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Biomedical subjects

A Celestino

Publications and source records attributed to A Celestino.

6 recordsLinked to original sources

[Massive lower digestive bleeding].

Lower digestive bleeding is the bleeding distal to the ligament of Treitz and ranges from occult loss to massive hemorrhage. Acute and massive form represents about 20% of all gastrointestinal acute bleeding. In children and young patients the most frequent causes are juvenile, polyps Meckel diverticula, and intussusception; in adult ages are the diverticular disease of colon, angiodysplasia and neoplasia; we must include also the intestinal TBC, typhoid fever, and intestinal amebiasis. The first aim in the management of this acute syndrome is the treatment of the hypovolemic shock; when the patient is well resuscitated, the diagnosis of the cause of hemorrhage will start using the clinical history and physical examination, proctosigmoidoscopy, emergency colonoscopy and/or angiography, or scintigraphy with 99mTc-labeled red blood cells. Definitive therapy include endoscopic an angiographic methods, or the emergency surgery. Mortality is 11% to 21%.

Adult

[Fiber endoscopy in the extraction of foreign bodies from the gastrointestinal tract].

23 patients that they swallowed foreign bodies, were treated. There were 16 male and 7 female, between 3 and 85 years old; 6 children and 17 adults. Of all, 7 were psychiatric patients. 15 foreign bodies were removed by upper digestive fiberendoscopy and 2, by procto/colonoscopy, without early nor late complications. 8 foreign bodies were eliminated spontaneously through the rectum/anus. Fiberendoscopy is an excellent method for treatment in these clinical problems.

Adolescent

[Colonoscopic diagnosis].

Between 1974 and 1992, we perform 3,054 colonoscopies for diagnosis in 2,770 patients, both of sexes, between the ages of 1 and 101 yr, most of them over the fifth decade of life. In 300 procedures the bowel cleansing was made with the standard method of liquid diet and enemas, and in the other 2,754 with the oral administration of saline solution 9% with optimal results. We get the sedation of patients with the intravenous administration of diazepam 10mg, or pethidine 50 mg, or midazolam 2.5 to 5 mg, and in children with ketamine and the anesthesiologist assistance. In 95% of the procedures we can see the cecum and the ileum; the diagnosis was abnormal in 52.78% of cases, normal in 45.20%, and insufficient in 02.02% specially for a bad cleansing of the bowel. In the abnormal group, the most frequent diseases we diagnose were: polyps, cancer, diverticular disease, and specific inflammatory disease of the bowel like TBC, radiation proctosigmoiditis, amebiasis, and non-specific bowel disease: "colitis", ulcerative proctocolitis, erosive colitis, and Crohn's disease. Colonoscopy is a very important method for diagnosis of colon diseases, alone or complementary of double contrast X-ray of the colon.

Adolescent

[Therapeutic colonoscopy in patients with colonic and rectal polyps].

598 colorectal polyps were removed by therapeutic colonoscopy from 377 patients, of both sexes, between 1 and 88 years old, most of them with lower digestive symptoms. The polyps were unique in 67.37% and multiple in 32.63% of patients, and mostly located in rectum and sigmoid colon; 42.14% were pedunculated, 33.95% sessile++/sub-pedunculated, and 23.91% sessile in shape. In 51% the size was over 10 mm in diameter. Histologically, 68.68% were of epithelial neoplastic type: 60.91% adenoma; 6.42% adenoma with adenocarcinoma, and 1.35% polypoid carcinoma. 30.64 were epithelial non-neoplastic type: 20.32% hyperplastic polyp, and 0.51% hyperplastic polyp with tubular adenoma. Two patients (0.53%) had lower digestive hemorrhage immediately after the polypectomy. The complications were controlled with conservative measures without blood transfusion.

Adolescent

[Adenoma of the colon and rectum].

318 adenomatous polyps were removed by colonoscopic polypectomy, from two hundred patients, between 25 to 88 years old; 60.50% men, and 39.50% women. 86.50% of patients were older than 50 years old. In 64.50% of patients the adenomatous polyp was single, and 35.50% had "multiple adenoma"; the lesions distribution was 72.64% in the rectum-sigmoid colon. The grade of dysplasia was severe in adenomas over 20mm, and in those of villous type. The malignant percentage was: 1.61% in the adenomatous polyp under 10mm in diameter, 8.49% in those of 10mm to 19mm, and 30.68% in the adenomas of 20mm or more. The adenocarcinomatous focus increased from 1.69% in the adenomas under 10mm to 58.33% in those of 40mm or more in diameter. The relationship between type of adenomatous polyp and his adenocarcinoma incidence was 7.66% in tubular type, 22.22% in tubular-villous, and 26.32% in villous type. The carcinoma incidence in all of the adenomas of this series was 11.95%.

Adenoma