Assuntos
Lesões por Radiação/cirurgia , Radioterapia/efeitos adversos , Doenças Retais/cirurgia , Adulto , Canal Anal/cirurgia , Colo/cirurgia , Incontinência Fecal/etiologia , Feminino , Neoplasias dos Genitais Femininos/radioterapia , Humanos , Métodos , Pessoa de Meia-Idade , Complicações Pós-Operatórias , Doenças Retais/etiologia , Fístula Retovaginal/etiologia , Fístula Retovaginal/cirurgiaRESUMO
Four patients are presented who sustained blunt trauma and later developed necrotizing fasciitis in the areas of contusion, associated with the distant locus of sepsis. Three of the cases developed acute renal failure and later died. Early recognition of this condition allows prompt debridement beyond the margins of involved necrotic fascia, followed by wound inspection 8-hourly, and treatment with antibiotics, most recently third-generation cephalosporins, piperacillin, amikacin, and vancomycin.
Assuntos
Traumatismos do Braço/complicações , Contusões/complicações , Fasciite/etiologia , Ferimentos não Penetrantes/complicações , Injúria Renal Aguda/etiologia , Adulto , Antibacterianos/uso terapêutico , Infecções Bacterianas/complicações , Infecções Bacterianas/terapia , Desbridamento , Fasciite/terapia , Feminino , Humanos , Masculino , Necrose , Infecção dos Ferimentos/complicações , Infecção dos Ferimentos/terapiaRESUMO
Two unusual complications related to fibre-optic endoscopy are described. In one case a pneumomediastinum occurred during gastroscopy with no evidence of perforation. The patient was treated conservatively and made an uneventful recovery. The suggested mechanism is that of alveolar leakage resulting from raised intrathoracic pressure. The other is a case of temporomandibular joint dislocation, a complication not previously described.
Assuntos
Gastroscopia/efeitos adversos , Luxações Articulares/etiologia , Enfisema Mediastínico/etiologia , Articulação Temporomandibular/lesões , Adulto , Tecnologia de Fibra Óptica/instrumentação , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
A case of malignant insulinoma in a Black patient is presented. An investigational protocol is suggested with a discussion of the newer techniques of pancreatic adenoma localization and the therapeutic measures available for the management of malignant islet cell tumours.
Assuntos
Adenoma de Células das Ilhotas Pancreáticas/diagnóstico , Insulina/sangue , Insulinoma/diagnóstico , Neoplasias Pancreáticas/diagnóstico , Humanos , Masculino , Métodos , Pessoa de Meia-Idade , Veia Porta/cirurgiaRESUMO
A case of torsion of the gallbladder is reviewed. The radiographic features of the case suggest that in future pre-operative diagnosis may be possible with the use of ultrasound and contrast radiography.
Assuntos
Doenças da Vesícula Biliar/diagnóstico por imagem , Idoso , Feminino , Humanos , Tomografia por Raios X , Anormalidade Torcional , UltrassonografiaRESUMO
A case of a young man with a choledochocele is presented. The entity is rare and symptoms are usually nonspecific. Pre-operative diagnosis is often not made but is usually possible provided both barium study and cholangiography are performed. The clinical presentation and diagnosis are discussed.
Assuntos
Ducto Colédoco/anormalidades , Cistos/congênito , Adulto , Ducto Colédoco/patologia , Cistos/patologia , Humanos , MasculinoRESUMO
An unusual case in which both testicular arteries arched over the left renal vein is described. A developmental explanation for the unusual vascular pattern is given. The possible importance of this and similar anomalies in the causation of varicocoele and orthostatic proteinuria is discussed.
