Asunto(s)
Músculos Abdominales/cirugía , Mallas Quirúrgicas , Absorción , Humanos , Laparotomía , Métodos , Peritoneo/cirugía , Poliglactina 910RESUMEN
The use of an absorbable material in the form of a permeable mesh of polyglactin 910 is proposed for the treatment of extensive evisceration regardless of etiology. Its strength and excellent tolerance by the body even in the presence of infection justify its intraperitoneal placement on the deep surface of the peritoneum, in contact with the viscera and in reconstruction of the parietal wall. Perfect retention of the viscera in place is assured and the reconstructed parietal wall seems solid and stable, the absorbable mesh being rapidly replaced by host connective tissue of good quality. This technique, applicable to all cases of evisceration, is valuable in the surgical treatment of such patients, which is frequently difficult at best.
Asunto(s)
Hernia Ventral/cirugía , Complicaciones Posoperatorias/cirugía , Mallas Quirúrgicas , Músculos Abdominales/cirugía , Absorción , Anciano , Humanos , Persona de Mediana Edad , Peritoneo/cirugía , Poliglactina 910 , Técnicas de SuturaRESUMEN
The authors report an unusual case of oesophageal pseudo-diverticulosis. A 63-year-old male patient presented with dysphagia. A preoperative diagnosis of oesophageal intramural tumour was made on radiological and endoscopic abnormalities. The histopathological study of the involved oesophagus showed a pseudocystic dilatation of glandular ducts in the submucosa with a lymphocytic infiltrate. The authors review the relevant literature on oesophageal intramural pseudodiverticulosis and suggest a possible pathogenesis for this rare and benign entity.
Asunto(s)
Divertículo Esofágico/patología , Quiste Esofágico/patología , Divertículo Esofágico/etiología , Quiste Esofágico/complicaciones , Esofagitis/etiología , Humanos , Masculino , Persona de Mediana EdadRESUMEN
A case of subcardial gastric diverticulum was surgically treated by an original technique which provided good exposure of the lesion and made it possible to sever all adhesions between the diverticulum and adjacent organs. This technique avoids gastrotomy and partial gastric resection.
Asunto(s)
Divertículo Gástrico/cirugía , Adulto , Cardias , Divertículo Gástrico/patología , Femenino , Humanos , MétodosRESUMEN
An exceptional case of spontaneous haemoperitoneum due to rupture of a thrombotic hepatic artery is reported. The thrombosis was of infectious origin and due to an untreated 3-week old dental abscess. The different causes of such thromboses, the different steps in the diagnostic approach, the consequences of hepatic artery obstruction and the different therapeutic possibilities are discussed.
Asunto(s)
Hemoperitoneo/etiología , Arteria Hepática , Trombosis/complicaciones , Anciano , Femenino , Infección Focal Dental/complicaciones , Humanos , Laparotomía , Arterias Mesentéricas/diagnóstico por imagen , Radiografía , Rotura Espontánea , Trombosis/etiologíaRESUMEN
Four further cases of retroperitoneal liposarcoma are reported. Principal modes of revelation and diagnostic features are discussed, values of different complementary examinations evaluated, and prognostic factors and therapeutic elements of this serious affection outlined.
Asunto(s)
Liposarcoma/cirugía , Neoplasias Retroperitoneales/cirugía , Adolescente , Anciano , Femenino , Humanos , Liposarcoma/diagnóstico , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Neoplasias Retroperitoneales/diagnóstico , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
The authors, who have a long experience of polyglactin 910 mesh advocate its use for pelvic peritonization in two different situations and with two different techniques. The "lower controlled peritonization" technique aims at obtaining rapid and satisfactory healing of the peritoneum in wide resections or resections in high risk patients. The "upper controlled peritonization" technique creates a "hammock" across the upper pelvic inlet, thus protecting intestinal loops against post-operative irradiations.
Asunto(s)
Pelvis/cirugía , Peritoneo/cirugía , Poliglactina 910 , Polímeros , Mallas Quirúrgicas , Femenino , Humanos , Masculino , Exenteración Pélvica/métodos , Neoplasias Pélvicas/radioterapia , Neoplasias Pélvicas/cirugía , Pelvis/efectos de la radiación , Peritoneo/efectos de la radiación , Traumatismos por Radiación/prevención & controlRESUMEN
In this study of a personal case of biliary hamartoma showing complete aplasia of the hepatic parenchyma as well as a cystic ectasy of the corresponding bile ducts, particular emphasis has been laid on the clinical, paraclinical and anatomo-pathological aspects of these dysgeneses. There seems to be an analogy between the radiographic, anatomical and anatomo-pathological studies made in this case and those that could have been made in pulmonary sequestration. As regards the pathogenesis of these complaints, the authors therefore put forward the same hypothesis for biliary hamartoma as for pulmonary sequestration and highlight the advantages of pre-operative angiography.
Asunto(s)
Neoplasias de los Conductos Biliares/diagnóstico , Hamartoma/diagnóstico , Neoplasias Hepáticas/diagnóstico , Angiografía , Neoplasias de los Conductos Biliares/etiología , Hamartoma/etiología , Humanos , Hígado/irrigación sanguínea , Hígado/diagnóstico por imagen , Neoplasias Hepáticas/etiología , Masculino , Persona de Mediana Edad , Cintigrafía , UltrasonografíaAsunto(s)
Linfangioma/diagnóstico , Adulto , Femenino , Humanos , Linfangioma/cirugía , UltrasonografíaRESUMEN
The first reported case of an association of Abrikossof's tumor and a cancer in the esophagus is described. After a general view of the published literature on these tumors, their clinical and pathological characteristics are outlined, and their histogenesis envisaged in relation to histochemical and ultrastructural findings. Therapeutic methods and means of follow-up surveillance are defined.
Asunto(s)
Neoplasias Esofágicas/patología , Neoplasias Primarias Múltiples/patología , Neoplasias de Tejido Muscular/patología , Anciano , Neoplasias Esofágicas/cirugía , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Primarias Múltiples/cirugía , Neoplasias de Tejido Muscular/cirugíaRESUMEN
The long term results obtained by Polyglactine 910 mesh in the treatment of eviscerations has lead us to specify its conditions of use in the surgical treatment of wall ruptures. As it is self resorbing, it may not be used on its own. But its remarkable acceptance allowing it to be fitted in an intra-peritoneal position, with very lateral stitches, makes it a most outstanding material for top quality assisted sutures.
Asunto(s)
Músculos Abdominales/cirugía , Herniorrafia , Poliglactina 910 , Polímeros , Mallas Quirúrgicas , Humanos , MétodosRESUMEN
Palliative oesophago-jejunal anastomosis via a purely abdominal approach is proposed in the treatment of inoperable carcinoma of the stomach, and in which gastro-enterostomy is not possible. The latero-lateral nature avoiding any dissection of the oesophagus and the wide calibre of the anastomosis made possible by automatic suture clamps are factors in ensuring the reliability and effectiveness of the method, which considerably improves the living conditions of these patients.