RESUMO
The intracolonic bypass has been used both experimentally and clinically to avoid high-risk primary colonic anastomosis in the face of peritonitis. Experimental and clinical data have established the Coloshield as safe, with few clinical complications reported. This is a review of the literature and a case report of a complication of an intracolonic bypass that was found to have eroded through the colon in the early postoperative period.
Assuntos
Colo/patologia , Colo/cirurgia , Stents/efeitos adversos , Colite/complicações , Doenças do Colo/complicações , Doenças do Colo/cirurgia , Cistite/complicações , Desenho de Equipamento , Feminino , Humanos , Fístula Intestinal/complicações , Fístula Intestinal/cirurgia , Pessoa de Meia-Idade , Necrose/etiologia , Fatores de RiscoRESUMO
In an effort to further define the immunologic mechanisms leading to acute composite-tissue allograft rejection, the migratory patterns of donor leukocytes were evaluated. Using a rat model, 52 orthotopic vascularized hindlimb transplants were performed in strains representing major histocompatibility mismatches. In order to evaluate the effect of allogeneic skin on limb rejection, all donor skin was removed in a second group of allografts. Recipient lymphoid organs were examined during the week following transplantation for antigen-presenting cells using a donor-specific class II monoclonal antibody. Donor leukocytes, with dendritic cell morphology, were identified in recipient spleen and lymph nodes draining the allograft. Significantly higher numbers of donor leukocytes were present during postoperative days 1 through 4 for both groups. Association of these important passenger leukocytes with host T-lymphocytes may represent the site of initiation of the immune response.
Assuntos
Células Dendríticas/imunologia , Células de Langerhans/imunologia , Perna (Membro)/transplante , Leucócitos/imunologia , Imunologia de Transplantes , Animais , Linfócitos T CD4-Positivos/imunologia , Linfócitos T CD4-Positivos/patologia , Movimento Celular , Rejeição de Enxerto/imunologia , Rejeição de Enxerto/patologia , Antígenos de Histocompatibilidade Classe II/imunologia , Perna (Membro)/cirurgia , Contagem de Leucócitos , Linfonodos/imunologia , Linfonodos/patologia , Ratos , Ratos Endogâmicos ACI , Ratos Endogâmicos WF , Baço/imunologia , Baço/patologia , Linfócitos T/imunologia , Transplante Homólogo , Transplante IsogênicoRESUMO
We have reported two instances requiring long term central venous access in which the more traditional access sites were no longer available. The use of the internal mammary vein has made it possible to easily obtain central venous access in these patients without thoracotomy. Also, based on the anatomy, we believe this to be superior to the intercostal venous approach, since the passage of the catheter is more direct, thus, avoiding the acute azygous arch angle and cumbersome positioning.
