1,720,981 research outputs found
[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
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
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
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
Risk factors for nodal metastasis and recurrence among patients with papillary thyroid microcarcinoma: differences in clinical relevance between nonincidental and incidental tumors
No full textBACKGROUND:
Papillary microcarcinoma (PMC) is a subgroup of papillary thyroid carcinoma (PTC) measuring 1.0 cm or less in diameter. Herein we focused on the search for risk factors predicting nodal metastasis and recurrence in PMCs, analyzing differences in presentation, treatment, and prognosis between nonincidental and incidental tumors.
METHODS:
From January 1998 to May 2007, 149 patients had a diagnosis of PMC in our department. A cross-sectional study of 76 patients with nonincidental and 73 patients with incidental PMC was carried out. Demographic data, diagnostic results, tumor characteristics, risk assessment, surgical treatment, and postoperative and follow up results were evaluated.
RESULTS:
Cytology detected thyroid cancer and nodal involvement in nonincidental PMC. Mean tumor size was significantly larger in nonincidental PMC (7.5 vs. 4.2 mm), which was commonly found within a normal thyroid gland or Hashimoto's thyroiditis, while incidental PMC was associated with a multinodular goiter. TNM staging system showed a higher cancer stage (IVA) in nonincidental. At multivariate analysis, capsular invasion and a nonincidental diagnosis were the two independent factors significantly affecting nodal metastasis. All patients with nonincidental PMC underwent iodine-131 ablation therapy after surgery compared with 49 patients with incidental. Nodal metastasis at diagnosis was the only factor influencing recurrence which was found in three nonincidental cases: two in the lateral and one in the central neck compartments.
CONCLUSIONS:
Several PMCs presented with risk-free clinical courses. Some nonincidental tumors had a more aggressive behavior and a tendency to recurrence. In these cases, early detection and aggressive treatment are mandatory as for conventional PTC according to risk stratification and cancer stage
Ecographic evaluation of the vitality/fertility in the hepatic hydatidosis as indication for pericistectomy].
No full text[
. May-Jun;():
Authors:
Abstract
Hepatic hydatidosis is still now a frequently observed pathology and the total pericistectomy, for surgical difficulties, often request a subtotal pericistectomy with complications such as biliary fistula, haemorrhage and subphrenic abscesses. The Authors reconsidered their hepatic hydatidosis cases to evaluate the indication to the surgery that in their opinion, should have to consider first of all the functional state of the cysts. Infact, only the vital and the fertil ones, less frequent even if rarely found, should have indications to the surgery, because more likely complicated. The dead and steril ones, instead being asymptomatic, should go under periodic control, since destined to degeneration and calcification. Are also compared the pre-surgery data with the parasitologic exam, to evaluate ETG reliability to determine the functional state of the cyst. Twenty one cysts out of 76 were operated correctly because vital/fertile and in 19 of these the ultrasound indications were correct (90.5%). 55 didn't have indications to the surgery since dead/steril and for 51 (92.7%) the ultrasound indication was correct. So we can say that morphological ultrasound data permitted a correct surgery indication for 70 cyst's on their functional state (93.4% of total). In this way the post-operative complication were reduced of 5%. The Authors found morphologic and/or functional ultrasound error for 6 cysts (7.9%), and in only 3 cases (3.9%) the error were both morphological and functional Infact we believe that a ultrasound morphologic classification should have a functional corrispective for the surgical indication So only the unilocular and multivescicular cysts, vital and fertil one, should have indication to the surgery. On the contrary the solid ones should have an ultrasound follow up and treated by chemotherapy if necessary.
PMID: [PubMed - indexed for MEDLINE
UTILITA' DELL'ECO-COLOR-DOPPLER NELLA DIAGNOSI PREOPERATORIA DELLA PATOLOGIA NODULARE TIROIDEA
No full textArgomenti di laparoscopia in chirurgia generale. Colecistectomia: principi e appunti di tecnica chirurgica laparoscopica.
No full text- …
