Assuntos
Adenocarcinoma/diagnóstico , Neoplasias da Mama/diagnóstico , Neoplasias Gastrointestinais/diagnóstico , Neoplasias Primárias Múltiplas/diagnóstico , Adenocarcinoma/mortalidade , Adenocarcinoma/cirurgia , Adulto , Idoso , Neoplasias da Mama/mortalidade , Neoplasias da Mama/cirurgia , Terapia Combinada , Feminino , Neoplasias Gastrointestinais/mortalidade , Neoplasias Gastrointestinais/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas/mortalidade , Neoplasias Primárias Múltiplas/cirurgia , Fatores de TempoRESUMO
An analysis is made of 80 re-interventions on the extra-hepatic biliary pathways in patients who had underwent one or more surgical interventions on the main biliary pathway. The cases have been classified according to the type of the initial intervention as follows: re-interventions following cholecystectomy, choledocotomy and Kehr drainage, following sphincterotomy, and following internal and external biliary derivations. An analysis is made of the causes of re-interventions, and of the increased risk due to severe complications which are at the origin of high morbidity and mortality rates. Particular stress is laid on the necessity for a correct diagnosis, as well as a complete one for the first intervention on the biliary pathways, which will allow to make an adequate choice for a second surgical solution.
Assuntos
Ductos Biliares/cirurgia , Ducto Colédoco/cirurgia , Adulto , Idoso , Neoplasias dos Ductos Biliares/cirurgia , Doenças Biliares/cirurgia , Doenças do Ducto Colédoco/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , ReoperaçãoRESUMO
Six cases of hepatic trauma are presented, that have raised particular problems of therapeutical attitude. The severity of the complications is discussed in this type of trauma, especially aspects related to hemobilia and hepatic suppurations which are accompanied by toxico-septic syndromes. The authors stress the role of sutures of deep hepatic wounds in the development of suppurations, as well as the opportunity of early re-interventions in such cases. Also some particular, more rare, clinical forms are discussed, that made necessary a differentiated therapeutical attitude.
Assuntos
Fígado/lesões , Adulto , Fístula Biliar/etiologia , Feminino , Hematoma/etiologia , Hemobilia/etiologia , Hemorragia/etiologia , Humanos , Icterícia/etiologia , Fígado/cirurgia , Abscesso Hepático/etiologia , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Ruptura , Choque Séptico/etiologia , Aderências Teciduais/etiologiaAssuntos
Complicações Pós-Operatórias , Fatores Etários , Idoso , Doenças Biliares/cirurgia , Feminino , Gastroenteropatias/cirurgia , Doenças dos Genitais Femininos/cirurgia , Humanos , Masculino , Neoplasias/cirurgia , Neoplasias Pancreáticas/cirurgia , Complicações Pós-Operatórias/mortalidade , PrognósticoRESUMO
The present paper reports on 37 primary tumours of the jejunoileum, of which 19 malignant and 18 benign. The authors emphasize the difficulty of establishing a diagnosis before the onset of one of the dramatic complications in the evolution of tumours of the small intestine. The patients were admitted for the following complications: occlusive syndrome -- 28 cases (72.9%), peritoneal syndrome -- 6 cases (16.2%) and hemorrhagic syndrome -- 3 cases (8.1%). All the patients with a peritoneal and hemorrhagic syndrome had malignant tumours.
