RESUMEN
The authors report a case of fungating cholangiocarcinoma of the porta hepatis, revealed by jaundice in a 73-year-old cholecystectomized female. The diagnosis of obstruction of the hepatic duct junction suspected by ultrasonography and computed tomography was confirmed intraoperatively. Disobstruction was followed by laterolateral choledocoduodenostomy. An early recurrence required a second disobstruction with surgical then endoscopic insertion of a drain, with 23 months of satisfactory survival. The discussion is focused on hilar fungating cholangiocarcinoma. The extrahepatic (Klatskin tumor) or intrahepatic origin of these lesions, the circumstances and morphological investigations for the diagnosis are discussed. Particularities of the treatment are mentioned, with emphasis on the possible participation of the endoscopist for choledocho or hepaticoduodenostomy.
Asunto(s)
Adenoma de los Conductos Biliares/diagnóstico por imagen , Neoplasias de los Conductos Biliares/diagnóstico por imagen , Adenoma de los Conductos Biliares/patología , Adenoma de los Conductos Biliares/cirugía , Anciano , Anastomosis Quirúrgica , Neoplasias de los Conductos Biliares/patología , Neoplasias de los Conductos Biliares/cirugía , Drenaje , Femenino , Humanos , Recurrencia Local de Neoplasia , Prótesis e Implantes , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
The authors report a case of fungating cholangiocarcinoma of the porta hepatis, revealed by jaundice in a 73-year- old cholecystectomized female. The diagnosis of obstruction of the hepatic duct junction suspected by ultrasonography and computed tomography was confirmed intraoperatively. Disobstruction was followed by laterolateral choledocoduodenostomy. An early recurrence required a second disobstruction with surgical then endoscopic insertion of a drain, with 23 months of satisfactory survival. The discussion is focused on hilar fungating cholangiocarcinoma. The extrahepatic (Klatskin tumor) or intrahepatic origin of these lesions, the circumstances and morphological investigations for the diagnosis are discussed. Particularities of the treatment are mentioned, with emphasis on the possible participation of the endoscopist for choledocho or hepaticoduodenostomy.
Asunto(s)
Adenoma de los Conductos Biliares/diagnóstico por imagen , Neoplasias de los Conductos Biliares/diagnóstico por imagen , Colestasis Intrahepática/etiología , Adenoma de los Conductos Biliares/complicaciones , Adenoma de los Conductos Biliares/patología , Adenoma de los Conductos Biliares/cirugía , Anciano , Neoplasias de los Conductos Biliares/patología , Neoplasias de los Conductos Biliares/cirugía , Colestasis Intrahepática/cirugía , Femenino , Humanos , Recurrencia Local de Neoplasia , Reoperación , Tomografía Computarizada por Rayos X , UltrasonografíaAsunto(s)
Apendicectomía/métodos , Apendicitis/cirugía , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Técnicas de Sutura/instrumentaciónRESUMEN
A case of mesenteric cystic lymphangioma revealed by hypochromic anemia and abdominal pain, secondary to an intracystic hemorrhage is reported in a 4-year old child. Etiology, pathology, diagnosis, treatment and prognosis of mesenteric lymphangioma in children are reviewed.
Asunto(s)
Linfangioma/complicaciones , Quiste Mesentérico/complicaciones , Mesenterio , Neoplasias Peritoneales/complicaciones , Preescolar , Femenino , Humanos , Linfangioma/diagnóstico por imagen , Linfangioma/cirugía , Quiste Mesentérico/diagnóstico por imagen , Quiste Mesentérico/cirugía , Neoplasias Peritoneales/diagnóstico por imagen , Neoplasias Peritoneales/cirugía , Pronóstico , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
A case of mesenteric cystic lymphangioma revealed by hypochromic anemia and abdominal pain, secondary to an intracystic hemorrhage is reported in a 4-year old child. Etiology, pathology, diagnosis, treatment and prognosis of mesenteric lymphangioma in children are reviewed.
Asunto(s)
Anemia Hipocrómica/etiología , Linfangioma/cirugía , Neoplasias Peritoneales/cirugía , Preescolar , Femenino , Humanos , Linfangioma/sangre , Linfangioma/complicaciones , Linfangioma/diagnóstico , Neoplasias Peritoneales/sangre , Neoplasias Peritoneales/complicaciones , Neoplasias Peritoneales/diagnóstico , Pronóstico , Tomografía Computarizada por Rayos X , UltrasonografíaRESUMEN
Two cases of squamous carcinoma of the anus developing from condylomata acuminata are reported. The general characteristics of condylomata acuminata are reviewed: viral etiology due to HPV virus, histological appearance and role in the the genesis of certain cancers. The association of condylomata acuminata and cancer of the anus is more particularly studied in a review of the literature: etiology, anatomoclinical aspects, treatment and current state of knowledge concerning the oncogenic role of HPV virus at this site.
Asunto(s)
Neoplasias del Ano/patología , Carcinoma de Células Escamosas/patología , Condiloma Acuminado/patología , Neoplasias Primarias Múltiples/patología , Adulto , Anciano , Neoplasias del Ano/etiología , Neoplasias del Ano/terapia , Braquiterapia , Condiloma Acuminado/complicaciones , Condiloma Acuminado/terapia , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Quality of care has been evaluated in this study by the criterion of mortality in a Digestive and Vascular Surgery unit. The analysis over a one-year period concerned 34 dead patients among 1298 entered and 1,108 operated patients who underwent 1,248 operations. The causes of death have been studied in the 3 groups: non operated (5 patients), digestive (20 patients), vascular (9 patients), with distinction of emergency surgery. Therapeutic habits have been systematically reexamined and considered either adapted or to be modified. Punctual conclusions of such a study are interesting for the medico-surgical team but also for the nursing team. Transparency of mortality for a whole team is a factor of progress by the periodical reappraisal of the therapeutic habits based upon accurate data, and by the better collaboration in the team.