Histopathological elements analyzed in dynamics in mechanical bowel obstructions - experimental study on laboratory animals.

Bowel obstruction is a syndrome that produces important alterations to the digestive tract, both macroscopically and microscopically. We conducted an experimental study using rats, Wistar strain, as subjects, dividing them into three groups. The group A consisted of six rats and served as control group, in the first day of the experiment a surgical procedure being performed to resect a small bowel and a colic segment to be analyzed microscopically afterwards. The 10 subjects from group B underwent a surgical procedure, in which we induced a mechanical bowel obstruction in the sigmoid colon, while to the 10 subjects from group C we induced a mechanical bowel obstruction in the small bowel. The initial protocol implied to observe the macroscopic modifications from five subjects from each group B and C after two days and afterwards to resect the digestive tract segment adjacent to the obstruction site. After another two days, a similar procedure was planned for the remaining subjects alive from both groups. A few subjects from group C died prematurely and the initial protocol had to be partially modified. The results highlighted an important distension of the digestive tract proximal to the obstruction, with important microscopically reactions, including edema, thrombosis, ischemic lesions and accumulation of polymorphonuclear neutrophils (PMN) and macrophages.

Traumatic Diaphragmatic Lesions - Considerations Over a Series of 15 Consecutive Cases.

Introduction: Diaphragmatic injuries are produced by blunt or penetrating thoracoabdominal trauma. They are potentially life-threatening due to the herniation of abdominal organs into the pleural cavities and severe associated lesions. The aim of this retrospective study was to analyse the clinical presentation and management of patients admitted with diaphragmatic rupture in our institution. Material and Method: We performed a 5-year retrospective study of patients admitted with acute blunt or penetrating diaphragmatic rupture in the Department of General Surgery of "Bagdasar- Arseni" Emergency Hospital. We have studied sex, age, mechanism of trauma, side-location, timeto-diagnosis, concomitant injuries, surgical treatment and outcome. Results: Fifteen patients (8 males, 7 females, mean age: 42 years) with diaphragmatic rupture (left-side: 13, right-side: 2) following blunt (8 patients) or penetrating (7) trauma were included. Patients with blunt diaphragmatic injury had larger tears and abdominal viscera herniation was observed in 6of these cases. A direct suture was performed for all 15 patients. Laparotomy was the surgical approach preferred in most of the cases. Mortality rate was 20%, mainly caused by severe associated lesions. Conclusion: Although traumatic diaphragmatic lesions are frequently associated with severe cerebral and thoraco-abdominal trauma that is also the main cause of death, a prompt diagnosis and treatment can lead to good outcome.