RESUMEN
Ninety-six patients with non-resectable malignant tumours occluding the bile duct were treated either with a transhepatic endoprosthesis (n = 60) or a surgical biliointestinal anastomosis (n = 36). The mean survival time for patients treated with a transhepatic endoprosthesis was 5.8 months, as compared with 8,1 months for patients treated surgically. The mortality rates in the first 30 days were 18% and 17% for patients treated anastomosis, respectively. We consider that this militates in favour of an endoprosthesis rather than surgery.
Asunto(s)
Colestasis/cirugía , Drenaje/instrumentación , Cuidados Paliativos/métodos , Anciano , Coledocostomía , Colestasis/etiología , Neoplasias del Sistema Digestivo/complicaciones , Femenino , Vesícula Biliar/cirugía , Humanos , Yeyuno/cirugía , MasculinoRESUMEN
Conventional arteriography, intraarterial digital subtraction angiography (DSA), and intravenous DSA were used in the evaluation of the patency of the pedal arterial arcades in 15 patients with advanced peripheral arteriosclerotic disease. Intraarterial DSA was found to be superior to conventional arteriography. In 12 of 15 patients, excellent or good results were achieved by intraarterial DSA compared with 5 or 15 patients examined by conventional arteriography. All intravenous DSA studies performed in 6 patients were classified as poor.
Asunto(s)
Angiografía/métodos , Arteriosclerosis/diagnóstico por imagen , Pie/irrigación sanguínea , Intensificación de Imagen Radiográfica , Técnica de Sustracción , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The occurrence and distribution of deep vein thrombosis after elective hip surgery were studied in 22 consecutive patients wearing graded pressure stockings as thromboprophylaxis. The frequency of thrombosis, as evidenced by leg-scan and phlebography, was 59%. Thirty-six per cent of the patients developed femoro-popliteal thrombosis. Thrombosis was unilateral and located in the operated limb, except for one patient who had concurrent leg-vein thrombosis in the non-operated limb. Two patients developed symptomatic lung embolism. Antithrombin III was determined pre- and postoperatively. There was no evidence of antithrombin III consumption due to postoperative thrombosis.
Asunto(s)
Vestuario , Articulación de la Cadera/cirugía , Prótesis de Cadera , Trombosis/prevención & control , Anciano , Antitrombina III/análisis , Femenino , Hematócrito , Heparina/uso terapéutico , Humanos , Masculino , Complicaciones Posoperatorias/prevención & control , Embolia Pulmonar/tratamiento farmacológico , Trombosis/tratamiento farmacológico , Warfarina/uso terapéuticoRESUMEN
Visceral angiography was performed in a double blind study in 54 patients using iohexol (350 mg I/ml) and meglumine-Na-Ca metrizoate (370 mg I/ml). No significant increase in serum values of either hepatic or pancreatic enzymes or electrolytes was registered. Both contrast media gave excellent demonstration of arteries as well as veins. Iohexol gave far less sensation of heat during the injections than metrizoate.
Asunto(s)
Angiografía/métodos , Medios de Contraste , Yodobenzoatos , Hepatopatías/diagnóstico por imagen , Ácido Metrizoico , Ácidos Triyodobenzoicos , Adulto , Anciano , Ensayos Clínicos como Asunto , Medios de Contraste/toxicidad , Método Doble Ciego , Tolerancia a Medicamentos , Femenino , Humanos , Yohexol , Hepatopatías/enzimología , Pruebas de Función Hepática , Masculino , Ácido Metrizoico/análogos & derivados , Ácido Metrizoico/toxicidad , Persona de Mediana Edad , Distribución Aleatoria , Ácidos Triyodobenzoicos/toxicidad , Equilibrio Hidroelectrolítico/efectos de los fármacosRESUMEN
To our knowledge, primary endoscopic diagnosis of pancreaticoduodenal fistulae has not so far been reported. The diagnosis is often made radiographically at endoscopic retrograde cholangiopancreatography (ERCP). We report one such case, in which a barium meal x-ray suggested duodenal ulceration, and the endoscopic findings suggested a duodenal diverticulum, the bottom of which could not be clearly defined. Instillation of contrast medium revealed the true fistulous nature of the diverticulum-like defect in the duodenal wall. This patient also had a pancreatic pseudocyst communicating with the fistula through the caudal part of the pancreatic duct, visualized during endoscopic fistulography. The patient did well on conservative treatment without surgical intervention.