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Biomedical subjects

A Giovinetto

Publications and source records attributed to A Giovinetto.

At least 37 records · Page 2Linked to original sources

[Sarcoidosis with a prevalent splenic localization: surgical option (presentation of a case].

Sarcoidosis is a granulomatosis disease of unknown origin with a variable clinical presentation. The reported frequency of splenomegaly in sarcoidosis ranges from 1% to 40%. Splenomegaly has been associated with clinical evidence of more extensive thoracic and extrathoracic sarcoidosis. We describe an interesting case of sarcoidosis with giant splenomegaly and abdominal pain but no evidence of systemic involvement. Sarcoidosis must be considered in the differential diagnosis of splenomegaly. The main indication for splenectomy is splenomegaly with resulting discomfort and/or haematological abnormalities. Though the natural history of sarcoidosis is generally unchanged after splenectomy, in our patient the operation resolved the abdominal pain completely with no need for further therapy.

Aged↗

[Acute cholecystitis in patients over 80 years of age: indication for immediate surgical treatment].

The Authors analyse the results of very early surgical treatment in 43 patients over 80 years of age. The severity of morphological changes in the gallbladder and complicated course of the disease are the main factors causing an unfavorable effect on the results of a later treatment. Echography allows, in a high percentage of cases, to confirm the clinical doubt of acute cholecystitis. Cholecystectomy was carried out in all the patients within the first 6 hours (very early surgery-VES). The overall mortality rate was 7%; the morbility rate was 18%.

Acute Disease↗

Recurrent hernia of Petit's triangle: a case report.

The Authors describe a case of recurrent hernia of Petit's triangle in a 43-year-old man. The most salient feature of lumbar hernias is the difficulty of their treatment. Numerous, more or less complex techniques have been proposed for the repair of lumbar hernias. The classic procedure is that of Dowd (1907). Repair in this case consists of a flap of fascia and aponeurosis from the gluteus medius muscle which is elevated and rotated to cover the defect. Many modifications of this technique have been proposed. The modern prosthetics mesh materials allow a tension-free repair of lumbar hernias without distortion of the normal anatomy. Correct placement of a prosthetic mesh is relatively simple. Recurrences are due not to the material used, but to patches which are too small or too tight.

Adult↗

[Use of PTF prosthesis in hernia in the elderly].

The paper reports the author's experience of the use intraperitoneal of Gore-Tex Dual Mesh Biomaterial in large incisional hernia operations in patients over seventy. From January 1999 to December 1999 we operated on 24 patients for treatment of abdominal wall defect. In all patients we used a Dual Mesh Plus Biomaterial. Overall mortality was 0. Morbility was 9.5%. Follow-up is too short for definitive considerations about the incidence of recurrences but our initial experience with this material encourages us to use it again for replacement of abdominal wall defects in the age.

Aged↗

[Metachronous carcinoma of the colon: report of a clinical case].

The Authors deal with a rare case of 'meta-metachronous' carcinoma of the colon. A seventy years old man was admitted to ward after being diagnosed an adenocarcinoma of the transverse colon. The anamnestic data pointed out that the patient had already been operated twice for the colon carcinoma, which had been diagnosed in the left colon and in the cecum respectively seven and two years before. A colonoscopy performed sixteen months before did not show any lesion of the residual colon. It is likely that tiny lesions, which were still in the adenoma phase, were not diagnosed by the endoscopy; it is also possible that the adenoma-carcinoma sequence was extremely fast. On the basis of this experience the Authors recommend that patients with metachronus carcinoma undergo either frequent controls or a preventive subtotal colectomy.

Adenocarcinoma↗

[Gastric lymphomas: surgical indications].

Primary gastric lymphoma (PGL) are lymphomas with an exclusive gastric localization. Histologically they are B-like non-Hodgkin lymphomas. Aim of Authors' study is to define the role of surgery in the treatment of PGL, on the basis of their series casistics and a review of the more recent literature data. The Authors observed 41 patients (23 F and 18 M) in a period of 10 years: 35 patients underwent to surgical operation associated in 18 of them to chemotherapic treatment; in 6 cases medical eradication of Helicobacter Pylori (H.P.) was performed as unique treatment. Antibiothic treatment allows the eradication of H.P. in 97% of the patients and a histologic decreasing of MALT lymphoma in 70% of the patients in about 6 months. That represents the first therapeutic choice for the low grade of malignancy MALT PGL at I and II stages. In the cases of partial decreasing or progression of PGL, the Authors consider opportune surgical operation. In the majority of the cases the surgical option represents, according to our advise, the best choice for the high percentage of definitive recoveries, allowing a 10 or more years of surviving of the 90%, if it is done in the first stages of the disease. The results of the association with neoadjuvant or aduvant chemotherapy are still controversial. On the basis of their experience total gastrectomy can be considered the elective choice operation, with IID level lymphadenectomy and possible splenectomy.

Female↗

[Predictive factors and treatment of small bowel adhesive obstruction].

Our study is based on a retrospective analysis about a ten years' control on patients with a small bowel adhesive obstruction (SBAO) due to primitive abdominal surgical operations. From the valuation of the obtained data and through a literatures review we tried to better define the best treatment. On 297 admissions of 248 patients with a diagnosis of SBAO 196 operations were performed, which indication was based on every clinical data, haematologic and radiologic examinations. Moreover, it was analysed the responsive factor that caused adhesions with a careful valuation of the primitive surgical operation and the possibility of recurrences. From this study it is evicted that SBAO can be considered as a surgical differentiable urgency, where there aren't any signs of intestinal strangulation or peritonitis, and where the principal etiologic factor is represented by colorectal operations in the male and gynecologic operations in the female. Morbility and mortality in the surgical procedures for SBAO show greater percentages than the elderly patients.

Adult↗

Abscess and cecum carcinoma in inguinal hernia: case report.

Cecal adenocarcinoma within an inguinal hernial sac is an uncommon clinical condition. A primary adenocarcinoma of the cecum in a right sided inguinal hernia is presented and discussed. This case represents one of the unexpected findings in a hernia sac and also very rare septic evolution. This particular condition is a main dignostic and therapeutic challenge.

Abdominal Wall↗

Pathological evaluation in colorectal polyps endoscopic treatment.

This retrospective study shows that endoscopic polypectomy is the technique of choice to remove the majority of polyps; follow-up and pathologic examinations shed light on the carcinogenesis of colorectal lesions. From January 1990 to December 2001, 1302 adenomatous polyps were removed, 1175 endoscopically, 127 with surgical procedures. The anatomical and morphologic conditions of the colon and some characteristics of the polyps represent limits to the feasibility and to the efficacy of polypectomy, and the most important variables for the correct management of the patients affected by colorectal adenomatous polyps.

Adenomatous Polyposis Coli↗