ABSTRACT
A case of full-thickness necrosis of the small bowel, and colon, which required partial resection of the jejunum and total resection of the ileum and colon is reported. The case gives the chance for a review of the Literature on intestinal necrosis not caused by vascular occlusion. Nonocclusive intestinal ischemia, acute neonatal necrotizing enterocolitis and adult necrotizing enterocolitis including the Pig-bel disease, common in Papua-New Guinea, are examined. Resemblances and differences in etiology, pathophysiology and clinical findings are discussed. The hypothesis that the process of "bacterial translocation" plays a central role in the pathogenesis of bowel infarction, representing therefore a possible link between infective and vascular mechanisms, is emphasized. Important suggestions on massive intestinal necrosis management are also reported.
Subject(s)
Enterocolitis, Pseudomembranous/diagnosis , Infarction/diagnosis , Intestines/blood supply , Acute Disease , Aged , Combined Modality Therapy , Enterocolitis, Pseudomembranous/classification , Enterocolitis, Pseudomembranous/surgery , Female , Humans , Infarction/classification , Infarction/surgery , Intestines/surgeryABSTRACT
Sixty consecutive cases of tumor of the right colon operated upon between 1981 and 1991 are reviewed. Age and sex distribution, clinical findings, preoperative diagnostics and system used staging, TNM classification, surgical management, operative mortality, follow up and survival were analyzed. Results are discussed and compared with published data. In the second of the two 5-year period considered an increased incidence of right-sided carcinoma compared with tumors of the left colon and rectum was observed. According to the TNM classification, more than 50% of patients were in stage III. Operative mortality was 5%. The overall 5-year survival rate was 58%, while the survival rate of patients treated with radical intent was 70%.
Subject(s)
Carcinoma/epidemiology , Colonic Neoplasms/epidemiology , Adult , Age Factors , Aged , Aged, 80 and over , Carcinoma/diagnosis , Carcinoma/mortality , Carcinoma/surgery , Colonic Neoplasms/diagnosis , Colonic Neoplasms/mortality , Colonic Neoplasms/surgery , Female , Follow-Up Studies , Humans , Italy/epidemiology , Male , Middle Aged , Sex Factors , Survival AnalysisSubject(s)
Colon/pathology , Hemorrhage/complications , Pancreatitis/complications , Acute Disease , Colectomy , Female , Hemorrhage/pathology , Hemorrhage/surgery , Humans , Middle Aged , Necrosis/etiology , Necrosis/pathology , Necrosis/surgery , Pancreatectomy , Pancreatitis/pathology , Pancreatitis/surgery , Postoperative Complications/etiology , Postoperative Complications/pathology , Postoperative Complications/surgery , ReoperationABSTRACT
Personal experience in an enterostomy centre over a 5-year period is report. The problems deriving from the presence of a stoma are examined with particular emphasis on surgical complications which are grouped into early and late forms.
Subject(s)
Enterostomy/adverse effects , Adult , Aged , Aged, 80 and over , Enterostomy/psychology , Female , Humans , Male , Middle Aged , Reoperation , Time FactorsABSTRACT
The Authors report a case of coeliac axis atheromatous obstruction, with superior mesenteric artery steal. The coeliac axis, stopped up the origin was indirectly revascularized by hepatic artery. The early diagnosis of chronic intestinal ischaemia should avoid the intestinal infarction. The development of intravenous digital angiography will certainly help an early diagnosis.
Subject(s)
Arteriosclerosis/diagnosis , Celiac Artery , Intestines/blood supply , Ischemia/etiology , Mesenteric Arteries , Abdomen, Acute/diagnosis , Abdomen, Acute/etiology , Aorta, Abdominal/surgery , Arteriosclerosis/complications , Arteriosclerosis/surgery , Hepatic Artery/surgery , Humans , Ischemia/diagnosis , Male , Middle AgedABSTRACT
34 patients admitted for suspected acute cholecystitis were evaluated using 99mTc IDA cholescintigraphy. The results of these studies are reviewed and compared with other diagnostic tests and the subsequent clinical diagnosis. Cholescintigraphy proved to be a safe, simple, highly accurate and sensitive technique. Therefore, 99mTc-IDA cholescintigraphy is proposed as the initial procedure of choice in the evaluation of patients with suspected acute cholecystitis.
Subject(s)
Cholecystitis/diagnostic imaging , Imino Acids , Organotechnetium Compounds , Acute Disease , Adult , Aged , Aged, 80 and over , Cholecystitis/diagnosis , Diagnosis, Differential , Evaluation Studies as Topic , False Negative Reactions , Female , Humans , Male , Middle Aged , Radionuclide ImagingABSTRACT
A case of emergency revascularisation of the hepatic artery for liver necrosis following its forced ligature during corpo-caudal pancreatectomy for cancer of the pancreas in referred. Necrosis protection mechanisms, namely higher portal flow, increase in O2 extraction and collateral circulation are analysed. The therapeutic aids for preventing this serious event are presented. It is considered that peripheral expansion of the hepatic artery thrombosis prevented the installation of a valid collateral circulation, although the hypothesis of a reduction in portal flow should not be ignored.