RÉSUMÉ
Percutaneous endoscopic gastrostomy is usually difficult in patients with malignant involvement of oral cavity, pharynx and esophagus. Flouroscopic guided insertion of Gastrostomy catheter with Gastropexy have gained acceptance because it is easy and less time consuming as well as less invasive as compare to surgical procedure[5]. This study was done to evaluate the safety and efficacy of percutaneous placement of gastrostomy with gastropexy using imaging guidance in patients with oropharyngeal and esophageal cancers. Over five years, 105 patients were referred to our department for percutaneous radiologic gastrostomy. In five patients the procedure was not performed because of overlying viscera and high position of stomach. We performed 100 gastrostomies with gastropexy procedures using seldinger technique. Success rate for percutaneous radiologic gastrostomy was 100%. No major complication had occurred. There were 11 minor complications occurred including 4 stomal infection, 3 catheter obstruction, one peritonism and three were extensive pneumoperitoneum. Stomal infection and catheter obstruction were not related to procedure. So, our true minor complications were only 4 [4%] which is comparable to literature. Percutaneous radiologic gastrostomy is an effective and safe procedure for enteric access of nutrition in patients with oral, pharyngeal and esophageal cancer where percutaneous endoscopic gastrostomy is difficult
Sujet(s)
Humains , Mâle , Femelle , Gastrostomie/effets indésirables , Radiologie interventionnelle , Tumeurs de l'oesophage , Tumeurs du pharynx , Tumeurs de la bouche , Complications postopératoiresRÉSUMÉ
To determine value of CT scan in diagnosis of acute pancreatitis, its complications and to correlate with severity among different age groups. The study was carried out from August 2001 to August 2002 at the Radiology Department, Aga Khan University Hospital. A total of 40 patients [33 male and 7 female] with age range from 16-71 years were divided in three groups. Group I was less than 40 years [12 patients], Group II was between 40-60 years [17 patients], and Group III was more than 60 years [11 patients]. CT scans were assessed for pancreatic necrosis and its complications. CT Severity Index [CTSI] was calculated according to Balthazar's method. In 17 patients with mild pancreatitis, 5 had necrosis involving one-third of pancreas. In 13 patients with severe pancreatitis, 8 had necrosis involving more than half of the pancreas and 5 had necrosis involving half of the pancreas. No significant correlation was demonstrated between moderate pancreatitis and degree of necrosis. Thirty patients had complications, 8 had mild CTSI, 9 had moderate CTSI and 13 patients had severe CTSI. The study demonstrated a relationship between CTSI and severity of pancreatic damage and incidence of complications
RÉSUMÉ
To determine value of CT scan in diagnosis of acute pancreatitis, its complications and to correlate with severity among different age groups. The study was carried out from August 2001 to August 2002 at the Radiology Department, Aga Khan University Hospital. A total of 40 patients [33 male and 7 female] with age range from 16-71 years were divided in three groups. Group I was less than 40 years [12 patients], Group II was between 40-60 years [17 patients], and Group III was more than 60 years [11 patients]. CT scans were assessed for pancreatic necrosis and its complications. CT Severity Index [CTSI] was calculated according to Balthazar's method. In 17 patients with mild pancreatitis, 5 had necrosis involving one-third of pancreas. In 13 patients with severe pancreatitis, 8 had necrosis involving more than half of the pancreas and 5 had necrosis involving half of the pancreas. No significant correlation was demonstrated between moderate pancreatitis and degree of necrosis. Thirty patients had complications, 8 had mild CTSI, 9 had moderate CTSI and 13 patients had severe CTSI. The study demonstrated a relationship between CTSI and severity of pancreatic damage and incidence of complications