscopically. This report describes a laparoscopic technique used in treating 3 cases of symptomatic solitary cysts of the posterior segments of the liver. The patients were placed in the left lateral position. The fenestration treatment was easy and the mobilization of the right hepatic lobe was not required. At one year follow-up, neither postoperative complications nor recurring episodes were observed.
Assuntos
Cistos/cirurgia , Laparoscopia/métodos , Hepatopatias/cirurgia , HumanosRESUMO
The authors describe two cases of recent observed internal-hernia, regarding in the first case the right para-duodenal dimple, and in the second a mesenteric breach. They report the clinic presentation and the diagnostic and therapeutic approach compared with the data deriving from the international literature. A complete clinical classification of the internal-hernia is illustrated showing the different clinical signs. The respective symptomatology that in the initial phases of this pathology is not too evident, shows that the internal hernia should always be held in due consideration at the moment of diagnosis because the consequent mortality due to complications such as intestinal-gangrene is rather high.
Assuntos
Enteropatias , Mesentério , Idoso , Diagnóstico Diferencial , Hérnia/diagnóstico , Herniorrafia , Humanos , Enteropatias/diagnóstico , Enteropatias/cirurgia , Masculino , Pessoa de Meia-Idade , Doenças Peritoneais/diagnóstico , Doenças Peritoneais/cirurgia , PrognósticoRESUMO
The authors discuss their experience of six cases of cancer of the gastric stump observed by them in the period from 1988 to 1992 inclusive. All the patients were operated; five total gastrectomies and a gastric re-resection were effected. In association also the spleen was removed in four patients, in one of them a hepatic metastasectomy and a distal pancreasectomy were effected. In the discussion the problems concerning the diagnostic and therapeutic implications with some references to the more likely etiopathogenetic theories were dealt with.
Assuntos
Adenocarcinoma/cirurgia , Complicações Pós-Operatórias , Neoplasias Gástricas/cirurgia , Estômago/cirurgia , Adenocarcinoma/etiologia , Adenocarcinoma/secundário , Idoso , Idoso de 80 Anos ou mais , Seguimentos , Gastrectomia , Humanos , Neoplasias Hepáticas/secundário , Neoplasias Hepáticas/cirurgia , Masculino , Pessoa de Meia-Idade , Pancreatectomia , Neoplasias Gástricas/etiologia , Fatores de TempoRESUMO
Meckel's diverticulum is a pathology not rarely found everyday clinical medicine especially when it present with one of its complications. The specific diagnosis is a bit difficult to put because of the low sensibility and specificity of symptoms of diagnostic and instrumental techniques used. The reported case shows a rare type of complication constituted by the phlogosis of Meckel's diverticulum, itself due to an extraneous thing ingested by the patient. The authors discuss the entity of the manifestations of this pathology and highlight every aspects.
Assuntos
Doenças do Íleo/cirurgia , Perfuração Intestinal/cirurgia , Divertículo Ileal/complicações , Doença Aguda , Apendicectomia , Apendicite/diagnóstico , Criança , Diagnóstico Diferencial , Diverticulite/complicações , Diverticulite/etiologia , Diverticulite/cirurgia , Feminino , Corpos Estranhos/complicações , Corpos Estranhos/diagnóstico , Humanos , Doenças do Íleo/diagnóstico , Doenças do Íleo/etiologia , Perfuração Intestinal/diagnóstico , Perfuração Intestinal/etiologia , Divertículo Ileal/diagnóstico , Divertículo Ileal/cirurgiaRESUMO
The authors describe a case of giant vesical calculus in an 89 year old patient. The diagnosis, as in the other cases reported in the international literature, was made after a series of laboratory and instrumental exams, for groups reported by the patient in the lower abdomen. Operated for the removal of the vesical calculus, he was considered healed after a fortnight. The vesical calculus has a mixed composition and it weighs about 380 grams. The revision of the literature shows the various chemical composition of the vesical calculus that does not permit to identify a common aetiology. It is not possible to demonstrate if the formation of this kind of calculus is primary (in the urinary bladder) or if it is proper of the high urinary tract or mixed. The most recurrent causes being various and different confirm the mixed aetiopathologic theory. The diagnosis, often casual, is made thanks to the most common diagnostic exams; as it is difficult to make a complete cystoscopic control because the bladder is almost completely occupied by the lithiasic formation. The surgical therapy consists of a epicystotomy with a following removal of the calculus. In literature, moreover, cases treated with extra-body lithotripsy are not reported, on the contrary ot happens daily for the lithiasis of the high urinary tract.
Assuntos
Cálculos da Bexiga Urinária , Idoso , Idoso de 80 Anos ou mais , Humanos , Masculino , Cálculos da Bexiga Urinária/patologia , Cálculos da Bexiga Urinária/cirurgiaRESUMO
Peritoneal mesothelioma is a quite rare tumor with an incidence of one or two cases per million inhabitants; approximately in the 30-45% of the cases diagnosed it is associated with the corresponding pleural mesothelioma. A predisposing factor is a previous occupational exposure to materials containing asbestos. Clinical symptomatology and instrumental findings may be confusing. Diagnosis is often possible only after direct vision and histologic examination during laparoscopy or laparotomy but it is always tardy, whereas therapy is still unsuccessful. Surgical excision and radiotherapy are less effective than intraperitoneal chemotherapy which seems to lengthen the average survival rate.
Assuntos
Mesotelioma , Neoplasias Peritoneais , Diagnóstico Diferencial , Humanos , Masculino , Mesotelioma/diagnóstico , Mesotelioma/patologia , Pessoa de Meia-Idade , Neoplasias Peritoneais/diagnóstico , Neoplasias Peritoneais/patologia , Peritônio/patologiaRESUMO
The Authors report three cases of epidermoidal carcinoma arising from a congenital cyst of the anterolateral region of the neck. This type of tumor, rarely found in daily practice, arises from a degenerate branchial tissue and differential diagnosis often includes nodal involvement from systemic neoplasias. However, diagnostic criteria of such diseases are well defined; furthermore the rarity of branchial carcinoma is opposed to the high frequency of metastatic lymph nodes deriving from tumors with similar histological aspects located in other sites which could alter the real percentage of branchial tumor manifestation.