RESUMO
The hepatodiaphragmatic interposition of the colon (Chilaiditi's Syndrome) and associated volvulus of the transverse colon is a rare cause of mechanical intestinal obstruction. The preoperative diagnosis is extremely difficult. We report a 26-year-old- male case, symptomatic since childhood, whose diagnosis by barium enema was confirmed surgically in Hospital Universitário de Taubaté. He underwent a transversectomy, and presented an intestinal obstruction in the post-operative period. Two reoperations were required. He has remained well, with outpatient supervision.
Assuntos
Doenças do Colo/complicações , Diafragma/anormalidades , Obstrução Intestinal/complicações , Ligamentos/anormalidades , Adulto , Seguimentos , Humanos , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/cirurgia , Masculino , Complicações Pós-Operatórias , Radiografia , Recidiva , Reoperação , SíndromeRESUMO
The anatomo-pathologic alterations determined by ethanol in the gastroduodenal mucosa of rats are studied, as well as its action about truncal vagotomy plus pyloroplasty (VT + P). We use albino rats submitted to the administration of ethanol, 33% --via orogastric catheter- and to truncal vagotomy plus pyloroplasty, as well the association of the 2 variants. The utilization of ethanol, according to the up to date methodology, can be confirmed by a simple experimental production method of acute ulcer in rats. The VT + P determined acute ulcers in the 24 hour observation group, besides acute inflammatory lesions and with the decrease of mucins, diffusively, in the gastroduodenal mucosa. The performance of VT + P, 2 hours after the administration of ethanol, period in which the lesions are entirely settled, determined and aggravation of the gastric lesions through the increase of the media ulcerous gastric area and its histological aspects. On the other hand, the performance of VT + P, followed by the administration of ethanol 2 hours after, also determined an aggravation of gastric lesions, according to the same former parameters. When it was the time to perform the VT + P, 10 days before the administration of ethanol, or the inverse, a small reduction at the ulcerous gastric area had accrued but it did not amount to much. There was not a characterization of preventive effects or curative of this surgical procedure considering the gastric lesions produced by ethanol, but there was characterization of aggravating effect. All the possible hypothesis to the aggravation of these lesions are also discussed with the utilization of VT + P, as well its clinical use on the human being.