ABSTRACT
Heparin induced thrombocytopenia with thrombosis, or the "white clot syndrome" is a rare but very important complication of heparin therapy. The syndrome is idiosyncrasic, immune-mediated and not dose dependent and therefore is equally likely to occur with prophylactic and therapeutic heparin dosage regimens. We report a typical case of HIT that occurs with prophylactic heparin therapy and results in bilateral amputation of the lower limbs. We discuss this important condition and some guidelines on its prevention and treatment.
Subject(s)
Heparin/adverse effects , Thrombocytopenia/chemically induced , Thrombosis/etiology , Acute Disease , Adjuvants, Immunologic , Amputation, Surgical , Female , Femoral Artery/surgery , Fibrin Fibrinogen Degradation Products/analysis , Heparin/therapeutic use , Humans , Ischemia , Leg/blood supply , Leg/surgery , Middle Aged , Ovarian Cysts/surgery , Popliteal Artery/surgery , Recurrence , Syndrome , Thrombectomy , Thrombocytopenia/complications , Thrombocytopenia/immunology , Thrombosis/immunology , Thrombosis/surgeryABSTRACT
Internal hernia into epiploic foramen is a rare clinical entity, representing 1% of all herniae and 8% of internal herniae. We report a peculiar case of internal herniation presented during a laparotomy for acute colecystitis where the caecum and ascending colon entered the lesser sac through the forame of Winslow and reentered the main abdominal cavity through a congenital defect of the lesser omentum.
Subject(s)
Cecal Diseases , Colonic Diseases , Omentum , Aged , Aged, 80 and over , Cecal Diseases/diagnostic imaging , Cecal Diseases/physiopathology , Cecal Diseases/surgery , Colonic Diseases/diagnostic imaging , Colonic Diseases/physiopathology , Colonic Diseases/surgery , Female , Hernia/diagnostic imaging , Hernia/physiopathology , Herniorrhaphy , Humans , RadiographyABSTRACT
A case of extensive gangrene of the colon secondary to fecal impaction is reported. The role of ischemia in the management of colonic obstruction and the pathogenesis and treatment of colonic gangrene are discussed.
Subject(s)
Colon/pathology , Colonic Diseases/etiology , Fecal Impaction/complications , Intestinal Obstruction/etiology , Aged , Colon/blood supply , Colonic Diseases/pathology , Gangrene , Humans , Intestinal Obstruction/pathology , Ischemia/etiology , MaleSubject(s)
Biliary Tract Neoplasms/surgery , Papilloma/surgery , Aged , Biliary Tract Neoplasms/diagnosis , Female , Humans , Papilloma/diagnosisABSTRACT
A case of diffuse papillomatosis of the bile duct, treated with external biliary drainage, is reported on account of its rarity. The extent and anatomopathological characteristics of the lesion make radical surgery impossible, so that the above-stated surgical solution appears to the Authors to be the most suitable one for resolving the biliary stasis and consequent cirrhosis.
Subject(s)
Bile Duct Neoplasms/surgery , Papilloma/surgery , Aged , Bile Duct Neoplasms/pathology , Cholangiography , Cholecystectomy , Cholestasis/etiology , Cholestasis/surgery , Drainage , Female , Humans , Liver Cirrhosis, Biliary/prevention & control , Papilloma/pathologyABSTRACT
The authors describe one case of biliary ileus occurring in the form of stepwise intestinal obstruction, successfully treated by surgery designed to resolve the obstruction and at the same time repair the biliodigestive fistula. Because of the high postoperative morbidity and mortality in emergency cases, this operation should be reserved in the authors' opinion to patients in satisfactory humoral balance and in the absence of general contraindictions.