351 research outputs found

    Rare surgical complications of Crohn's disease. Clinical and therapeutic considerations.

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    We 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.

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    The 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

    sj-vid-1-phl-10.1177_0268355518805686 - Supplemental material for A novel endovenous scaffold for the treatment of chronic venous obstruction in a porcine model: Histological and ultrastructural assessment

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    Supplemental material, sj-vid-1-phl-10.1177_0268355518805686 for A novel endovenous scaffold for the treatment of chronic venous obstruction in a porcine model: Histological and ultrastructural assessment by Paolo Zamboni, Alessia Giaquinta, Erika Rimondi, Massimo Pedriali, Eugenio Scanziani, Pietro Riccaboni, Massimiliano Veroux, Paola Secchiero and Pierfrancesco Veroux in Phlebology</p

    sj-vid-2-phl-10.1177_0268355518805686 - Supplemental material for A novel endovenous scaffold for the treatment of chronic venous obstruction in a porcine model: Histological and ultrastructural assessment

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    Supplemental material, sj-vid-2-phl-10.1177_0268355518805686 for A novel endovenous scaffold for the treatment of chronic venous obstruction in a porcine model: Histological and ultrastructural assessment by Paolo Zamboni, Alessia Giaquinta, Erika Rimondi, Massimo Pedriali, Eugenio Scanziani, Pietro Riccaboni, Massimiliano Veroux, Paola Secchiero and Pierfrancesco Veroux in Phlebology</p

    Novel Compliant Scaffold with Specific Design for Venous System: Results of a Porcine Model Study

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    Background. 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

    A rare surgical complication of Crohn's diseases: free peritoneal perforation

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    BACKGROUND: 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
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