Assuntos
Abscesso/etiologia , Candidíase/etiologia , Pelve , Diálise Peritoneal Ambulatorial Contínua/efeitos adversos , Peritonite/etiologia , Esplenopatias/etiologia , Abscesso/diagnóstico por imagem , Adolescente , Feminino , Humanos , Pelve/diagnóstico por imagem , Radiografia , Esplenopatias/diagnóstico por imagemRESUMO
Bucrylate (isobutyl 2-cyanoacrylate) was used for the transcatheter embolization of the splenic artery in 4 patients with bleeding gastric varices secondary to splenic vein thrombosis, 3 patients with symptoms of hypersplenism, and 8 patients with bleeding esophageal varices secondary to portal hypertension. The splenic artery was completely occluded in 13 patients and partially occluded in 2. In all but one of the patients, functioning splenic tissue was preserved and no abscess developed. Medical splenectomy with Bucrylate appears to be a safe and effective method for treating bleeding gastric varices secondary to splenic vein thrombosis, and it can alleviate symptoms of hypersplenism. Its role in controlling bleeding from esophageal varices in patients with generalized portal hypertension is worth further study.
Assuntos
Adesivos/uso terapêutico , Bucrilato/uso terapêutico , Cianoacrilatos/uso terapêutico , Embolização Terapêutica/métodos , Artéria Esplênica , Varizes/terapia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Ensaios Clínicos como Assunto , Varizes Esofágicas e Gástricas/terapia , Feminino , Humanos , Hiperesplenismo/complicações , Hipertensão Portal/complicações , Masculino , Pessoa de Meia-Idade , Esplenectomia , Estômago/irrigação sanguínea , Tromboflebite/complicações , Varizes/etiologiaRESUMO
Abdominal aneurysmectomy in a patient with an abdominal aortic aneurysm who has cardiac, renal, or pulmonary disease is associated with a high surgical mortality. Fifteen such patients underwent nonresective therapy of an abdominal aortic aneurysm consisting of an axillobifemoral bypass graft which maintains blood flow to the lower extremities. At the time of the graft the iliac vessels were ligated, occluding the outflow tract from the aneurysm, and resulting in retrograde thrombosis. In three of the 15 patients, however, the aneurysm remained patent because of patency of the hypogastric arteries. The outflow tract in these three patients was occluded by a transcatheter injection of Bucrylate, a tissue adhesive, into the distal abdominal aorta and iliac vessels. Bucrylate embolization is a potentially useful adjunct to nonresective treatment of abdominal aortic aneurysms.
Assuntos
Aneurisma Aórtico/terapia , Bucrilato/administração & dosagem , Cianoacrilatos/administração & dosagem , Embolização Terapêutica/métodos , Idoso , Aorta Abdominal/efeitos dos fármacos , Artéria Axilar/cirurgia , Prótese Vascular/métodos , Feminino , Artéria Femoral/cirurgia , Seguimentos , Humanos , Artéria Ilíaca/efeitos dos fármacos , Injeções Intra-Arteriais , Ligadura , MasculinoRESUMO
The authors describe a method involving percutaneous transhepatic placement of T tubes for patients with jaundice due to a malignant obstruction. These rubber tubes have a larger caliber than standard polyethylene catheters and consequently, provide better drainage, thus minimizing the the occurrence of cholangitis due to debris obstructing the drainage tube.
