RESUMEN
118 cases of traumatic lesions of the liver have been reviewed. The patients were admitted to the First Aid and Emergency Surgery Division of Niguarda General Hospital between 1965 and 1976. The statistico-clinical data were elaborated in accordance with classical subdivisions of each disease form and compared and discussed, as far as possible, with similar data provided by the recent literature. Stress is laid on the increase in the number and gravity of cases in recent years, the prevalent localization of lesions in the right lobe, the importance of trauma pathogenesis for diagnostic and therapeutic purposes, and diagnostic difficulties. The importance of peritoneal probing and dialysis and of the examination for bile salts in the urine are underlined. As for treatment, the various surgical techniques are mentioned and discussed in relation to the characteristics of the traumatic lesion; the commonest technique was simple suture of the break in the liver parenchyma. Mortality was 33.05%. The cause of death in the 39 cases is mentioned.
Asunto(s)
Hígado/lesiones , Adolescente , Adulto , Anciano , Niño , Femenino , Humanos , Italia , Hígado/cirugía , Masculino , Persona de Mediana Edad , Rotura , Heridas y Lesiones/diagnóstico , Heridas y Lesiones/epidemiología , Heridas por Arma de Fuego/cirugía , Heridas Penetrantes/cirugía , Heridas Punzantes/cirugíaRESUMEN
Differential haematological and instrumental examinations (OGTT, protracted fasting, i.v. tolbutamide, blood insulin, pancreatic scintiscanning, oesophagogastroduodenoscopy, panoramic abdominal arteriography, and selective arteriography of the coeliac trunk), preceded subtotal pancreasectomy in a severe case of hypoglycaemia attributable to organic hyperinsulinism. Epstein's method was used to extract insulin from the pancreatic tissue for radioimmunological assay.