RESUMEN
A case of enterogenous cysts of the duodenum in a 44-yr-old man complicated by duodenal obstruction and relapsing pancreatitis is presented. The cystic duodenal lesions were visualized by endoscopic retrograde cholangiopancreatography and for the first time by computed tomography and abdominal sonography. Thus, the diagnosis was made preoperatively. The cysts were excised successfully during a Whipple procedure. Awareness of this rare condition combined with modern x-ray, sonographic, and endoscopic techniques permit accurate preoperative diagnosis.
Asunto(s)
Quistes/diagnóstico , Enfermedades Duodenales/diagnóstico , Pancreatitis/etiología , Adulto , Colangiopancreatografia Retrógrada Endoscópica , Quistes/patología , Quistes/cirugía , Enfermedades Duodenales/patología , Enfermedades Duodenales/cirugía , Obstrucción Duodenal/complicaciones , Duodeno/diagnóstico por imagen , Humanos , Masculino , Recurrencia , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
The worldwide introduction of H2-receptor antagonists has resulted in changes in the management of gastric and duodenal ulcers. Today surgery is reserved mainly for patients with problem ulcers or ulcer complications. In this decision a lower recurrency rate of operative treatment must be weighed against higher immediate risks of this form of therapy. The treatment of choice for duodenal ulcers is the selective proximal vagotomy (SPV) without drainage, for gastric ulcers the partial gastrectomy (Billroth I- or II-procedures) or SPV, depending on their localizations. Only the differentiated use of medical and surgical treatment modalities permits optimal ulcer therapy.
Asunto(s)
Úlcera Duodenal/cirugía , Antagonistas de los Receptores H2 de la Histamina/uso terapéutico , Úlcera Gástrica/cirugía , Úlcera Duodenal/complicaciones , Úlcera Duodenal/tratamiento farmacológico , Gastrectomía , Humanos , Úlcera Péptica Hemorrágica/mortalidad , Úlcera Péptica Hemorrágica/cirugía , Úlcera Péptica Perforada/mortalidad , Úlcera Péptica Perforada/cirugía , Síndromes Posgastrectomía/prevención & control , Antro Pilórico/cirugía , Recurrencia , Úlcera Gástrica/tratamiento farmacológico , VagotomíaAsunto(s)
Fístula Biliar , Colelitiasis/terapia , Conducto Colédoco , Adulto , Dilatación , Femenino , Fístula/patología , Humanos , PielRESUMEN
Twenty-two aphakic eyes in seven females and thirteen males were fitted with a new type of soft contact lens designed for continuous wear. Nine patients were operated on for unilateral traumatic cataract, and eleven patients were operated on for senile cataract. Sixteen patients terminated the study. In all cases the visual acuity with lens was almost equal to the acuity obtained with spectacles. The lenses were well tolerated without any special wearing schedule. No serious complications occurred. However, about one third of the patients developed conjunctivitis during the investigation period of eleven months. Four patients showed mild limbal vascular reaction, while only one patient had neovascularisation along the corneal scar caused by the original trauma. The new lens was found to be a good alternative to other contact lenses.
Asunto(s)
Afaquia Poscatarata/terapia , Lentes de Contacto Hidrofílicos , Adolescente , Adulto , Niño , Lentes de Contacto Hidrofílicos/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Agudeza VisualRESUMEN
Suturing of traumatic or surgical iris wounds has proved to be a safe and feasible microsurgical procedure. Various suture materials have been tried experimentally and clinically. If the human iris forms scar tissue the ideal suture would be an absorbable, inert, proteinfree material causing no uveal reaction. It was the purpose of this study to evaluate the ocular tissue reaction to nylon, virgin-silk and polyglycolic acid (Dexon) after suturing of an experimental iridomy in 24 rabbit eyes. The tissue response was studied by biomicroscopy, iris fluorescein colour angiography, and histology. Nylon did not disintegrate and caused virtually no inflammatory reaction. Silk showed fragmentation and complete absorption after four to six months with moderate tissue response. Polyglycolic acid gave rise to a marked uveal reaction and depolymerised from the fifth to the sixth week. There was no wound dehiscence of the iris scar and the pupillary function remained intact. It is concluded that the non-absorbable materials are superior to the currently available absorbable sutures in iris surgery.
Asunto(s)
Iris/cirugía , Ácido Poliglicólico , Suturas , Absorción , Animales , Cicatriz/prevención & control , Femenino , Reacción a Cuerpo Extraño , Masculino , Nylons , ConejosRESUMEN
The aim of all ocular surgery is to preserve or restore optimal visual function. Reduction of excessive postoperative astigmatism after keratoplasty, cataract extraction, or other anterior segment operations has been obtained in clinical surgery by corneal wedge resection. The purpose of this experimental investigation was to quantify and evaluate the results of different microsurgical techniques in crescentic resection of a corneal wedge. Twenty-five rabbits were operated and the induced changes of corneal curvature measured by keratometry. The immediate and long-term results are presented. The effect of wedge resection was a steepening of the meridian perpendicular to the resection and a flattening of the meridian parallel to the resection. The astigmatism induced was less pronounced than the changes obtained in human surgery. There were no postoperative ocular complications and all corneas remained clear. It is suggested that the operation be performed in all cases of severe corneal astigmatism uncorrected by lenses.