RESUMEN
INTRODUCTION: Acute appendicitis is the most frequent surgical emergency arising during pregnancy. Definitive diagnosis is often difficult. The therapeutic options remain the same, i.e. appendectomy. PATIENTS AND METHODS: We present a series of 29 pregnant women who underwent surgery for acute appendicitis over a period of 10 years. The mean age was 28.6 years. Mean gravidity was 1.75 and mean parity was 0.84. The average period of gestation was 18 weeks and 5 days since the last menses. Seven patients underwent surgery during the 1st trimester, 15 during the 2nd trimester, and seven during the 3rd trimester. Eighteen patients underwent appendectomy through a laparoscopic approach and 11 through a McBurney incision. RESULTS: The postoperative course was uncomplicated in 27 patients. Two patients miscarried in the week following surgery. CONCLUSIONS: Acute appendicitis puts both maternal and fetal prognosis at risk. Management should be prompt and undertaken by a multidisciplinary team approach. Morbidity and mortality are not negligible.
Asunto(s)
Apendicectomía , Apendicitis , Complicaciones del Embarazo , Aborto Espontáneo/etiología , Adolescente , Adulto , Apendicectomía/métodos , Apendicitis/diagnóstico , Apendicitis/cirugía , Femenino , Humanos , Laparoscopía , Complicaciones Posoperatorias , Embarazo , Complicaciones del Embarazo/diagnóstico , Complicaciones del Embarazo/cirugía , Trimestres del Embarazo , Estudios Retrospectivos , Resultado del Tratamiento , Ultrasonografía Prenatal , Adulto JovenRESUMEN
Lipomas of the colon are relatively rare benign tumors. Colo-colonic intussusception is an unusual complication of colonic lipoma. We report the case of a 79-year-old man who presented with spasmodic, self-limiting abdominal pain associated with rectal bleeding. Colonoscopy revealed a submucosal mass suggestive of a benign tumor but that was too large for endoscopic resection. CT scan demonstrated an endoluminal fatty mass in the transverse colon, typical of lipoma, and suggested colo-colonic intussusception due to the mass. The mass was removed laparoscopically. Recovery was uneventful.
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Neoplasias del Colon/diagnóstico , Colonoscopía , Intususcepción/etiología , Lipoma/diagnóstico , Tomografía Computarizada por Rayos X , Anciano , Neoplasias del Colon/complicaciones , Humanos , Lipoma/complicaciones , MasculinoAsunto(s)
Fístula Biliar/etiología , Conducto Colédoco/lesiones , Trasplante de Hígado/efectos adversos , Errores Médicos , Vena Porta/lesiones , Stents/efectos adversos , Fístula Vascular/etiología , Fístula Biliar/cirugía , Conducto Colédoco/cirugía , Remoción de Dispositivos , Femenino , Humanos , Ictericia/etiología , Persona de Mediana Edad , Vena Porta/cirugía , Prótesis e Implantes/efectos adversos , Prurito/etiología , Resultado del Tratamiento , Fístula Vascular/cirugíaRESUMEN
AIM: The aim of this retrospective study was to report the results of the laparoscopic management of common bile duct stones in an unicentric series of 30 patients. METHODS: From January 2001 to April 2004. 30 patients: 23 women, 7 men (mean age: 54 years). underwent a common bile duct exploration for lithiasis through a laparoscopic approach. The patients were hospitalized for angiocholitis (n = 12), cholecystitis (n= 4), jaundice (n = 4), pancreatitis (n = 3), abnormality of hepatic tests (n = 7). All the patients underwent an intra operative cholangiography. Removal of the stones was tried in 30 cases through a choledochotomy. never through the cystic duct, using Dormia and Fogarty catheters. External biliary drainage with T tube (kehr) and postoperative cholangiography was done systematically. RESULTS: In 21 patients (70 %), removal of the stones was laparoscopically successful. The average diameter of the common bile duct was 10.5 mm (range 6-20 mm). The median number of stones was 5 (E: 1-12). The median operation time was 180mn (range 150-300mn). In 9 patients, a conversion into laparotomy was necessary for several reasons. In 2 patients with residual common bile duct, the stones were treated successfully by endoscopic sphincterotomy. There was no mortality and the morbidity rate was 10 %. The mean postoperative hospital stay was 14.7 days (range 7-18days) and 13.3 days in case of successful laparoscopic management. CONCLUSION: In 70 % of the patients, the treatment of the common bile-duct lithiasis could be achieved laparoscopically, but conventional approach and endoscopic sphincterotomy are still useful in case of failure of the laparoscopic management.
Asunto(s)
Cálculos Biliares/cirugía , Laparoscopía , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios RetrospectivosRESUMEN
Our actual work studies the effectiveness in vivo of the Benzathin penicillin that is realized on 88 subjects suffering from a stable rheumatic fever. It has shown that: The first hours after an intramuscular injection, the benzathin penicillin is found at an efficient concentration superior to 0.02 ug/ml at the level of the blood. The highest dose in the blood is obtained the first 24 hours. The amount of antibiotic at the level of the blood is very efficient during 4 weeks.