Asunto(s)
Malformaciones Arteriovenosas/cirugía , Hemorragia/cirugía , Complicaciones del Trabajo de Parto/cirugía , Arteria Esplénica/anomalías , Enfermedades del Bazo/cirugía , Vena Esplénica/anomalías , Adulto , Malformaciones Arteriovenosas/complicaciones , Malformaciones Arteriovenosas/diagnóstico , Femenino , Hemorragia/diagnóstico , Hemorragia/etiología , Humanos , Recién Nacido , Embarazo , Enfermedades del Bazo/diagnóstico , Enfermedades del Bazo/etiología , Resultado del TratamientoRESUMEN
This prospective clinical study was done to assess the efficacy of postcholecystectomy drainage. A total of 173 cholecystectomized patients were randomized into two groups; group A (86 patients) without drainage and group B (87 patients) with drainage. Group B included two types of patients; B1 (52 patients) with suction drain and B2 (35 patients) with gravity drain. Evidence of wound infection, chest complications, and duration of hospital stay were recorded in every case. Ninety five patients were assessed for chest complications and subhepatic collection by chest x-ray and abdominal ultrasonography. In group B patients the total amount of fluid drained was measured. The results were analysed by appropriate statistical methods. There was no significant difference in the rate of wound infection or atelectasis in either group, although there was apparent increase of lung complications and subhepatic collections in Group B1. The average postoperative hospital stay was significantly increased in group B patients. Considering all the parameters of this study, it was found that drainage with gravity was attended with the least morbidity.
Asunto(s)
Colecistectomía , Drenaje , Cuidados Posoperatorios , Adulto , Drenaje Postural , Femenino , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Atelectasia Pulmonar/prevención & control , Infección de la Herida Quirúrgica/prevención & controlRESUMEN
The large bowel is the most frequent primary site for metastases in inguinal hernial sacs. We report four cases, two due to carcinoid of unknown primary, and one each due to adenocarcinoma of colon, stomach and pancreas. We recommend that all hernial sacs, particularly in the elderly, be examined microscopically.
Asunto(s)
Neoplasias Gastrointestinales/patología , Hernia Inguinal/patología , Neoplasias Peritoneales/secundario , Adenocarcinoma/patología , Adenocarcinoma/secundario , Adenocarcinoma Mucinoso/patología , Adenocarcinoma Mucinoso/secundario , Adulto , Tumor Carcinoide/patología , Tumor Carcinoide/secundario , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Primarias Desconocidas , Neoplasias Pancreáticas/patología , Neoplasias Peritoneales/patología , Peritoneo/patologíaRESUMEN
In this series of seven uncommon and complicated cases of foreign bodies in the aerodigestive tract of children, the difficulties in the management, and complications encountered are described. Various factors affecting the outcome of these cases have been highlighted.
Asunto(s)
Broncografía , Esófago/diagnóstico por imagen , Cuerpos Extraños/terapia , Tráquea/diagnóstico por imagen , Preescolar , Femenino , Cuerpos Extraños/diagnóstico por imagen , Cuerpos Extraños/cirugía , Humanos , LactanteRESUMEN
Ten children had massive hiatal hernias repaired between January 1982 and February 1991. Their clinical presentation, association with other congenital abnormalities, and postoperative complications were different from those seen in adults. Vomiting (n = 7) and anaemia (n = 7) were the most common symptoms, followed by respiratory distress (n = 5), cough (n = 3), and regurgitation (n = 3). Abdominal pain was uncommon. The clinical diagnosis was confirmed in seven cases by barium meal examination. The most common operation was Nissen's fundoplication (n = 7); the hiatus alone was repaired in the remainder. Five patients developed postoperative complications and two died probably as a result of delay in diagnosis and associated malformations.
Asunto(s)
Hernia Hiatal/cirugía , Preescolar , Femenino , Hernia Hiatal/diagnóstico , Hernia Hiatal/etiología , Humanos , Lactante , Recién Nacido , Intubación Gastrointestinal , Masculino , Trastornos Nutricionales/complicaciones , Complicaciones PosoperatoriasRESUMEN
A clinical and radiological analysis of 13 right-sided diaphragmatic hernias is described. Four anatomically distinct though clinically similar variants (Bochdalek; paraoesophageal; eventration and Morgagni) of equal frequency make it a heterogeneous disease. Associated anomalies, found in ten out of 13 (77%), are a strong diagnostic indicator. The presence of congenital hypertrophic pyloric stenosis in 25% of infants suggests a degree of predisposition. Delay in pre-admission diagnosis was a median of 23.5 weeks from onset of symptoms and median age of diagnosis was 9 months, despite the onset of symptoms in the first week of life. A significant perinatal morbidity emphasizes the need for early diagnosis. Possible diagnostic indicators are: multiple anomalies, including chromosomal disease; an early recurrence of apparently 'cured' respiratory infection; and early onset of gastric outlet obstruction. Barium studies are the mainstay of diagnosis and were needed in ten patients. Fundoplication is a useful deterrent to recurrence in paraoesophageal hernias.