RESUMEN
The etiological diagnosis for the colorectal strictures can be very difficult. With the colonoscopy, it was possible to obtain samples with direct vision of the lesion. Consequently, the cytologic efficiency improved, with similar or even better results than histopathology. In the present study (107 patients) it was used the cytopathology performed during colonoscopy. After a specimen was obtained, it was smeared on glass slide, fixed in 95% alcohol, stained by HE, and examined microscopically, with conclusions during the procedure. The results were compared and further correlated to the histopathology of surgical specimen or based on clinical follow-up in those case not submitted to operation. The results showed a striking degree of correlation between both exams. For the cytopathology there were no inconclusive results, false-negative were less frequent than with histopathology, and only one case of false-positive (rectal villus adenoma) was observed. Considering the type, localization and perviousness of the lesion, similar conclusions were drawn, and did not affect the results, except that there were more false-negatives in both exams when the lesions were impervious. The cytopathological and histopathological studies were both highly sensitive and specific for the diagnosis of carcinoma. In conclusion, cytopathology performed during colonoscopy is safe and efficient in the study of colorectal strictures, which contributes to improve the orientation of these patients.
Asunto(s)
Carcinoma/diagnóstico , Neoplasias Colorrectales/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma/ultraestructura , Colonoscopía , Neoplasias Colorrectales/ultraestructura , Femenino , Humanos , Obstrucción Intestinal/etiología , Masculino , Persona de Mediana Edad , Sensibilidad y EspecificidadAsunto(s)
Enfermedad de Chagas/complicaciones , Megacolon/cirugía , Adolescente , Adulto , Anciano , Femenino , Humanos , Masculino , Megacolon/etiología , Métodos , Persona de Mediana Edad , Complicaciones Posoperatorias , Dehiscencia de la Herida Operatoria/etiología , Infección de la Herida Quirúrgica/etiologíaRESUMEN
The authors study 84 patients that had damages of the duodenum and or pancreas and underwent different types of surgery. In 39 patients who had damage only in the duodenum; there were 2 (4.0%) duodenal fistulas, and 3 (6.0%) intraperitoneal abscess. In 38 patients who had injuries only in the pancreas; there were 6 (13.1%) acute pancreatities, pancreatic fistulas and 1 (2.2%) pancreatic pseudocyst. In 7 cases, injuries were found to both pancreas and duodenum. The author reports 1 case of duodenal fistula (14.3%) 1 case of acute pancreatitis (14.3%) and 3 cases of pancreatic fistula (43.0%). Only 7 patients died (8.3%), and of these 2 died for reasons not directly related to the operatory technic used. A simple suture can be performed in those cases where a complete section of the duodenum is unnecessary and there is no injury to the duodenal papilla. A burying suture of the stomas associated with a side-to-side duodenojejunal anastomosis should be preferred in the complete section of the duodenum localized beyond the ampulla of Vater. In all superficial wounds of small extension a suture of the pancreas should be performed. Distal pancreatectomy of body or tail should be made in the wounds with a possible lesion to the Wirsung duct and when there is an extensive glandular lesion. The associate wounds of duodenum and pancreas should be treated as if they were isolated lesions.
Asunto(s)
Traumatismos Abdominales/cirugía , Duodeno/lesiones , Páncreas/lesiones , Pancreatectomía , Adolescente , Adulto , Niño , Preescolar , Duodeno/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Pancreatectomía/métodos , Pancreatectomía/mortalidad , Complicaciones Posoperatorias , Heridas por Arma de Fuego/cirugía , Heridas no Penetrantes/cirugíaAsunto(s)
Esofagoplastia/métodos , Técnicas de Sutura , Animales , Perros , Cicatrización de HeridasRESUMEN
The authors made a comparative study of the use of glucagon (4 mg/day IV) in 30 dogs with acute pancreatitis. They found that the mortality and amylasemia were significantly lower in the glucagon-treated group than in the control groups (saline and glucose solution 5%). In the glucagon group, the areas of necrosis were smaller (1.5 cm) and rarely found; microscopically, the areas of necrosis and the inflammatory reaction were much smaller than in the other groups. These findings lead to the conclusion that the beneficial action of glucagon is due to another mechanism other than its hyperglycemic effect and that the administration of hypertonic solutions of glucose does not have a beneficial effect in acute pancreatitis.