Asunto(s)
Adenocarcinoma/diagnóstico , Adenocarcinoma/cirugía , Enfermedades del Colon/diagnóstico por imagen , Neoplasias del Colon/diagnóstico , Neoplasias del Colon/cirugía , Intususcepción/diagnóstico por imagen , Adenocarcinoma/complicaciones , Colectomía , Enfermedades del Colon/etiología , Enfermedades del Colon/cirugía , Neoplasias del Colon/complicaciones , Medios de Contraste , Femenino , Estudios de Seguimiento , Humanos , Intususcepción/etiología , Intususcepción/cirugía , Persona de Mediana Edad , Tomografía Computarizada por Rayos X , Resultado del TratamientoRESUMEN
Spontaneous splenic rupture associated with infectious mononucleosis is an infrequent occurrence. Splenectomy has been advocated as the appropriate treatment for these patients. Recently, three patients with spontaneous splenic rupture were successfully treated at our institution without surgery. Management of spontaneous splenic rupture in 37 other patients in the literature was reviewed. Nine of these patients also were treated nonoperatively. Although it has been suggested that splenectomy is the treatment of choice for patients with spontaneous splenic rupture, we believe selective nonoperative treatment of these patients is a realistic and safe option if it is employed appropriately.
Asunto(s)
Rotura del Bazo/terapia , Adulto , Femenino , Humanos , Masculino , Rotura EspontáneaRESUMEN
Hepatic infarction is an unusual event. A patient is described who had a hepatic infarct after a sigmoid resection. She was found to have occluded superior mesenteric and celiac arteries, with visceral circulation dependent on the inferior mesenteric artery. Disruption of the collateral circulation was presumed to have caused the subsequent liver infarct. A review of the pathophysiology of liver infarction is presented with particular reference to the relation of arterial occlusion to infarction.
Asunto(s)
Infarto/etiología , Obstrucción Intestinal/cirugía , Isquemia/etiología , Hígado/irrigación sanguínea , Arterias Mesentéricas , Complicaciones Posoperatorias , Enfermedades del Sigmoide/cirugía , Anciano , Aortografía , Femenino , Estudios de Seguimiento , Humanos , Infarto/diagnóstico por imagen , Infarto/cirugía , Isquemia/diagnóstico por imagen , Isquemia/cirugía , Arterias Mesentéricas/diagnóstico por imagen , Tomografía Computarizada por Rayos XAsunto(s)
Megacolon/diagnóstico , Colon/patología , Humanos , Masculino , Megacolon/patología , Megacolon/terapia , Persona de Mediana EdadRESUMEN
We present an experience with 20 patients undergoing interposition mesocaval shunts for decompression of esophageal varices. There were 14 men and six women, ranging in age from 32 to 80 years. Two patients were classified as good risks, nine as moderate risks, and nine as poor risks. There were ten elective operations, seven urgent operations, and three emergency procedures. An operative mortality of 10% was noted in the entire group, with one late death due to shunt occlusion. All deaths occured in the emergency group. A shunt patency of 88% and minimal problems with postoperative hepatic encephalopathy were noted. The interposition mesocaval shunt is judged to be a safe, technically easy procedure that is currently a satisfactory solution to the problem of hemorrhage from esophageal varices.