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A Codina Cazador

Publications and source records attributed to A Codina Cazador.

At least 19 recordsLinked to original sources
PubMed2004

[Recurrent ingestion of foreign bodies and abdominal self-injury as a form of attempted suicide].

Accidental ingestion of foreign bodies is fairly common in the general population. However, recurrent, deliberate ingestion of foreign bodies associated with continual abdominal self-mutilation with blunt objects is extremely unusual. We present the case of a young woman with an underlying psychiatric disorder who repeatedly presented to the emergency department of our hospital for attempted suicide. The most frequent reason for presenting to the emergency department was ingestion of multiple objects, usually sharp metal objects, frequently associated with abdominal self-mutilation using a sharp instrument. Treatment consisted of extraction of the foreign bodies through upper gastrointestinal endoscopy or abdominal surgery. The patient has survived all these attempts with minimal morbidity.

Abdominal Injuries↗
PubMed2003

[Diaphragmatic hernia of Morgagni-Larrey in adults: analysis of 10 cases].

Congenital diaphragmatic hernia of Morgagni-Larrey is a rare entity that usually presents on the right side. These hernias, occurring in the anterior midline through the sternocostal hiatus of the diaphragm, are usually discovered incidentally when the patient has reached adulthood, or when they become symptomatic due to intestinal involvement (occlusive symptoms) or when respiratory dysfunction occurs. We present 10 patients (mean age: 69 years) with symptomatic sternocostal hernia and intestinal occlusion. In 7 patients, the hernia was located on the right (Morgagni's hernia) and in three it was located on the left (Larrey's hernia). Most of the patients presented important associated comorbidity, mainly cardiovascular and neoplastic. Surgical treatment consisted of reduction of the contents of the herniated sac and hernia repair through simple suture with or without mesh for reinforcement, mainly through the abdominal approach. Mortality in this series was nil. The infrequency of this entity and its diagnosis mainly in adults, with a high prevalence of circumstances favoring abdominal hernias, suggest that an embryological defect of the sternocostal foramina of Morgagni or Larrey are an essential element in the physiopathology of these processes.

Adult↗
PubMed2001

[Gallstone Ileus: results of analysis of a series of 40 patients].

Gallstone ileus is an infrequent surgical emergency that nevertheless represents a not insignificant percentage of occlusions of the small intestine without strangulation. We present a retrospective study of 21 years (1980-2000) in 40 patients. Mean age was 76 years and most of the patients (85%) were women. Mean age and associated disease increased throughout the study period. Cases of gallstone ileus decreased in the second and third 5-year periods and clearly increased in the fourth (1996-2000). Localization of gallstones was ileum in 25 patients, jejunum in 9, duodenum in 3, colon in 1 and feces in 2. Only 12 patients (30%) received a correct preoperative diagnosis. Treatment was surgical in 38 patients with 7.5% mortality and 57.5% morbidity. Enterolithotomy was the technique of choice. A high degree of suspicion for gallstone ileus and early treatment may be the factors required to improve prognosis. The increase in life expectancy and associated comorbidity, which contraindicate elective surgery for cholelithiasis, may be contributing towards an increase in the population prone to developing gallstone ileus.

Aged↗
PubMed1998

Analysis of the quality of life in patients after pelvic pouch operation.

AIM: The aim of this study is to analyse the quality of life in patients with ileoanal pouch respect to a diverting loop ileostomy. MATERIALS AND METHODS: Fifteen patients (8 women and 7 men) with mean average age of 33 years who underwent mucosal proctectomy, colectomy, ileal-pouch-anal anastomosis and temporary loop ileostomy. Quality of life was studied when the patients had an ileostomy and follow-up evaluation, one year after restitution of anal defecation. The surgeons' evaluation was done using a health scale. RESULTS: Among the patients with temporary ileostomy, 40% reported bad tolerance, 53% leakage of stoma bag and 26% skin problems. The mean stool frequency among ileoanal anastomosis was four per day, 87% reported total continence, 13% had major complications and they needed pouch removal. 67% patients with ileostomy reported dietary restrictions against 13% patients functioning with pelvic pouch (p = 0.004). 13% patients with ileostomy had restricted sport activities. Social activities were restricted for 40% and 26% had limitations in their ability to work. Sex life was affected in 20% of patients with ileostomy and 13% of patients with ileal pouch anastomosis. 73% of patients presented an excellent level of satisfaction with pouch. CONCLUSION: Quality of life after ileoanal pouch anastomosis is higher than ileostomy.

Activities of Daily Living↗
PubMed1996

[Low digestive hemorrhage caused by amebic colitis].

Amebiasis is an infectious disease produced by Entamoeba histolytica, which has invasion capacity of the colon mucosa. It has different clinical forms, varying from the asymptomatic carrier state to severe, although not frequent, fulminant or necrotizing colitis, with an important necrosis of the colon mucosa. Perforation or intestinal bleeding are possible. We report one case of patient who had a history of recent travel to India. Was admitted with a clinical picture of abdominal pain, diarrhea and fever. Initially he received treatment with Metronidazole and steroids, because of doubts in the endoscopy diagnosis of Crohn's Disease versus Amebic Colitis. The patient developed a fulminant colitis, that required emergency surgery because of lower intestinal massive bleeding. During the operation perforations of the caecum and rectum were found. We performed a total colectomy with ileostomy and closing of the stump rectal. Six months later a second operation was made for the reconstruction of the intestinal continuity by an ileal pouch and rectal anastomosis.

Adult↗
PubMed1994

[Cytomegalovirus enteritis and colitis in nonimmunodepressed patients, a primary disease or superinfection?].

Cytomegalovirus disease is an opportunistic infection that is seen in patients with inmunodeficiencies. The group most commonly affected are AIDS and transplanted patients. Only a few cases of cytomegalovirus disease in non-immunocompromised patients have been reported. In localized disease, the gastrointestinal tract is the most frequently affected. We report two cases of acute abdomen caused by cytomegalovirus enteritis and colitis (histopathological diagnosis) without any underlying immune disorder. The role that the cytomegalovirus infection might play in the development of the clinical manifestations in these two cases is discussed. Without an established immunodeficiency we must be careful to attribute to cytomegalovirus infection the direct responsibility of the lesions. In the reported cases, the existence of intestinal ischemia is more than just a clinical hypothesis and pathological examination is inconclusive. The absence of an immunocompromised state, the presentation as an acute abdomen and the clinical course forwards intestinal occlusion in the first case are not characteristic of cytomegalovirus enteritis and colitis. We conclude that the two reported cases are in fact an ischemic enteritis upon which cytomegalovirus enteritis and colitis was superimposed, an association that has not been reported before.

Abdomen, Acute↗
PubMed1993

Multicentre study of a continent colostomy plug.

A multicentre clinical study was carried out to assess the performance of a new disposable device, the Conseal 1-Piece, for colostomy control and continence. Forty-three patients were studied; none had any complication at the stoma. The time elapsed since surgery and the condition of the stoma and surrounding skin were recorded. The new product was compared with the patients' usual colostomy bag, studying the following parameters: ease of application, reliability, leakage, confidence, ease of removal, adhesion and comfort. Thirty-seven patients completed the study. No complications arose, and complete faecal continence was obtained with 71.1 per cent of applications. The plug was kept in position for a mean of 11.5 h and a normal stoma bag was used for the remainder of the day. Of the 37 patients who completed the trial, 26 preferred the Conseal 1-Piece to a colostomy bag. In this preliminary study the device was easy to apply, involved no major complications and provided a high degree of continence. This product deserves further study because of its simplicity of use. However, research to improve the level of continence should continue.

Aged↗
PubMed1993

[Synchronous colonic and rectal carcinomas].

We present a retrospective study of 360 patients with surgically treated colorectal neoplasm between 1982 and 1990, in order to determine the incidence of synchronous colorectal carcinomas; and to analyze diagnosis procedures, detection time, pathology and treatment strategies. The incidence of synchronous carcinomas was 5.5% (20 cases). Only 30% of them were diagnosed preoperatively, and up to 40% were discovered in the pathological examination. In 2 patients 3 synchronous tumors were well found. All the synchronous neoplasms were differentiated, 65% of them were Dukes stage A. Synchronous colorectal polyps were found in 80% of patients. Complete exploration of the colon preoperatively by a routine pan-colonoscopy is recommended. In regard to the treatment of patients with synchronous colorectal carcinomas, partial colectomies are indicated as long as oncological criteria are followed, and the colon had been fully explored.

Adult↗
PubMed1993

[Retroperitoneal hematoma secondary to anticoagulation treatment as a cause of abdominal pain].

Retroperitoneal haematoma during anticoagulant therapy is a rare cause of abdominal pain. Over the past five years, five cases of retroperitoneal haemorrhage, two of them due to heparin and three to oral anticoagulant, were diagnosed in our hospital. All patients presented with abdominal pain and a mass. The authors conclude that a high degree of suspicion is mandatory when patients on anticoagulant therapy present with abdominal pain.

Abdominal Pain↗
PubMed1990

[Usefulness of transrectal echography in the study of rectal cancer].

This paper presents the initial results of a study designed to measure the ability of transrectal ultrasonography (TU) in determining the degree of local invasion of rectal cancer, comparing the preoperative radiographic diagnosis with the histological one. The series consists of 30 patients. In 24 cases preoperative TU was performed--following confirmation of the histological diagnosis--and in six cases UT was used after surgery to study the anastomosis. The postoperative group consists of eight males and 16 females, with a mean age of 70; in 14 cases the tumors were located in the lower third of the rectum, and in 10 cases in the middle third. In 12 of these 24 cases, pelvic CAT was also performed. TU showed the correct stage in 17 of the 24 (70.8%), with two false positives and five false negatives. CAT showed the correct diagnosis in 10 out of 12 (83%), with one false positive and one false negative. In the follow-up of the surgical patients, TU was normal in five cases and local recurrence was diagnosed. On the basis of our results, we consider that TU is a method with a high degree of diagnostic reliability in preoperative staging of rectal cancer; it can be associated with CAT; furthermore, it is an important screening method for early diagnosis of local recurrence at the suture line. Its main drawbacks are in studying high and stenosing lesions.

Aged↗
PubMed1989

[Appendicular diverticulitis: a review of 5 cases].

Of a total of 3,669 appendectomies, five corresponded to appendicular diverticulosis (0.13%), all of which had an inflammatory pathology. Four patients underwent emergency surgery with a diagnosis of acute appendicitis, and in only one was a correct preoperative diagnosis made. There were three cases of acute primary diverticulitis and one appendicitis with secondary diverticular affectacion. Another patient was operated electively for a history of long evolution; during the surgical act an appendicular inflammatory mass was found that the pathological report described as diverticulitis with subacute periappendicitis. Certain aspects of this entity are remarked and the bibliography is reviewed.

Adult↗
PubMed1989

[Immunoglobulins and the complement system in colorectal cancer].

In the present paper is studied the concentration in peripheral blood of immunoglobulins IgG, IgA, IgM and factors C3 and C4 of the complement system in a group of 120 patients with colorectal cancer operated on with radical intention. Preoperative values are compared to postoperative results and the values obtained on diagnosis of tumoral recurrence with the object of describing possible immunologic alterations existent in the patient with colorectal carcinoma. It is concluded that there are no significant relations between the biochemical parameters studied and age, sex, tumoral localization and Duke's clinical stages. Patients with pre and postoperative IgA values above normal present a poor prognosis, with an associated recurrence of 60% (p = 0.001) and 80% (p = 0.000), respectively; postoperative C3 levels above normal also represent a factor of poor prognosis, recurrence appearing in 80% (p = 0.001) and metastases in 85% (p = 0.000).

Adult↗
PubMed1989

[Descriptive analysis of 660 cases of upper digestive hemorrhage: relation of emergency endoscopy and mortality].

A study was made of 660 patients admitted for upper gastrointestinal bleeding in which the endoscopic findings were analyzed, excluding patients with esophageal varices and cases in which the lesions responsible for bleeding were not appreciated (5.7% diagnostic failure). 71.7% were males and 38.3% females, average age was 59.9 +/- 17.5 years and average hematocrit on admission was 27.4 +/- 8.2. 58.3% were over 60 years-old. There was a history of ingestion of gastro-erosive drugs in 56.8%. Gastroscopy was performed within 24 hours of admission in 77.4%, the first clinical symptom of bleeding being melenas in 50%. Peptic ulcer was the most common cause of upper gastrointestinal bleeding. Eighty-one patients required surgery, 30 early and 51 delayed. The global mortality was 3.6% and surgical mortality, 13.5%. After relating the endoscopic groups of upper gastrointestinal bleeding and individual risk with mortality rates, emphasis is placed on the need for early endoscopy as a diagnostic tool of prognostic value.

Adult↗