1,721,120 research outputs found
Tumori non resecabili della testa del pancreas e della regione periampollare: quale palliazione? Evoluzione negli ultimi 27 anni
No full textIl miglioramento delle metodiche per immagini nello studio del pancreas e delle regione periampollare non ha consentito un aumento del numero degli interventi ad intento radicale e l'introduzione di tecniche radiologiche ed endoscopiche di tipo interventistico hanno reso più ampia la scelta del tipo d'intervento palliativo. Gli Aurori ritengono che il drenaggio biliare esterno temporaneo non abbia alcuna influenza sull'incidenza delle complicanze postoperatorie e quindi possa essere abbandonato. L'epaticodigiunostomia e la colecistodigiunostomia, nei pazienti in peggiori condizioni generali, garantiscono la migliore palliazionedell'ittero. La gastrodigiunostomia è consigliabile quando esista l'evidenza di un'ostruzione duodenale in atto o nell'immediato futuro. Le metodiche di radiologia ed endoscopia interventistica sono indicate in quei pazienti, sicuramente non resecabili, che presentano un rischio chirurgico proibitivo ed una breve aspettativa di vit
[Obstructive jaundice caused by hepatocellular carcinoma].
No full textThe Authors take a hint from recent observation of two patients with
hepatocellular carcinoma presenting with obstructive jaundice to analyse the
litterature and their clinical cases. They conclude that in the evolution of
hepatocellular carcinoma can be found "early" or "late" jaundice. The latest is
hepatocellular and/or obstructive jaundice and it is harbinger of fatal prognosis
because of a big hepatocelluar carcinoma that has invaded biliary tree and/or
liver failure by concomitant cirrhosis. The "early" jaundice appears when the
tumor is still small and it is always obstructive due to intrabile duct tumor
growth. This kind of jaundice has a good prognostic meaning because, together
with imaging techniques, permits an early diagnosis of the hepatocellular
carcinoma necessary for satisfactory palliation or occasional cure
Agenesis of the gallbladder
No full textAgenesis of the gallbladder is a rare anomaly that is usually asymptomatic, but
sometimes the patients may have symptoms compatible with a biliary disorder like
cholelithiasis. Its preoperative diagnosis is often difficult, especially if
dysplastic cyst is associated and simulates the gallbladder. When the diagnosis
is doubtful its confirmation and treatment of dysplastic cyst require open
surgery, careful dissection of the common bile duct to avoid biliary lesions and
intraoperative ultrasonography or cholangiography to be performed to exclude
other associated anomalies. The Authors describe the case of agenesis of
gallbladder and dysplastic cyst associated and comment on its clinical,
diagnostic, and therapeutic aspects
Surgery of the obstructive complication of carcinoma of the left colon. The clinical problems and the authors' personal experience with 56 surgical cases
No full textA retrospective analysis was carried out on 56 pts., (37 M, 19 F), mean age 64 yrs., operated for moderate to severe obstruction due to left colon carcinoma. Clinical and pathological features, treatment and results were compared with those of 108 pts. with left colon cancer who underwent elective surgery. Mean duration of obstructive symptoms was 5.3 days and mean delay between admission and operation was 1.15 days. Site and nature of the obstruction were assessed pre-operatively in 80.3% of the pts. Distribution of tumor localization was similar in the two groups. ASA risk was statistically higher in pts. with obstruction. Staging according to the Astler-Coller (mod. 1978) classification, showed a greater incidence of more advanced stages in the obstructing tumors. In the group with obstruction a three stage surgery was carried out in 18 pts. (32.1%), a two stage in 6 (10.7%), a primary resection in 6 (10.7%) and a decompressive colostomy in 26 (46.5%). Radicality and resectability rates were 50% and 53.6% vs 69.4% and 82.4% in elective surgery. Mean post-operative stay was 42 and 21 days respectively in the two groups. Overall post-operative death rate was 19.6% vs 9.2%, and 3.3% vs 7.8% after resective surgery. Post-operative complications accounted for 21.4% vs 21.3%. 5-year survival rate after curative surgery was 47.8% vs 76.8%. On the basis of their results and on Literature reports the Authors suggest a reevaluation of a staged surgical treatment for obstructing left colon cancer based on primary decompression following an E.L. when needed. Consequent resection and intestinal reconstruction should be performed after 2-3 weeks.(ABSTRACT TRUNCATED AT 250 WORDS
Tumoral calcinosis: a case report.
No full textTumoral calcinosis is a rare tumour-like mass characterized by soft tissue
calcification of obscure aetiology. A case of tumoral calcinosis is presented
here, and its clinical, radiological and pathological features are described. The
differential diagnosis versus hydatid cyst is discussed. Diagnosis is possible
with imaging techniques but histopathological study is essential to establish it
with certainty. Complete surgical excision appears to be the only effective
treatme
Carotid body tumour. Case report and literature review
No full textThe tumour of the carotid body is rare. About 1000 cases had been reported in the literature. It may occur sporadically in 90% of cases and it affects both sexes in the same proportion and in the middle age. This tumour may be misdiagnosed if it is not suspected. Ultrasono-graphy and color-Doppler scan show a hypervascular tumour between the internal and external carotid arteries. CT-scan defines the tumour s extent on the surrounding structures. Angiography is the gold standard for diagnosis, showing a hypervascular mass displacing the bifurcation of the carotid arteries. Sometimes radiotherapy and embolization are indicated but the surgical excision of carotid body tumours is the therapy of choice. The surgical approach through incision like carotid artery operation is performed. If the subadventitial plane between tumour and arterial wall is not identified, resection of carotid artery and insertion of a shunt is required. Although the diagnosis and the surgical technique advances, the incidence of postoperative nerve injury is high in the different series. The clinical suspect and the early diagnosis are very important because low morbidity rate occurs with resection of a small chemodectoma. The surgical excision can be followed by postoperative respiratory depression or dyspnea both with regional and general anesthesia. The authors report a case of a medium size tumour operated on and developing a mild transient weakness of cranial nerve VII. Recent trends in evaluation and therapy are analysed and the literature is reviewed
Radical vs Conservative Treatment of Hydatid Liver Disease: The Reasons of our Current Surgical Guidelines.
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Diverticolite acuta e diverticolite perforata del colon: Strategia terapeutica in urgenza.
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