RESUMEN
The authors dwell upon the deep changes which the surgery of the inguinal hernia has recorded in the last years with the aim to reduce the rate of relapses and based on the philosophy tension free repair, particularly on the prosthetic patch and plug hernioplastics which represent the evolution of this concept and among these must be includes the D.SR.P. and flat plug hernia repair, that they have set with a sort of eclecticism and of integration of some of the operation times of Valenti's and Trabucco's methodologies and of some prosthetic protections used by themselves. Then, they dwell upon the rational of the variant in the Valenti's original technique put forward them, and this variant arise from a critical testing, they perform their preliminary clinic experience about primitive inguinal hernia repair through the methodology that has been proposed, then they declare that they can confirm it from the point of view of the effectiveness and safety only after further confirmations based on far wider surveys and on longer "follow-up" and after an objective comparison between this one and the two methods of whom it forms the technical compromise.
Asunto(s)
Hernia Inguinal/cirugía , Adulto , Anciano , Procedimientos Quirúrgicos del Sistema Digestivo/métodos , Ingle , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The Authors report a case of bowel occlusion due to intramural ileocecocolic haematoma in a patient in treatment with oral anticoagulants. This case is interesting both to unusual etiology correlated to the localization and because there are many concomitant pathogenetic factors; this case was treated on urgency by bowel resection and it had a good prognosis. The Authors discuss the diagnostic and therapeutic difficulties and conclude that in patients with anticoagulant oral therapy an accurate clinical follow-up is required.
Asunto(s)
Anticoagulantes/efectos adversos , Enfermedades del Ciego/etiología , Enfermedades del Colon/etiología , Hematoma/complicaciones , Enfermedades del Íleon/etiología , Obstrucción Intestinal/etiología , Anciano , Hematoma/inducido químicamente , Hematoma/patología , Humanos , MasculinoRESUMEN
Taking as their starting point the observation of a patient with blunt trauma of a voluminous inguinoscrotal hernia and with peritonitis due to perforation of the small bowel within the hernia, the Authors illustrate the aetiological, pathogenetic and physiopathological mechanisms of "seat belt syndrome". In the case described, they postulate that the incidental presence of taenia saginata in the small bowel lumen contributed considerably to the rupture. They then go on to focus on the difficult clinical diagnosis of this pathology and analyze its treatment. In view of the direct correlation between the prognosis and the therapeutic interval, they stress that resorting to diagnostic laparotomy in doubtful cases is a rational course of action. Laparoscopy today also constitutes an effective diagnostic and therapeutic option.