RESUMO
We present the case of a 35-year-old woman with a history of apparent bilateral hernia who had a surgical intervention that included a diagnostic laparoscopy converted to open laparotomy. The patient experienced endometrial implants exclusively at trocar sites. This case is cited as validation of the pneumoperitoneum-induced free cell implantation theory, or the so-called aerosolization theory.
Assuntos
Endometriose/etiologia , Complicações Pós-Operatórias , Punções , Abdome Agudo/cirurgia , Adulto , Feminino , Hemoperitônio/cirurgia , Humanos , Laparotomia , Pneumoperitônio ArtificialAssuntos
Dióxido de Carbono/administração & dosagem , Laparoscopia/métodos , Obesidade Mórbida/complicações , Pneumoperitônio Artificial/métodos , Adulto , Humanos , Masculino , Postura , Pressão , Púrpura Trombocitopênica Idiopática/complicações , Púrpura Trombocitopênica Idiopática/cirurgia , Esplenectomia/métodosAssuntos
Colectomia/métodos , Colo Sigmoide/cirurgia , Laparoscopia/métodos , Ureter , Humanos , Elastômeros de SiliconeRESUMO
The patient with a malignant pericardial effusion can be extremely difficult to treat and provide optimal palliation. The performance of transabdominal laparoscopic pericardial window may prove to be a significant advance in the management of these individuals. No previously reported description of this procedure has been found in the world literature as far back as 1966. A presentation of the case, description of the surgical procedure, and discussion of the therapeutic implications are provided.
Assuntos
Laparoscopia , Técnicas de Janela Pericárdica/métodos , Idoso , Humanos , Masculino , Derrame Pericárdico/cirurgiaRESUMO
A case of subcapsular hematoma with hemorrhage from the left lobe of the liver in a 37-year-old multiparous patient with toxemia is reported. Approximately 120 cases have been reported in the past, mostly in obstetric and gynecologic journals. The great majority of hematomas were in the right lobe. A triad of toxemia of pregnancy, right upper quadrant pain, and sudden hypotension has been described in these cases. The etiology of subcapsular hemorrhage in patients with toxemia is likely due to fibrin thrombi in hepatic arterioles and sinusoids with periportal hemorrhagic necrosis, since this has been observed in fatal cases. Presumably, subcapsular hemorrhage, once initiated, perpetuates itself to involve an entire lobe. The overall mortality rate in these patients remains at about 75%. Failure to recognize the syndrome and intervene surgically almost always results in death. The only hope for survival is laparotomy with prompt control of hemorrhage. Hepatic artery ligation to control hemorrhage should probably be avoided it is clear that toxemia is a generalized process that adversely affects hepatic reserve and that further compromise may not be tolerated.
