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Biomedical subjects

A Franchello

Publications and source records attributed to A Franchello.

42 records · Page 3Linked to original sources
PubMedDate not supplied

[A rare case of Merkel's tumor with intestinal metastases].

A rare case of intestinal metastasis of a neuroendocrine carcinoma of the skin (Merkel Cell Tumor) is reported. The primary tumor was excised from the left arm two years earlier and followed an aggressive course with lymph-nodes, tonsillar and intestinal spread. Histologically, the intestinal lesion was similar to the primary tumor with small, undifferentiated cells. Undifferentiated small cell carcinoma and lymphomas of the gastrointestinal tract are to be considered in the differential diagnosis. Merkel Cells Tumor usually affects head and neck (44%) and extremities (48%), and is a highly malignant neoplasia, with early recurrence and distant metastases. Wide surgical excision of the primary lesion is the treatment of choice, while controversial is the role of prophylactic regional lymphadenectomy. Adjuvant radio- and chemo-therapy is frequently associated.

Carcinoma, Merkel Cell↗
PubMedDate not supplied

[Biliary drainage in neoplastic obstructive icterus].

The authors consider the use of endoscopic or transhepatic bile drainage to regress jaundice and cholestasis before surgical treatment (radical or palliative) or like an alternative to it.

Catheterization↗
PubMedDate not supplied

[Cystic dilatation of the choledocus].

Choledochal cyst is an uncommon congenital lesion of the pancreatobiliary system. The pathologic features are cystic dilatation of the common bile duct, normal liver parenchyma, a normal intrahepatic biliary system and partial obstruction of the terminal common bile duct. More than 1400 cases have been reported in tre literature, 83 per cent of which have been diagnosed in patients below the age of 30. A triad of abdominal pain, jaundice and a palpable abdominal mass in the right hypocondrium has been classically associated with this condition. Ultrasonography and CT scanning are usually successful in demonstrating the mass. Cholangiography by the endoscopic retrograde approach may demonstrate the cystic dilatation of the common bile duct. The precise relation ship of the cyst to the biliary tree should be demonstrated by cholangiography at operation. The common type I fusiform cyst is currently treated either by excision combined with a biliary intestinal anastomosis of by anastomosis of the cyst to the intestinal tract. Treatment of the rare type II diverticulum consist of simple excision, while the rare type III choledococele is treated by transduodenal excision of the cyst wall. The current mortality rate of choledochal cyst treated by surgical decompression is 5 to 10 per cent. A case of choledochal cyst in a 58 years old woman is described. The anatomopathologic, clinic features and therapeutic lines are pointed out.

Cholangiography↗
PubMedDate not supplied

[Gallstone ileus, observations on 13 cases].

The authors expose some considerations about clinical features of this unusual condition. Thirteen cases of gallstone ileus are reported. The medium age was 70 years. The postoperative course was regular for 12 cases, and only one patient died seven days after the operation.

Aged↗
PubMedDate not supplied

Rupture of thoracic aorta resulting from blunt trauma.

BACKGROUND: Traumatic rupture of thoracic aorta caused by blunt trauma has been observed more frequently in recent years. The aim of this study was to evaluate the state of the art of diagnostic methods used to identify this injury and the surgical techniques used to repair it. METHODS: The study was performed in 29 patients undergoing surgery for traumatic rupture of thoracic aorta from November 1979 to July 1995. RESULTS: All patients presented multiple blunt traumatic injuries. The suspicion of traumatic aortic rupture always arose when evidence of an enlarged mediastinal shadow was found on the chest X-ray, subsequently confirmed in 27 cases using aortography. During the period 1993-1995 11 patients underwent CT scan before aortography, which resulted false negative in 3 cases (27.2%). The decision to perform surgery was based on well defined priorities: abdominal injuries took priority over the aortic injury, and in stable patients with intracerebral injuries, head CT scan and neurosurgery were performed first. Eight patients died (overall mortality was 27.5%). CONCLUSIONS: CT scan should not be used for the diagnosis of aortic traumatic rupture because it is a waste of time (all patients have to undergo aortography before surgery) and the false negative rate is too high.

Adult↗