ABSTRACT
Esophageal perforation is most often caused by instrumental lesion during endoscopy. Mortality is still high; underlying malignant disease, septic complications and cardiopulmonary problems are endangering the patient. In small perforation with poor clinical symptoms, conservative treatment (i.e. antibiotics, gastric suction, parenteral nutrition) should be considered. We could treat in this way more than 50% of our cases. On the other hand, some patients require agressive surgical procedures, e.g. cervical esophagostomy gastrostomy and disconnection of esophageal continuity.
Subject(s)
Esophageal Perforation/surgery , Esophagoscopy , Adolescent , Adult , Aged , Child , Child, Preschool , Esophageal Neoplasms/surgery , Esophageal Stenosis/surgery , Female , Humans , Male , Middle Aged , Palliative Care , Prostheses and Implants , Wound HealingABSTRACT
Intussusception in adults is rare. Symptoms are often uncharacteristic. Therefore diagnosis is difficult. Diagnosis can be confirmed by radiologic and endoscopic measures. Surgical treatment consists in the resection of the struck part of the intestine according to the principles of tumor surgery. The danger of perforation rises if desinvagination is tried. It is reported about 11 own cases in which 7 neoplasms were the cause of intussusception. Two patients died of aspiration pneumonia and intracerebral hemorrhage caused by rupture of an aneurysm of the cerebri media artery.
Subject(s)
Intussusception , Adolescent , Adult , Aged , Diverticulum, Colon/complications , Enteritis/complications , Female , Humans , Intestinal Neoplasms/complications , Intussusception/diagnostic imaging , Intussusception/etiology , Intussusception/surgery , Male , RadiographyABSTRACT
The percentage T-lymphocyte subpopulations were determined with the aid of radioactively-labelled monoclonal antibodies to the antigens of total T-lymphocytes and to suppressor T-lymphocyte surface antigens and the responsiveness of the lymphocytes in the presence of ConA and PHA was investigated in groups of 8 subjects aged either between 20 and 30 years or over 75 years. It was found that there was no difference with respect to the response of the lymphocytes to the plant mitogens ConA and PHA. The percentage of suppressor T-lymphocytes, on the other hand, was significantly reduced in the older subjects, whilst the percentage of total T-lymphocytes did not differ significantly from the percentage in younger subjects. These results are discussed in connection with published data.
