RESUMO
We report the case of a pediatric patient, treated for acute lymphoid leukemia, who developed a mycotic aneurysm (angioinvasive aspergillus infection) of the common carotid artery. In an emergency procedure we ligated the common carotid artery. The patient made a full recovery.
Assuntos
Aneurisma Infectado/diagnóstico , Aspergilose/diagnóstico , Doenças das Artérias Carótidas/microbiologia , Hospedeiro Imunocomprometido , Falso Aneurisma/tratamento farmacológico , Falso Aneurisma/microbiologia , Falso Aneurisma/cirurgia , Aneurisma Infectado/tratamento farmacológico , Aneurisma Infectado/cirurgia , Antifúngicos/uso terapêutico , Aspergilose/tratamento farmacológico , Aspergilose/cirurgia , Doenças das Artérias Carótidas/diagnóstico , Doenças das Artérias Carótidas/tratamento farmacológico , Doenças das Artérias Carótidas/cirurgia , Artéria Carótida Primitiva/microbiologia , Artéria Carótida Primitiva/cirurgia , Criança , Humanos , Masculino , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológicoRESUMO
Between January 1984 and May 1988, 25 patients with fourth degree haemorrhoids were treated in the acute phase by lateral internal sphincterotomy under narcosis. Pain relief was immediate. The median hospital stay was 3 days. The median follow-up period was 26 months. For 20 patients a single lateral internal sphincterotomy alone was adequate treatment. If further therapy was required, simple band ligation was enough. There was one recurrence, which was treated with a further lateral internal sphincterotomy. In the long term, 18 patients had no complaints and seven had only minor complaints. Twenty-three patients were very satisfied and two were moderately satisfied. Nobody was dissatisfied. Lateral internal sphincterotomy is an attractive alternative in the treatment of fourth degree haemorrhoids, its major benefits being simplicity, efficiency and low morbidity.
Assuntos
Canal Anal/cirurgia , Hemorroidas/cirurgia , Doença Aguda , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Comportamento do Consumidor , Feminino , Seguimentos , Hemorroidas/patologia , Humanos , Masculino , Métodos , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Prolapso Retal/patologia , RecidivaRESUMO
From January 1986 until December 1988 twenty two patients entered a prospective trial comparing primary closure versus T-tube drainage after exploratory choledochotomy for lithiasis, giving 11 primary closures (P) and 11 on T-tube (T). Both groups were well matched for age and risk factors. Preoperative values of alkaline phosphatase on day 2 and 7 were significantly lower in case of primary closure (p less than .025). In case of primary closure there was 1 bile leakage without peritonitis. In 9 T-tube biles additional micro-organisms appeared without clinical importance. In each group 1 infectious complication occurred. Post-operative hospital stay was 12 days (P) versus 14 (T) (p less than .05). There was 1 residual lithiasis (P), without detrimental effect on the healing of the primary closure. Endoscopic sphincterotomy and stone extraction was performed. Within the given exclusion criteria closing a choledochotomy primarily is a safe and attractive procedure.
