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Biomedical subjects

A Mambrini

Publications and source records attributed to A Mambrini.

At least 55 records · Page 3Linked to original sources
PubMed1992

[Volvulus of the colon. Apropos of 37 cases].

A retrospective study of 37 case reports of patients with volvulus of the colon was carried out to define diagnostic and therapeutic strategies. The group comprised 22 men and 15 women, mean age 69 +/- 4 years (range 26-88 years), the volvulus being located in the sigmoid colon (n = 23), ascending colon (n = 13) or transverse colon (n = 1). The diagnosis, suggested by the straight abdominal film in almost all cases, was confirmed by a barium enema in 70% of cases. Treatment was surgical in 30 patients (81%) including 12 as emergency operations. Mortality was 5.4% (2 cases), and morbidity high (43% including fatal complications) the majority of adverse reactions being respiratory. Volvulus of the ascending colon was treated by hemicolectomy in 9 cases with no mortality or relapse. In patients with sigmoid volvulus, a "medical" reduction was performed in 7 patients, with success in 5 cases, one recurrence and no mortality, ideal sigmoidectomies in 14 cases resulting in one recurrence and no mortality. Right hemicolectomy appears to be the technique of choice even for urgent cases, there being no contraindications to a one-stage re-establishment of continuity. Inversely, an urgent intervention should at all costs be avoided in cases of sigmoid volvulus, a "medical" reduction (radiology, intubation, endoscopy) allowing preparation of the patient for a deferred ideal sigmoidectomy. Obviously, failure to reduce the volvulus or signs of colon necrosis require urgent surgery and raise the problem of whether or not to re-establish colon continuity.

Adult↗
PubMed1991

[Cholelithiasis in patients over 75 years of age. Apropos of 147 cases].

The authors perform a retrospective study of a series of 147 patients aged 75 and more, who were treated for gallstone. AMong them, 104 had conventional surgery and 43 a nonsurgical treatment. The noticeable elements produced by this analysis are: the frequency of common bile duct lithiasis and of severe septic complication in elderly patients, the frequency of previous gallstone, sometimes remote in time, a significantly higher mortality when the treatment is non-surgical (p less than 0.001), mainly due to the septic complications of the lithiasis. the influence of the diathesis on mortality, and finally, the greater inocuity of the right infracostal approach in view of respiratory complications.

Age Factors↗
PubMed1991

[Sigmoido-uterine fistula of diverticular origin. Review of the literature apropos of a case].

The authors report one case of sigmoid-uterine fistula of diverticular origin with a favorable outcome after an ideal colectomy associated with subtotal hysterectomy. They emphasize the rarity of this complication, due to the resistance of the uterine tissue. Its diagnosis is primarily clinical, and other examinations are required only to establish the etiological diagnosis. Surgery must be curative, ideally in one stage including the treatment of the diverticular disease and that of its gynecological consequences, which may vary according to the local conditions.

Colectomy↗
PubMed1991

[Prognostic factors for peritonitis in elderly patients. Multifactorial statistical analysis apropos of 216 cases].

The aim of this paper is to analyse retrospectively the data of our patients over 60 years old who had an acute peritonitis, localized or diffuse, to establish prognostic factors. They were 216 patients, who underwent surgical treatment between 1971 and 1990. We observed 243 variables and its significance using the chi 2 test. We divided our study in two stages: from 1.10.71 to 30.09.80 (group I = 93 patients) and from 1.10.80 to 31.01.90 (group II = 123 patients). Group I was composed by 51 men and 42 women with a mean age of 71.9 +/- 5.3 years. General mortality of this group was 36% (33 patients). Group II corresponded to 55 men and 68 women with a mean age of 74.26 +/- 7.1 years. Mortality was 23% (28 patients). Age, sex and associated clinical disorders were not significant on prognosis, meanwhile the clinical and biological form of presentation were not adequate to establish a severity index. The most common ethiologies were: biliar (24 patients = 26%) in group I and appendicular (41 patients = 32.2%) In group II. Significant factors on mortality rates in group II were: delay between onset of symptoms and surgical treatment (over 96 hs, p less than 0.05), generalized or purulent peritonitis operated after 96 hs from onset of the attack (p less than 0.05) and malignancy (p less than 0.01).

Acute Disease↗
PubMed1990

[Gastropericardial fistula. Review of the literature apropos of an original case].

The authors present a case of pneumopericarditis consecutive to a perforating gastric ulcer complicating a left, post-traumatic diaphragmatic hernia, evolving favorably after radical surgery. 52 cases of gastro-pericardial fistulas were reported in the literature, 42 of which related to benign pathology. The overall mortality rate for this disease was 85%, although the course was favorable in one patient out of two, whenever radical surgery had been resorted to. In order to ensure these patients the best chances for survival, treatment should combine pericardial drainage and case-adapted gastro-intestinal surgery in an intensive care setting.

Aged↗
PubMed1990

[Diagnostic splenectomy. Apropos of 38 cases].

The authors report a retrospective study of 38 splenectomies performed as a diagnostic procedure. In the first group, the diagnosis was made by surgery: 27 cases (71.1%) included the usual large number of lymphomas. In the second group, there was no conclusion: 11 cases (28.9%), patients were younger and the spleen was lighter with a statistical significance (p less than 0.006 and p less than 0.003). Three of the 11 patients in the second group subsequently developed a malignant blood disease. Morbidity was high: out of 38 cases, 14 complications occurred in 11 patients (28.9%). One patient died on the fifty fifth postoperative day. The authors consider that splenectomy for undiagnosed splenomegaly is an effective procedure for diagnosing lymphoma, but not without risk. Indications for surgery must be carefully evaluated. It is more questionable in young, asymptomatic patients or in the case of moderate splenomegaly. After surgery, with no histologic diagnosis only a long-term survey will differentiate patients with malignant blood diseases from patients with idiopathic splenomegaly.

Adolescent↗
PubMed1989

[A new case of cystic lymphangioma of the pancreas].

The authors describe a new case of cystic lymphangioma of the pancreas treated surgically by cephalic duodeno-pancreatectomy associated with right hemicolectomy. Following a review of the literature, they recall the anatomo-pathological and clinical characteristics of vascular connective tissue tumors of the pancreas. From a therapeutic viewpoint, they conclude on the necessity for complete removal of these unusual tumors, either by tumor resection or by appropriate pancreatic resection, which are the only guarantees of a definitive curve.

Abdominal Pain↗
PubMed1988

[Intraperitoneal rupture of an aseptic necrotizing fibroma in pathological pregnancy. Apropos of a case].

The authors report a rare case of complication of aseptic necrosis of a fibroma. In early pregnancy: intraperitoneal rupture resulting in an obstructive syndrome secondary agglutination of small bowel loops. They attempt to explain the mechanism of this complication and stress the fact that surgical treatment is exceptional in complications of necrosis, and a medical treatment is usually sufficient, in most cases.

Adult↗
PubMed1988

[Splenectomy in the treatment of idiopathic thrombopenic purpura in adults. Apropos of 43 cases].

Case reports of 43 patients with idiopathic thrombocytopenic purpura (ITP) operated upon from 1975 up to the present were analyzed. After revision of therapeutic indications the predictive prognostic factors for splenectomy, essentially the initial response to corticotherapy, were studied. Findings indicated that splenectomy is effective treatment for ITP since permanent total remissions were obtained in 76% with a morbidity of 16% and a mortality of 2%. Emphasis is placed on the need for minute pre-, intra- and post-operative precautions.

Adrenal Cortex Hormones↗
PubMed1983

[Effects of insulin on the deformability of normal erythrocytes suspended on artificial tampons, in normal plasma and plasma of diabetic patients].

The effect of different insulin concentrations on the deformability of normal red blood cells resuspended in different media was studied in vitro. Insulin enhances red blood cell deformability measured by the filtration method and the observed increases are directly correlated with insulin concentrations. When red blood cells are resuspended in plasma of diabetic patients, the red blood cell filterability through Nucleopore filters is slower than that observed by resuspending the erythrocytes in normal plasma. This suggests that the plasma of diabetic patients contains an unknown factor able to reduce red blood cell deformability.

Diabetes Mellitus, Type 1↗
PubMed1981

[Barotraumatic rupture of the esophagus : a case report (author's transl)].

A case of barotraumatic rupture of the thoracic esophagus with a favorable outcome is reported, and the 12 cases found in the published literature reviewed. Mortality was 3 out of 5 in unoperated cases, and only 1 out of 7 in the patients treated by surgery. This emphasizes the need for early diagnosis, thoracotomy for esophageal repair, drainage by-passing digestive secretions, and parenteral feeding, this constituting the best guarantee in the fight against mediastinitis.

Adult↗
PubMed1980

[Repair of duodenal defects by a pedunculated jejunal flap. Experimental study in the dog (author's transl)].

The authors operated 18 dogs on whom they carried out a large duodenal defect which was then repaired, in the same operation, by an open pedunculated jejunal flap. They studied the progress of this flap and the quality of the duodenal repair. After about 4 months, on average, the animals were re-operated to check the quality of the repair and to see if the vascular peduncle could be cut. Section of the vasculature was well tolerated because of the development of very small vascular anastomoses.

Animals↗