RESUMEN
Lipoma is a benign tumour of mesenchymal origin which is not frequently localized in the gastroenteric tract; in anatomopathological statistics it is less rare: this is due to the fact that it rarely reaches dimensions which warrant surgical treatment. It is usually either an occasional finding during the course of laparotomy due to other motives or is the cause of complications, as in the present case of intestinal occlusion due to ileocolic invagination, resulting in emergency surgery. As a cause of occlusion tumours of the small bowel are second in terms of incidence to adhesive factors, volvuli and hernias. Invaginations account for 2/3 of small bowel occlusions caused by up to 80% of tumours: the lipoma is the most frequent benign tumour to cause invagination in its submucous polypoid and more or less scissile form. Symptoms are not specific and this causes a delay in diagnosis. Patients are often young subjects with a history of recurrent abdominal colic and sensitivity to anti-spastic drugs so much so that in the past they were diagnosed as "chronic colic" sufferers. Sometimes the only symptom is dyspepsia, or nausea and vomiting, or occasionally abdominal distension with constipation or attacks of diarrhoea. Radiology is not of great value in the diagnosis except for indicating the possible need for emergency surgery. There are no radiological tests, with or without contrast mediums, echography, CAT or MNR which can diagnose this pathology. The decision to operate is usually triggered by the presence of a complication, but perioperative extemporary histological tests are advisable for a correct surgical approach: if the form is scissile, segmentary resection of the small bowel is necessary.(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Enfermedades del Íleon/etiología , Neoplasias del Íleon/complicaciones , Obstrucción Intestinal/etiología , Lipoma/complicaciones , Humanos , Enfermedades del Íleon/patología , Enfermedades del Íleon/cirugía , Neoplasias del Íleon/patología , Neoplasias del Íleon/cirugía , Íleon/patología , Obstrucción Intestinal/patología , Obstrucción Intestinal/cirugía , Tiempo de Internación , Lipoma/patología , Lipoma/cirugía , Masculino , Persona de Mediana Edad , Factores de TiempoRESUMEN
The aim of this procedure is to obtain a permanent prosthesis (after mastectomy and the insertion of a tissue expander) that is similar to the contralateral breast in volume, morphology and inframammary border. The technique involves aspiration of the tissue expander fluid until the desired volume is obtained and the measurement of the fluid which indicates the volume of the prosthesis to be inserted. Given the satisfactory results obtained, the intention is to continue adopting this procedure.
Asunto(s)
Mamoplastia/métodos , Dispositivos de Expansión Tisular , Adulto , Estética , Femenino , Humanos , Mastectomía , Pronóstico , Prótesis e ImplantesRESUMEN
In order to assess the effect of felodipine, a new calcium antagonist with vascular selectivity, on regional blood flow distribution at rest in chronic congestive heart failure, ten patients were studied during an acute test. Right heart catheterization allowed the evaluation of hemodynamic parameters; renal blood flow was calculated using paraamino-hippuric acid clearance; hepatic blood flow measurement was based on indocyanine green clearance; and limb blood flow was assessed with venous occlusion plethysmography. Blood samples were collected for the analysis of plasma catecholamines, renin, and aldosterone. All parameters were recorded in duplicate under basal conditions and after felodipine infusion. The infusion of felodipine induced a significant increase in cardiac index, stroke work index, and limb blood flow. Systemic and pulmonary arterial blood pressure, pulmonary wedge pressure, and systemic resistance underwent a significant decrease. The heart rate, pulmonary resistance, renal blood flow, and hepatic blood flow were not changed. In conclusion, felodipine was of benefit in congestive heart failure at rest in an acute test, acting through a marked decrease in vascular resistance and a consequent improvement in cardiac output and limb blood flow. No changes in renal and hepatic blood flow were observed.