ABSTRACT
The purpose of this paper is to evaluate factors affecting the outcome of cholangitis after PTBD in jaundiced cancer patients. Twenty nine patients with neoplastic jaundice (male/female ratio 13/16, median age 55 years) with full clinical data, were treated by PTBD and developed cholangitis at a median of 9 days later. Four patients (14%) died of biliary sepsis a median of one month after PTBD while the other 25 survived a median of 6 months, with one week median duration of cholangitis. The probability of the cholangitis resolving was analyzed by time to resolution and it was found that 50% and 100% of the recoveries occurred 5 and 9 months respectively from the onset of the complication. The series was analyzed to determine the role of several variables (disease/patient/treatment related) in the resolution of cholangitis. Only a low stricture site, a large initial drainage catheter (10F) and a temperature increase exceeding 39 degrees C were correlated with a positive outcome. We conclude that PTBD-related cholangitis has, in our experience, a good chance of cure, low mortality rate and satisfactory 6 months median survival.
Subject(s)
Cholangitis/etiology , Cholestasis/etiology , Cholestasis/surgery , Drainage/methods , Liver Neoplasms/complications , Acute Disease , Adult , Aged , Bile/microbiology , Catheterization/instrumentation , Cholangitis/physiopathology , Cholestasis/pathology , Drainage/adverse effects , Drainage/instrumentation , Equipment Design , Female , Follow-Up Studies , Humans , Liver Neoplasms/secondary , Male , Middle Aged , Prognosis , Recurrence , Retrospective Studies , Treatment OutcomeABSTRACT
The growing importance of gastrointestinal interventional radiology has led to the development of new instruments and materials for the different proposed purposes. The authors present a set consisting of two coaxial catheters which was created for percutaneous transhepatic biliary drainage (Severini set). Its easy handling, adaptability and tolerability make it a versatile instrument in the hands of interventional radiologists for positioning large-calibre catheter (9-14 F) in deep sites. Hereafter are reported the results in 29 patients treated with different therapeutic aims and the use of the set for different pathologies. The catheters allowed a complete resolution of the collections communicating with the gastrointestinal tract in 4 of 5 patients. The catheter was inserted as a feeding tube in 22 patients. Finally, it was used as a gastrostomy catheter in 2 patients. Neither early nor late complications due to insertion or use of this set were observed.
Subject(s)
Catheterization , Digestive System/diagnostic imaging , Drainage/instrumentation , Enteral Nutrition/instrumentation , Gastrostomy/instrumentation , Radiography, Interventional , Adenocarcinoma/diagnostic imaging , Adenocarcinoma/surgery , Carcinoma/diagnostic imaging , Carcinoma/surgery , Esophageal Neoplasms/diagnostic imaging , Esophageal Neoplasms/surgery , Evaluation Studies as Topic , Humans , Pancreatic Neoplasms/diagnostic imaging , Pancreatic Neoplasms/surgeryABSTRACT
In the present series of 296 PTBDs in 281 patients, 103 complications of different degree developed (34.7%). Early complications directly connected to the procedure (32/296 = 10.8%) and late complications generally due to malfunctioning of the catheter or progression of the disease (71/296 = 23.9%) are analyzed. Caveats to prevent complications, therapeutic procedures to resolve them, as well as obtained results are reported. On the whole, major complications directly related to the procedure are present in a small percentage and the procedure appears well tolerated also in patients with poor general conditions.
Subject(s)
Bile Ducts, Intrahepatic , Drainage/adverse effects , Bile Duct Neoplasms/complications , Cholestasis/complications , Cholestasis/etiology , Cholestasis/therapy , Drainage/instrumentation , Drainage/methods , Equipment Failure , Follow-Up Studies , Gallstones/complications , Humans , Palliative Care , Time FactorsABSTRACT
Squamous cell carcinoma represents more than 90% of esophageal cancers; its prognosis is still extremely severe. A treatment consisting in the combined use of preoperative chemotherapy and radiotherapy is now in course of experimentation at Istituto Nazionale Tumori, Milan. Over a period of 28 months (July 1985 to October 1987), 21 patients with 22 lesions (stage III) underwent a double contrast study of the esophagus, both before and after therapy. The radiological evaluation of the lesions after treatment was compared with the pathological diagnosis. Radiological diagnosis has been confirmed in 86.3% of cases (19/22 lesions) as far as mucosal detailing was concerned. On the contrary, radiological evaluation has proven unreliable as far as submucosal layers were concerned. No radiological false positives have been observed.
Subject(s)
Carcinoma, Squamous Cell/diagnostic imaging , Esophageal Neoplasms/diagnostic imaging , Adult , Aged , Biopsy , Carcinoma, Squamous Cell/pathology , Carcinoma, Squamous Cell/therapy , Combined Modality Therapy , Esophageal Neoplasms/pathology , Esophageal Neoplasms/therapy , Esophagoscopy , Esophagus/diagnostic imaging , Esophagus/pathology , False Positive Reactions , Female , Humans , Male , Mediastinum/diagnostic imaging , Middle Aged , Radiography, ThoracicABSTRACT
The aim of this case report is to underline some unusual features of a colonic juvenile polyp found in a young adult: lack of symptoms, site, sessile morphology and increase in site (greater than 50% in 2 years). The usefulness of the radiological survey to indicate endoscopic polypectomy is emphasized.
