293 research outputs found
LONG TERM SUCCESS OF ENDOVASCULAR TREATMENT OF BENIGN SUPERIOR VENA CAVA OCCLUSION WITH CHYLOTHORAX AND CHYLOPERICARDIUM
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Traumatic complete transsection of the left hepatic duct: Another approach to repair
No full textI.F.= 0.51
Rare surgical complications of Crohn's disease. Clinical and therapeutic considerations.
No full textWe present our clinical experience in the management of rare surgical
complications in Crohn's disease. Two hundred and eight patients affected by
Crohn's disease were treated surgically between January 1992 and September 2001,
at the Department of Surgical and Gastroenterological Sciences of the University
of Padua. Rare surgical complications were identified in 17 patients (6.2%): 4
with small intestine adenocarcinoma, 5 with massive gastrointestinal bleeding, 5
with free peritoneal perforation and 3 with psoas abscesses. The very substantial
clinical variability of Crohn's disease is a constant challenge to researchers.
In particular, the high incidence of associated pathologies and complications
related to Crohn's disease makes this pathology extremely disabling. In addition,
this disease quite often appears to occur together with a rare complication
which, though in most cases its course tends to remain unknown, at times may be
potentially life-threatening. For this reason, it is crucial to suspect the
occurrence of these pathologies, especially in patients responding poorly to
therapy or in those whose symptoms suddenly become acute. Early diagnosis and
treatment are therefore fundamental for the most appropriate treatment to be
administered
True solitary pancreatic cyst in an adult: report of a case.
No full textThe differential diagnosis of cystic neoformations in the pancreas is challenging. We report a case of a true solitary cyst of the pancreas in a 26-year old woman. Abdominal magnetic resonance imaging and computed tomography showed a unilocular neoformation in the head of the pancreas, without obstruction of Wirsung's duct. We excised the cyst and performed Roux-en-Y loop pancreaticojejunostomy, but the patient suffered recurrent acute pancreatitis from Wirsung's duct stenosis. Thus, a new Roux-en-Y loop pancreaticojejunostomy was successfully done 6 months later. Histologically, the cyst was lined by cuboidal epithelium, immunohistochemically positive to anti-carbohydrate antigen 19-9 antibodies. To our knowledge, only 11 cases of solitary true cyst of the pancreas in adults have been reported, so the characteristics of this unusual entity are not well known. We propose a scheme for the differential diagnosis of cystic neoformations of the pancreas, starting from the histopathological definition of a true solitary cyst
A rare surgical complication of Crohn's diseases: free peritoneal perforation
No full textBACKGROUND: Free peritoneal perforation is a rare complication of Crohn's
disease.
METHODS: We evaluated the incidence of free peritoneal perforation among 208
patients with Crohn's disease surgically treated in the period 1992-2000.
RESULTS: Five patients (2.4%) suffered from free peritoneal perforation. In 1
patient free peritoneal perforation was the first symptom of Crohn's disease. In
3 cases the perforation was in the small bowel and in 2 in the large bowel. All
patients underwent surgery: all cases had a resection of the involved bowel and
in two cases an ileostomy was performed in order to prevent severe peritonitis.
We did not observed mortality or major complications.
CONCLUSIONS: Free peritoneal perforation is rare with about 100 cases reported in
literature. No correlation seems to exist with previous corticosteroid treatment.
The surgical treatment is mandatory. Simple suture should be avoided. The most
appropriate treatment, whenever it is feasible, is resection of the involved
bowel with immediate or, in case of severe sepsis, delayed anastomosis
Cystadenoma and laparoscopic surgery for hepatic cystic disease: a need for laparotomy?
No full textBACKGROUND:
This study aimed to evaluate the incidence of cystadenoma diagnosis in a series of laparoscopic treatments for nonparasitic liver cysts, as well as its management.
METHODS:
From 1996 to 2004, 26 patients with a nonparasitic cyst of the liver were selected for laparoscopic liver surgery. Solitary nonparasitic liver cysts were, whenever feasible, completely enucleated.
RESULTS:
In four patients, the histopathologic examination showed a cystadenoma. Three patients with 13, 9, and 12-cm cysts, respectively, had undergone complete enucleation of the lesion, with no evidence of recurrence in the follow-up visit. One patient with multicystic liver experienced a recurrence and required an open hepatic resection.
CONCLUSIONS:
When a complete laparoscopic enucleation of the cyst can be ensured, a strict follow-up assessment should be considered as the definitive treatment, with surgical intervention demanded only in the case of recurrence or high suspicion for malignancy
Novel Compliant Scaffold with Specific Design for Venous System: Results of a Porcine Model Study
No full textBackground. Stenting has become the first-line treatment of obstructive venous disease because of poor results of balloon angioplasty. This preclinical study aimed to investigate the safety and efficacy profile of a novel compliant venous scaffold (CVS) denominated Petalo CVS, specifically designed for venous diseases. Materials and Methods. Twelve healthy pigs weighing 90 kg were used to test Petalo CVS. The devices were implanted into the internal jugular veins (IJVs) using a femoral vein percutaneous approach. The safety profile including the success rate of device releasing, anchoring, and positioning was evaluated immediately. Fracture, migration, primary patency, and endothelial response were assessed at 1, 2, 3, and 6 months after the study procedure. Results. A total of 32 devices were successfully released in both IJVs. No procedure- or device-related complications were reported, and all pigs successfully completed the different scheduled follow-up periods. The primary patency rate was 100%, and no fracture or migration of the device into the brachiocephalic trunk was reported. Histological examination revealed only minimal lesions with minimal or absent inflammatory reaction surrounding the incorporated metallic rods. Conclusions. This porcine model study showed a promising safety and efficacy profile of Petalo CVS, a novel endovenous device based on specific concepts.</jats:p
Blunt liver injury: from non-operative management to liver transplantation
No full textI.F.= 0.511
Abstract: Therapeutic options for blunt hepatic trauma include both non-operative and operative management. We have reviewed our experience of the management of blunt hepatic trauma, from non-operative to liver transplantation. A total of 72 patients with blunt hepatic injury observed at the first surgical unit of Padua in a 3-year period (1998-2000) were analysed; we also included a patient who had a liver transplant in 1993 for severe liver trauma. Twenty-nine patients (39.7%) were treated conservatively, with a 93% success rate; 60.3% were treated surgically. Suture hepatorraphy was the most common procedure performed (52.3%). Advantages of non-operative management in our experience were the reduced need for transfusion (1.1 U versus 4.3 U) with 92% of patients not needing transfusion, and a reduced stay in the intensive care unit; there was no liver-related mortality. The overall morbidity in surgical patients was 30%, with 16% liver-related complications. Twelve surgical patients (27.2%) died, with a liver-related mortality of 18.2%. A large number of patients may present with an associated endo-abdominal injury, even in low-grade liver trauma, requiring rapid laparotomy. In high-grade hepatic trauma, the evolution toward liver failure is an indication for liver transplantation. (C) 2002 Elsevier Science Ltd. All rights reserve
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