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2.
Respiration ; 64(5): 367-70, 1997.
Article in English | MEDLINE | ID: mdl-9311054

ABSTRACT

Pulmonary arteriovenous fistula (PAVF) is an abnormal connection between pulmonary arteries and veins. Patients with PAVF may have the Rendu-Osler-Weber syndrome, a disease transmitted by autosomal dominant mechanisms. Here we describe a case of PAVF in a 56-year-old woman, who was admitted to our department because of dyspnea, hemoptysis, and a mass in the left lower lung found on chest X-ray. The diagnosis of PAVF was suspected according to clinical and physiological criteria and confirmed by magnetic resonance imaging of the chest. The PAVF was removed by left lower lobectomy. Anamnestic and clinical investigations of the patient's relatives led to the diagnosis of the Rendu-Osler-Weber syndrome.


Subject(s)
Arteriovenous Fistula/diagnosis , Pulmonary Artery/abnormalities , Telangiectasia, Hereditary Hemorrhagic/diagnosis , Adult , Aged , Arteriovenous Fistula/complications , Arteriovenous Fistula/genetics , Arteriovenous Fistula/surgery , Blood Gas Analysis , Female , Humans , Magnetic Resonance Angiography , Male , Middle Aged , Pedigree , Pneumonectomy , Syndrome , Telangiectasia, Hereditary Hemorrhagic/complications , Telangiectasia, Hereditary Hemorrhagic/genetics
3.
Arch Otolaryngol Head Neck Surg ; 122(12): 1326-9, 1996 Dec.
Article in English | MEDLINE | ID: mdl-8956744

ABSTRACT

OBJECTIVE: To outline the most appropriate treatment of descending necrotizing mediastinitis. DESIGN: Case series. SETTING: General community, institutional practice, hospitalized care. PATIENTS: Five consecutive cases of descending necrotizing mediastinitis that were treated at our institution from 1983 to 1995. Selection criteria included clinical manifestations of severe cervical infection, characteristic radiographic features, documentation of the mediastinal infection at operation, and establishment of the relationship of the oropharingeal infection with the mediastinal process. Cases of mediastinitis due to perforation of the cervical esophagus were excluded. A cervicothoracic computed tomographic scan was obtained in the last 4 patients on admission. In the first case, computed tomographic scanning was not yet available at our institution. INTERVENTIONS: All patients underwent drainage of the cervical infection through a cervical incision. Mediastinitis was drained by thoracotomy in 2 patients, since the lower mediastinum was involved, whereas 3 patients underwent cervicomediastinal drainage alone. Tracheostomy was performed in 2 patients. RESULTS: All patients survived, with a short hospital stay (mean, 35 days). CONCLUSIONS: Cervicomediastinal drainage is adequate when the descending mediastinitis is limited to the upper mediastinum. Thoracotomy has to be performed only when the process has diffusely spread below the carina. Early diagnosis is crucial, and we strongly recommend a cervicothoracic computed tomographic scan in every patient with deep cervical infection. We consider tracheostomy not always necessary. Adequate early drainage, with the cervical wounds left open, and antibiotic and anti-inflammatory therapy should prevent upper airway obstruction.


Subject(s)
Drainage , Mediastinitis/surgery , Tracheostomy , Adult , Aged , Humans , Male , Mediastinitis/etiology , Mediastinitis/pathology , Middle Aged , Neck , Necrosis , Retrospective Studies
4.
Minerva Chir ; 51(12): 1049-55, 1996 Dec.
Article in Italian | MEDLINE | ID: mdl-9064573

ABSTRACT

The authors report their experience of 21 cases of post-traumatic hernias of the diaphragm. On the basis of the results obtained by discussion of etiologic, diagnostic and therapeutic patterns they make at the conclusion that the high mortality, associated with diaphragmatic hernias, can be reduced only with a short time of diagnosis and a prompt surgical treatment of the associated lesions.


Subject(s)
Hernia, Diaphragmatic, Traumatic/surgery , Accidents, Occupational , Accidents, Traffic , Adult , Aged , Hernia, Diaphragmatic, Traumatic/diagnosis , Hernia, Diaphragmatic, Traumatic/etiology , Humans , Middle Aged , Time Factors , Wounds, Gunshot/complications
8.
Minerva Chir ; 49(12): 1335-41, 1994 Dec.
Article in Italian | MEDLINE | ID: mdl-7746458

ABSTRACT

Congenital cysts of the choledochus and of the glandulae mucosae biliosae are rare anomalies generally observed in pediatric age: it is in fact exceptional to detect them in adults. There seems also to be a difference in the occurrence among the various races since the disease is more frequently seen in the Japanese and in women. In the Western world the incidence of this pathology has rated to be 1 out of 26,000 hospitalizations, consequently the personal experience and familiarity of every surgeon with this disease will be naturally limited. The authors describe the case of a women, aged 21, under observation as carrier of cystoduodenostomy after congenital cyst of the choledochus. A calculosis of the common hepatic duct as well as the stenosis of the previous cystoduodenostomy are also discovered. The abscission of the cyst and the confection of a Roux's en Y loop hepaticojejunostomy with the separation of the previous gastrojejunostomy are then performed. According to the authors, the complete abscission of the cyst and the Roux hepaticojejunostomy should be considered the surgery of choice when the local situation and the patient's general condition allow it because this treatment reduces the occurrence of late postoperative accidents such as lithiasis and cholangitis and the possibility of malignant degeneration of the cyst. Two years after the operation, the patient is in excellent health conditions.


Subject(s)
Choledochal Cyst/diagnosis , Adult , Cholangiography , Cholangiopancreatography, Endoscopic Retrograde , Choledochal Cyst/surgery , Common Bile Duct/diagnostic imaging , Common Bile Duct/surgery , Female , Follow-Up Studies , Humans , Radionuclide Imaging
10.
Chir Ital ; 41(4-6): 192-206, 1989.
Article in Italian | MEDLINE | ID: mdl-2701739

ABSTRACT

The authors present a review of the cases of pleural mesothelioma diagnosed and treated in the Institute of Special Surgical Pathology of the University of Ancona. They confirm the causative role of asbestos in the aetiology of this disease and indicate that the surgical approach is the best diagnostic means available via open biopsy and that the only curative procedure is pleuropneumonectomy. Such surgery, however, is confined to patients properly studied according to the scheme proposed by Butchart, namely stage I patients in excellent physical condition.


Subject(s)
Mesothelioma/surgery , Occupational Diseases/surgery , Pleural Neoplasms/surgery , Aged , Asbestos/adverse effects , Biopsy , Clinical Protocols , Female , Humans , Male , Mesothelioma/diagnostic imaging , Mesothelioma/etiology , Mesothelioma/pathology , Middle Aged , Neoplasm Invasiveness , Occupational Diseases/diagnostic imaging , Occupational Diseases/etiology , Occupational Diseases/pathology , Pleural Neoplasms/diagnostic imaging , Pleural Neoplasms/etiology , Pleural Neoplasms/pathology , Radiography
11.
Chir Ital ; 40(2): 117-25, 1988 Apr.
Article in Italian | MEDLINE | ID: mdl-2844425

ABSTRACT

Taking as their starting point the observation of a pancreatic malignant endocrine neoplasm with mixed production of serotonin and pancreatic polypeptide, the authors go on to review the literature on the diagnosis and treatment of pancreatic apudomas. The possibility of performing an extempore intraoperative histological examination makes it possible to obtain a correct diagnosis of endocrine neoplasm and thus to proceed with surgery which could not be contemplated in adenocarcinomatous forms at an equivalent stage. Chemotherapy may then provide additional therapeutic possibilities, using specific markers for malignancies of the APUD system in order to detect possible recurrences.


Subject(s)
Adenoma, Islet Cell/metabolism , Apudoma/metabolism , Pancreatic Neoplasms/metabolism , Pancreatic Polypeptide/metabolism , Serotonin/metabolism , Adenoma, Islet Cell/pathology , Adenoma, Islet Cell/surgery , Aged , Apudoma/pathology , Apudoma/surgery , Female , Humans , Pancreatic Neoplasms/pathology , Pancreatic Neoplasms/surgery
12.
Chir Ital ; 39(1): 3-16, 1987 Feb.
Article in Italian | MEDLINE | ID: mdl-3607979

ABSTRACT

The authors considered a series of 13 patients undergone surgical operation for primary malignant lymphoma of digestive system, with gastric, gastro-jejunal, jejunal, ileal and colic localization. They examined diagnostic and therapeutic features and the follow-up data. According to literature, the authors remark the importance of roentgenology and endoscopy, that together with bioptic data may reach a definite and early diagnosis; an elective and wide surgical exeresis seems useful in early stages, showing a better prognosis and epithelial malignancies. IV stage patients, however, had a very poor survival; a quick management appears today the only factor affecting long-term results in these patients.


Subject(s)
Gastrointestinal Neoplasms , Lymphoma/surgery , Adult , Aged , Female , Gastrointestinal Neoplasms/diagnostic imaging , Gastrointestinal Neoplasms/pathology , Gastrointestinal Neoplasms/surgery , Humans , Lymphoma/diagnostic imaging , Lymphoma/pathology , Male , Middle Aged , Radiography
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