ABSTRACT
Esophageal fistulas in the cervical region are usually difficult to manage and carry a high morbidity. We report a case of an esophago-colonic fistula after colonic interposition, successfully managed with vacuum-assisted closure 'V.A.C. system', (Kinetic Concepts Inc., San Antonio, TX, USA). The patient initially presented with purulent fluid from the cervical wound 13 days after surgery. Esophagogram confirmed a leak. Since the patient had a history of anastomotic leaks, a surgical intervention was not the treatment of choice. In light of this, conservative treatment with V.A.C. system was initiated. She underwent full recovery.
ABSTRACT
The effects of lead (Pb) intoxication during pregnancy and lactation were studied in the hepatic system of pups and young Wistar rats to test the hypothesis that gestational and lactational lead exposure alters the normal function of the liver in neonates. Lead acetate (300 mg/L) dissolved in distilled water was administered ad libitum to mothers during gestation and lactation. At days 12 and 21 postnatal (PN), pups were sacrificed, blood was collected, and livers were removed. Blood lead (PbB) levels were also measured. Although, histological evaluation revealed neither abnormalities in the liver structure nor depositions of lead, the toxicant produced biochemical alterations. Lead-intoxicated pups exhibited a decrease in hemoglobin, iron, and alkaline and acid phosphatase levels and an increase in PbB content. Protein, DNA, and lipid total amounts were reduced, and hepatic glycogen content was diminished at days 12 and 21 PN, with a higher level of glucose in the blood. Lead administration also resulted in a decrease in alkaline phosphatase in the liver of pups at day 21 PN, but acid phosphatase was unaltered. The findings of this study support the hypothesis that lead intoxication of mothers in gestation and lactation results in alterations in the hepatic system in neonates and pups.
