169 research outputs found
ALTERAZIONI GENETICHE E CARCINOMA DEL GROSSO INTESTINO
No full textDuring the past few years molecular genetics has made rapid advances in the knowledge of the mechanisms involved in the pathogenesis of human malignancies. Development of large bowel carcinoma apppears to take place by stepwise accumulation of multiple genetic alterations during the progression form normal colon to adenoma to carcinoma. Two mechanisms are involved in the pathogenesis of human malignancies: oncogene activation and suppressor gene inactivation. Ras and myc oncogenes are the most studied: mutation of ras is found in 50% of colon cancers, overexpression of c-myc is found in 80% and inactivation of suppressor genes is noted in wave than 70% of tumors. Understanding these genetic factors and how they influence cellular function will have an important role on the diagnostic, prognostic and therapeutic management of patients with colon rectal carcinoma identifying high risk populations
Use of Comfeel Transparent Hydrocolloid Dressing in the management of postoperative wounds
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Sclerosing encapsulating peritonitis: a rare complication of peritoneal dialysis. A case report
No full textSclerosing encapsulating peritonitis is a typical, but at the same time, not so frequently observed complication of peritoneal dialysis. The aim of this article is to report on the authors' clinical and surgical experience with this disease. After a review of the international literature and a description of the typical clinical features of this disease, the authors describe a case of sclerosing encapsulated peritonitis observed in their surgical department, on its mode of onset (intestinal occlusion), clinical behaviour and surgical treatment. The treatment of the patient consisted in the removal of fibrous tissue, resection of a necrotic ileal loop and intestinal reconstruction by an end-to-end ileo-ileal anastomosis. From the technical point of view the result was good and resolution of the intestinal occlusion was obtained. Cardiocirculatory complications arose on 6th postoperative day were the cause of the patient's death. Sclerosing encapsulating peritonitis is a rare complication of peritoneal dialysis, but it should be borne in mind whenever a patient with a history of peritoneal dialysis reports episodes of abdominal pain, nausea and vomiting associated with weight loss. This kind of peritonitis may require surgical and non-surgical treatment, though laparotomy provides us with a reliable diagnosis and may be considered essential to resolve the intestinal obstruction
Case report of gastrointestinal localization of SARS-CoV-2 and open abdomen technique in an Italian emergency surgery department for gastrointestinal bleeding
No full textThis article aims to present the case of a man affected by SARS CoV-2 and to discuss the association between this manifestation, viral infection and Open Abodmen. A 52 years old Caucasian man, affected by SARS CoV-2 infection, was admitted to the Emergency department of Arcispedale Sant'Anna of Ferrara for epigastralgia followed by syncopal episode, vomiting and diarrhea with bloody stools. The next day the patient underwent colonoscopy, which detected an ulceration proximally to the ileocecal valve without active bleeding. Subsequently an initial non-operative management and two pharyngeal swabs negative, for another rectorrhagia and hypotensive episode, underwent emerging surgery and an Open Abdomen was performed. The patient was discharged in 12th post-surgery day without complications. The IHC analysis with anti-SARS-CoV-2 nucleocapsid-protein revealed the presence of viral protein expression in epithelial cell of ulcerated intestinal mucosa. In this case report, we showed the presence of viral inclusion in small intestinal wall after two negative pharyngeal swabs for SARS-CoV-2 RNA. We can also say that the largest amount of viral inclusions was in the tissue of ulceration of the last ileal loop. This case report showed that SARS-CoV-2 can be unseen also after clinical healing. It's probably can be expelled with stools and rectal swabs search for SARS-Cov-2 RNA after pharyngeal swabs could be mandatory for declare heled a patient. Moreover, damage control surgery and Open Abdomen as a surgical technique can be a valid alternative in case of uncertainty of the bleeding source and when a second surgical look is necessary
Ectasia vascolare gastrica antrale (GAVE o Watermelon Stomach): descrizione di un caso
No full textGastric antral vascular ectasia (GAVE), recently described in literature, is an important cause of gastric bleeding. A case of great gastrectasia with vascular ectasia in an elderly male patient is reported. The lesion was characterized by great linear and brush folds along the antrum and body of the stomach, Endoscopically, this folds seems like the watermelon streakings. It could be an acquired lesion probably linked to traumatism on gastric mucosa
IL LAVAGGIO PERITONEALE POSTOPERATORIO.RICHIAMI DI FISIOPATOLOGIA DEL PERITONEO E PRIMI RISULTATI SPERIMENTALI
No full textComparison Between Duplex Ultrasound and Multigate Quality Doppler Profile Software in the Assessment of Lower Limb Perforating Vein Direction
No full textOBJECTIVES:
The aim was to assess more accurately the net flow of the lower limb perforating veins (PVs).
MATERIAL AND METHODS:
This was an observational prospective study. Two hundred and twenty one limbs with chronic venous disease (C1-6EpAs,pPr) of 193 patients underwent a duplex ultrasound (DUS). All identified PVs were scanned also by means of quality Doppler profile (QDP) multigate analysis in order to determine their net inward and outward flow direction. A comparison between the traditional pulsed wave Doppler analysis and QDP was performed to detect potential discrepancy between the traditional definition of PV incompetence and a net outward flow.
RESULTS:
The DUS investigation identified 774 PVs. Only 7.7% of the PVs showed an outward flow lasting more than 500 ms. Among the PVs showing a longer than 500 ms outward flow, QDP assessment revealed net outward flow in only 84% of the PVs along the thigh and in 28.6% along the lower leg. Among the PVs showing a shorter than 500 ms outward flow, QDP assessment reported a net outward flow in 2.4% of the PVs along the thigh and in 47.3% of those along the lower leg. The sensitivity of an outward flow lasting more than 500 ms in detecting an actual net outward flow was 13.9% (9-20.1%). The specificity of an outward flow lasting less than 500 ms in detecting a net inward flow was 96.4% (93.2-98.3%).
CONCLUSIONS:
A lack of overlap exists between the finding of a PV outward flow lasting more than 500 ms and the net outward flow of the same vessel. The traditional definition of PV incompetence is challenged by the reported data and further investigations are required to identify a gold standard assessment
Segmental saphenous ablation for chronic venous disease treatment
No full textBackground: Endovenous thermal ablation for chronic venous disease treatment is recommended over traditional surgery. The present investigation compares endovenous laser ablation (EVLA) with radiofrequency (RF) for segmental endovenous sapheno–femoral junction ablation. Methods: This is a retrospective study in which 79 patients underwent a 6 cm great saphenous vein ablation by RF or by EVLA. Primary outcome was occlusion rate. Secondary outcomes included Venous Clinical Severity Score (VCSS), Aberdeen Varicose Vein Questionnaire (AVVQ) score, peri-procedural pain, aesthetic satisfaction. Results: At 12 ± 1 months recanalization of shrunk tract was recorded in 5/85 (5.8%) cases (2 RF, 3 EVLA) [OR: 1.6; 95%CI: 0.2–10.4; P = 0.6689]. Two cases (1/44 RF group and 1/38 EVLA group) also showed reflux recurrence [OR: 1.0; 95%CI: 0.06–17.8; P = 1.0000]. No significant differences between groups were found in AVVQ, VCSS, peri-procedural pain, or aesthetic satisfaction. Conclusion: Saphenous sparing is feasible and effective by means of both EVLA and RF, representing a possible alternative to surgery
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