1,721,006 research outputs found
Recurrent parastomal hernia and middle incisional hernia: surgical treatment through midline incision with wide prosthetic mesh [Ernia parastomale recidiva e laparocele mediano: trattamento chirurgico con ampia rete protesica per via mediana.]
No full textParastomal hernia is a frequent complication of stoma surgery. The results of parastomal hernia repair however are poor, showing an high incidence of postoperative recurrences. In the last years, hernia repair with prosthetic mesh has given better postoperative results. The parastomal hernia, however, is associated with middle incisional hernia. The authors review the problem of surgical repair of parastomal hernia and report a case of recurrent parastomal hernia associated to middle incisional hernia. The technique of surgical repair using, through midline incision, one, wide, prosthetic polypropylene mesh, in sublay position, according to Rives' technique, is described. The mesh has been incised in a trasverse direction for the stoma crossing. At 6 years follow-up the patient does not show postoperative recurrence. According literature and the authors' results, the parastomal hernia might be considered an incisional hernia and, therefore, a sing of diffuse abdominal wall disease. The Rives' surgical technique might be the gold standard for treatment of parastomal hernia, even if not associated to incisional hernia. The more complexity of Rives' technique compared to local fascial mesh repair is compensated by the result of total abdominal wall reinforcemen
Primary gastroduodenal tuberculous infection presenting as pyloric outlet obstruction
No full textAbstract
Gastroduodenal tuberculosis occurs in underdeveloped areas and, although rarely, also in western countries, affecting mainly immigrants, immunodepressed, or low socioeconomic classes. We report a case of gastroduodenal tuberculosis presenting as pyloric outlet obstruction. We describe the clinical features and the diagnostic approach to the patient, emphasizing the role played by surgery in the diagnosis and treatment of the established complication. Developments are needed in the diagnostic area (video-laparoscopy, polymerase chain reaction of mycobacterial DNA) and in the mini-invasive treatment of obstructive complications (endoscopic balloon dilatation, video-laparoscopic surgery)
Intestinal obstruction due to ischemic colitis: Description of 3 surgical cases [OCCLUSIONE INTESTINALE DA COLITE ISCHEMICA: DESCRIZIONE DI 3 CASI TRATTATI CHIRURGICAMENTE
No full textAbstract
The diagnosis of ischemic colitis is challenging and still based upon a high index of suspicion. We report here, three patients affected by ischemic colitis causing stenosis and intestinal obstruction who required surgical treatment. Results of surgery in the three cases were not fair reflecting the high mortality and morbidity rate of ischemic colitis. However, the three cases showed peculiar features allowing us to make a few speculative considerations. Better results in the treatment of ischemic colitis might be achieved by means of a prompt recognition of the initial picture and through a better control of the many associated diseases, that represent the main risk factor for the development of ischemic colitis itself and for the bad prognosis of surgical treatmen
Diagnosis and treatment of haemorrhoids in the elderly: Results from 291 patients
No full textAbstract
Haemorrhoids are believed to be rare in elderly patients, occurring mainly in young and middle-aged subjects. Symptoms of haemorrhoids in elderly patients, in addition, require a precise differential diagnosis in order to rule out neoplasia. In this paper we report our experience in dealing with haemorrhoidal disease in 291 patients older than 65 years. Symptoms of presentation were those commonly reported by younger patients. Accurate clinical examination, proctoscopy and flexible sigmoidoscopy allowed reaching a differential diagnosis in the majority of patients. Extensive colorectal diagnostic screening was required in 28.5% of patients due to the clinical presentation. Treatment was conservative in most cases, with 57.2% of the patients treated medically and 36.7% undergoing rubber band ligation (RBL). In this group of patients no complications occurred although several risk factors were present (e.g. anticoagulant medications, diabetes, cardiovascular diseases). A further 13% of the patients underwent surgery with no complications or mortality. Haemorrhoids in elderly patients occur with features similar to those of other ages and ambulatory treatment can be performed. In particular, RBL can be performed safely even in those patients presenting with associated illness
Oxyuriasis in acute appendicitis. Description of two cases and review of the literature [L'ossiuriasi nell'appendicite acuta. Descrizione di due casi e revisione della letteratura]
No full textAbstract
Two cases of oxyuriasis of the appendix observed out of 870 cases of acute appendicitis are presented. Our aim was to examine the incidence of such condition and to correlate personal experience with data from the current literature. In personal experience, the incidence of pinworm appendicitis is low (0.22%) in line with a generalized decrease of oxyuriasis infestation. Such data is even more significant if we take into account that it is observed in a rural area. Of course we can confirm the presence, although rarely, of the pin-worm in the appendix but whether or not the parasite is cause of a true acute appendicitis is still matter of debate. Symptoms of our patients and signs on physical examination were those of typical acute appendicitis. Finally, treatment of such cases could not be represented merely by appendectomy, but antihelminthic therapy should be instituted in order to eradicate the parasite from the intestine of the patient as well as from parents since reinfection is frequent
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
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