ABSTRACT
116 cases of post-caustic esophageal stenosis hospitalized in the Emergency Surgical Clinic of Iasi during the period 1982-2004 have been analyzed. The patients' ages, the 4th decade of age (24.13%) prevailed. The alkaline substances prevailed (84.48%). Eight patients benefited from an endoscopic examination in the 15th day from the injury, and presented lesion degree 1-2 C. Progressive dysphagia, retrosternal pain and weight loss-symptoms were in all cases. The most of the patients (65.50%) came for a medical consultation within the first 6 months. The diagnosis and localizing the esophageal stenosis were based on the endoscopic examination and radiology. The single or double stenosis esophagus prevailed. The corrosive substances represent a frequent cause of benign esophageal stenosis.
Subject(s)
Burns, Chemical/complications , Burns, Chemical/diagnosis , Caustics/toxicity , Esophageal Stenosis/chemically induced , Esophageal Stenosis/diagnosis , Esophagus/injuries , Adult , Aged , Deglutition Disorders/etiology , Esophagoscopy/methods , Female , Humans , Male , Middle Aged , Retrospective Studies , Weight LossABSTRACT
The management of splenic injuries is still controversial, with an increasing trend toward non-operative treatment. The aim of this study was to assess for patients with splenic traumatic injuries, the treatment methods, the factors contributing in selecting appropriate management and the patients outcomes. Between 1994 and 2003, 77 patients were admitted and treated in our hospital for splenic traumatic injuries. There were 69 blunt (89.61%) and 8 penetrating injuries (10.38%). Nineteen patients were initially proposed for non-operative treatment, eventually only 5 patients (16.49%) were successfully treated (success rate 26.31%). Splenic conservation was used in 6 patients (7.79%; success rate 100%) and splenectomy on 66 patients (85.71%). Indications for laparotomy were: hemodynamic instability (35 patients), peritonitis (9 patients) and the presence of hemoperitoneum and splenic injury (22 patients). Overall mortality was 7.79%, with 4 deaths in splenectomy group and 2 deaths in proposed non-operative group. In conclusion, conservative treatment of splenic injuries can be performed with good results and an increasing number of patients can be treated in this way. For this purpose are necessary a perfect selection of the patients, a surgeon skilled in conservative splenic techniques and good techniques facilities.
Subject(s)
Spleen/injuries , Wounds, Nonpenetrating/therapy , Wounds, Penetrating/therapy , Adolescent , Adult , Aged , Aged, 80 and over , Female , Humans , Injury Severity Score , Male , Middle Aged , Retrospective Studies , Romania/epidemiology , Splenectomy , Survival Analysis , Treatment Outcome , Wounds, Nonpenetrating/mortality , Wounds, Nonpenetrating/surgery , Wounds, Penetrating/mortality , Wounds, Penetrating/surgeryABSTRACT
Hemangiomatosis of the liver is growing in the last decades, because of the abdominal imaging progresses: brain CT scan, MRI. In the presented case, the onset was with symptoms and biochemical disorders characteristic for acute viral hepatitis, with negative serological markers for the A and B hepatitis viruses. The persistence of the clinical symptoms and of the hepatic and biliary retention tests, determined the abdominal echography; which orient the diagnosis to vascular tumour with liver metastasis. Intraoperatively was found: diffuse hemangiomatosis of the liver. The patient didn't benefit from liver transplantation and died due to subfulminant hepatic failure.
