Asunto(s)
Endoscopía , Tumores del Estroma Gastrointestinal/cirugía , Endosonografía , Estudios de Seguimiento , Tumores del Estroma Gastrointestinal/diagnóstico por imagen , Humanos , Ligadura , Masculino , Persona de Mediana Edad , Técnicas de Sutura , Factores de Tiempo , Resultado del TratamientoAsunto(s)
Antiinflamatorios/administración & dosificación , Estenosis Esofágica/tratamiento farmacológico , Triamcinolona/administración & dosificación , Administración Tópica , Dilatación , Estudios de Seguimiento , Glucocorticoides , Humanos , Hialuronoglucosaminidasa/administración & dosificación , Inyecciones , Masculino , Persona de Mediana Edad , Factores de TiempoRESUMEN
After reviewing 10,000 upper gastrointestinal endoscopies performed at the endoscopy unit of the city of Vigo over a 38 month period, we have found 485 partial gastric resections for peptic ulcer, 357 gastric carcinomas were found, of which 26 occurred after partial gastric resection for peptic ulcer. Therefore the incidence of gastric cancer in this area was 22-23/100,000. The frequency of gastric cancer after partial resective surgery was lower than expected during the first 20 years after surgery. However, thereafter a significant increase of gastric cancer occurred in those patients in which a Billroth-II but not Billroth-I procedure was used.
Asunto(s)
Adenocarcinoma/epidemiología , Úlcera Péptica/cirugía , Síndromes Posgastrectomía/epidemiología , Neoplasias Gástricas/epidemiología , Adenocarcinoma/etiología , Factores de Edad , Gastrectomía/métodos , Gastrectomía/estadística & datos numéricos , Humanos , Incidencia , Síndromes Posgastrectomía/etiología , España/epidemiología , Neoplasias Gástricas/etiología , Población Urbana/estadística & datos numéricosRESUMEN
Choledocholithiasis in patients with a gallbladder "in situ" is presently one of the most frequent indications of endoscopic sphincterotomy. The crucial problem of these patients is whether or not they require eventual cholecystectomy to avoid the risks of potential complications of cholelithiasis. Of the 39 patients (mean age 80.1 +/- 8.2 years) with choledocholithiasis and gallbladder "in situ" released from this hospital from October 1979 to December 1985 after a successful endoscopic sphincterotomy (expulsion, spontaneous or not, of gallstones), 33 (84.6%) have been followed-up for an average of 41.5 +/- 20.8 months (7-92 range). During this time only one patient (3%) developed acute cholecystitis that required cholecystectomy, and two (6%) denoted mild pains in the right upper quadrant, while the other 30 (91%) remained asymptomatic. Over these years 10 patients (30.3%) died from nonbiliary causes. In conclusion, in elderly or high surgical risk patients who present choledocholithiasis and gallbladder "in situ", endoscopic sphincterotomy is effective. Later cholecystectomy to prevent the complications of cholelithiasis would not be justified as a routine measure in most of these patients.
Asunto(s)
Colecistectomía , Cálculos Biliares/cirugía , Esfinterotomía Transduodenal , Anciano , Anciano de 80 o más Años , Colecistitis/prevención & control , Duodenoscopía , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/prevención & control , Factores de TiempoRESUMEN
Mesenteric venous thrombosis (TVM) is an uncommon entity with a mortality without surgical treatment of virtually 100%. However, recently some cases have been reported of a good evolution with conservative treatment. We present a patient with mesenteric venous thrombosis diagnosed by arteriography who, after refusing surgical intervention, underwent parenteral nutrition and anticoagulant treatment. This case constitutes another proof that mesenteric venous thrombosis is not invariably fatal without surgical treatment.