ABSTRACT
Meckel's diverticulum (MD) is the most frequent congenital abnormality of the small bowel and it is often difficult to diagnose. The authors report a case of a patient with long-term symptoms erroneously not related with MD disease and developing a diverticulum perforation.
Subject(s)
Meckel Diverticulum/diagnosis , Abdomen, Acute/etiology , Adolescent , Dehydration/etiology , Humans , Intestinal Perforation/diagnosis , Intestinal Perforation/etiology , Intestinal Perforation/surgery , Male , Meckel Diverticulum/surgery , Nausea/etiology , Peptic Ulcer Perforation/diagnosis , Peptic Ulcer Perforation/etiology , Peptic Ulcer Perforation/surgery , Vomiting/etiologySubject(s)
Adenocarcinoma/mortality , Intestinal Neoplasms/mortality , Intestine, Small , Adult , Aged , Female , Humans , Male , Middle Aged , Prognosis , Retrospective Studies , Survival RateABSTRACT
During the last years operators implanting totally implantable venous access devices (TIVADs), type of access, and kind of complications are changed. Aim of this work is to evaluate the incidence of early complications during the learning curve of residents in surgery or inexperienced surgeons, besides considering the tutoring to evaluate its rule to prevent early complications. TIVADs, implanted by residents in surgery or by inexperienced surgeons in the Department of Surgical Science Organ Transplantation and Advanced Technologies of University of Catania from January 1995 to October 2003, have been considered for the present study. Age and sex of the patients, indication, type of surgical access and early complications of the TIVADs have been considered. Early complications are those complications that occur within 30 day after the implant. Ninety-five TIVADs were implanted by surgical approach in 95 patients: 58 males (61%) and 37 females (39%), with a mean age of 55 years (range 31-79). Inexperienced surgeons performed 40 implants (42%) instead resident in surgery implanted 55 TIVADs (58%). The migration out of the vein of a catheter 20 days after the operation was the only complication recorded. TIVADs implant by cut-down technique represent the way to avoid early complications. The learning curve is short and the tutoring is limited at the first phase.
Subject(s)
Catheterization, Central Venous/adverse effects , Catheters, Indwelling/adverse effects , Clinical Competence , Infusion Pumps, Implantable/adverse effects , Learning , Postoperative Complications/etiology , Vascular Surgical Procedures/education , Adult , Aged , Female , Humans , Male , Middle AgedABSTRACT
Totally implantable venous access devices (TIVADs) are more and more used in oncologic patients. Early and late complications frequently occur with the techniques of implantation. Thrombosis is the most important and common late complication. On the opposite stenosis of the vessel is not frequently reported. The Authors report the case of a patient with subclavian vein stenosis after implantation of a TIVAD by percutaneous technique. On the basis of the published knowledges they try to explain this phenomenon and suggest an hypothesis for future works.
