ABSTRACT
After a review of first two causes of bisalbuminemia: genetic mutation and overdosage during antibiotherapy with beta-lactamines, the authors underline the importance of searching for a bisalbuminemia during the course of pancreatic disease or when confronted with a serous collection, particularly an ascite of undetermined origin. Effectively, the finding of a bisalbuminemia in these two circumstances, after having eliminated the first two etiologies, permits the confirmation of the diagnostic of a pancreatic fistula. This diagnostic should imply exploratory surgery, even without other confirmation, and a per-op. wirsungography if the fistula is not visible macroscopically. The surgical correction of the fistula cures the patient and the bisalbuminemia disappears in several hours.
Subject(s)
Blood Protein Disorders/etiology , Pancreatic Fistula/complications , Serum Albumin , Adult , Anti-Bacterial Agents/adverse effects , Blood Protein Disorders/chemically induced , Blood Protein Disorders/congenital , Humans , Male , Pancreatic Ducts/diagnostic imaging , Pancreatic Fistula/diagnostic imaging , Pancreatic Fistula/surgery , RadiographyABSTRACT
A 48-year-old man, operated upon with a diagnosis of perforation of a hollow viscus, in whom a spontaneous perforation of the rectum was discovered. Such perforations are rare since only 36 cases have been reported in the literature. The mechanism is unknown and various factors have been suggested, including increased pressure or local ischaemia. Treatment is rendered difficult by local infection and the frequently fragile general condition of the patients.
Subject(s)
Intestinal Perforation , Rectal Diseases , Humans , Intestinal Perforation/diagnosis , Intestinal Perforation/etiology , Intestinal Perforation/surgery , Male , Middle Aged , Rectal Diseases/diagnosis , Rectal Diseases/etiology , Rectal Diseases/surgery , Rupture, SpontaneousSubject(s)
Heart Block/etiology , Myocardial Infarction/etiology , Thoracic Injuries/complications , Cardiac Tamponade/complications , Cardiac Tamponade/etiology , Female , Heart Block/physiopathology , Hemodynamics , Humans , Middle Aged , Myocardial Infarction/physiopathology , Shock, Cardiogenic/etiologyABSTRACT
The authors present the results of therapy in 26 cases of fungal septicemia occurring in a 2,471 patients population with 169 septicemia, over a 9 year period in a surgical intensive care service. An analysis of the etiology, clinical and paraclinical factors confirms the notions classically described in the literature. Three points are particularly insisted upon: 1) The effectiveness of preventive measures; 2) The monitoring of the therapy and its tolerance by means of a simple protocol; 3) The eventual possibility of an haematologic toxicity by flucytosine, the primary and secondary resistances to this anti-fungal agent. The strict application of preventive measures seems to reduce the incidence of fungal septicemia but not to eradicate them. The prognosis of these states remains grave.
