Asunto(s)
Aneurisma Falso/etiología , Aneurisma Roto/etiología , Arteria Hepática , Ganglios Linfáticos/diagnóstico por imagen , Tuberculosis Ganglionar/complicaciones , Adulto , Aneurisma Falso/diagnóstico , Aneurisma Roto/diagnóstico , Biopsia , Angiografía por Tomografía Computarizada/métodos , Humanos , Masculino , Tuberculosis Ganglionar/diagnósticoRESUMEN
Anastomosis leakage (AL) after colorectal surgery is an embarrassing problem. It is associated with poor consequence. This review aims to summarize published evidence on prevention of AL after colorectal surgery and provide recommendations according to the Oxford Centre for Evidence-Based Medicine. We conducted bibliographic research on January 15, 2020, of PubMed, Cochrane Library, Embase, Scopus, and Google Scholar. We retained meta-analysis, reviews, and randomized clinical trials. We concluded that mechanical bowel preparation did not reduce AL. It seems that oral antibiotic or oral antibiotic with mechanical bowel preparation could reduce the risk of AL. The surgical approach did not affect the AL rate. The low ligation of the inferior mesenteric artery could reduce the AL rate. The mechanical anastomosis is superior to handsewn anastomosis only in case of right colectomies, with similar results in rectal surgery between the 2 anastomosis techniques. In the case of right colectomies, this anastomosis could be performed intracorporeally or extracorporeally with similar outcomes. The air leak test did not reduce AL. There is no interest of external drainage in colonic surgery but drains reduced the rate of AL and rate of reoperation after low anterior resection. The transanal tube reduced the rate of AL.
Asunto(s)
Tumores del Estroma Gastrointestinal/complicaciones , Hemoperitoneo/etiología , Neoplasias del Íleon/complicaciones , Anciano de 80 o más Años , Tumores del Estroma Gastrointestinal/diagnóstico por imagen , Hemoperitoneo/diagnóstico por imagen , Humanos , Neoplasias del Íleon/diagnóstico por imagen , Masculino , Pelvis , Rotura Espontánea , Tomografía Computarizada por Rayos XRESUMEN
Gastrointestinal bleeding secondary to a rupture of an aneurysm of the hepatic artery is rare. We report a case of an 81-year-old man, who was admitted with hematemesis and melena. Gastroduodenoscopy revealed an abundant bleeding from the posterior wall of the duodenal bulb. CT-scan shoved an aneurysm arising from the hepatic artery. Ultrasound, computed tomography and angiography are the methods of choice for gastrointestinal bleeding diagnosis if endoscopy is inconclusive.
Asunto(s)
Aneurisma Roto/complicaciones , Hemorragia Gastrointestinal/etiología , Arteria Hepática/patología , Anciano , Anciano de 80 o más Años , Humanos , MasculinoRESUMEN
Gastric cancer is a serious disease with a high mortality rate. Early diagnosis of the disease improves its prognosis. We report two cases of early gastric cancer and we specify the clinical, endoscopic, histologic and therapeutic aspects of the disease. This study is about two female patients, respectively, 36 and 70 years old. The diagnosis of early gastric cancer was based on pathologic examination of the resected stomach. The two patients are in remission 2 years and 6 months later, respectively. The diagnosis of early gastric cancer is often made on nonspecific symptoms. Oeso-gastro-duodenoscopy shows gastric mucosal anomalies. Pathologic examination of gastric biopsies confirm the diagnosis of adenocarcinoma. Endoscopic ultrasound is essential; it specifies the submucosal infiltration and evaluates the lymph node invasion. Surgery is the primary treatment but in some cases endoscopic mucosal resection provides good long-term results. Early diagnosis of adenocarcinoma improves the prognosis of the disease, which remains poor nowadays.