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Biomedical subjects

C Dragomirescu

Publications and source records attributed to C Dragomirescu.

11 recordsLinked to original sources
PubMed1991

[The clinical and therapeutic characteristics of a bulky gastrinoma].

The case of a 55-year-old woman with a duodenal ulcer developing since 6 months is reported, in whom the surgical indication was early established on the basis of increasing of suffering and inefficacy of the medical treatment. Intraoperatively an exophytic pancreatic tumour sited on the upper border of the isthmus, sized 5/6/4 cm, was found. In view of the suspicion of gastrinoma and considering that total gastrectomy or splenopancreatectomy would be excessive taking into account the patient's state, option was made for exeresis of the tumour. The ulcerous suffering disappeared and the histological examination of the specimen (weighting 70 g) confirmed a benign gastrinoma. The peculiarities of the case and data from the literature dealing with gastrinomas are discussed.

Duodenal Ulcer↗
PubMed1991

[A solitary nonparasitic liver cyst].

The paper reports on an observation of hepatic nonparasitic solitary cyst, size 10/12 cm, noncomplicated, in a 77-year-old woman. The lesion was treated by digital enucleation and suture of the hepatic wound, with a good result. The paper presents literature data on the hepatic nonparasitic solitary cyst.

Aged↗
PubMedDate not supplied

[Diverticula of the duodenal orifice].

The authors present a synthesis of data from the literature, as well as of particularities that have confronted them in connection with 16 observations of mucous diverticuli of duodenal windows (of which 7 were interposed and 9 were juxtaposed). After a definition of the window diverticuli, of their types and of their repercussions, clinical data are commented upon, the possibilities offered by paraclinical investigations and by the intra-operatory methods, as well as the different therapeutical procedures. In relation with the clinical manifestation the diverticuli may be latent (or asymptomatic), they may be accompanied by direct signs of stasis and inflammation, or with biliary and pancreatic signs--an expression of the unfavourable influence exerted by the diverticuli on the biliary and pancreatic transits. The choice of the therapeutical procedure depends on the type of the diverticuli, the modality of the clinical expression and the bilio-pancreatic effects determined by them. Direct interventions can be performed on juxtaposed diverticuli, although this implies considerable risk, but indirect interventions are to be preffered, in which, in relation with the particularities of the case, the biliary transit is derivated or the duodenum is excluded from the digestive pathways.

Adult↗
PubMedDate not supplied

[Complications of splenectomy].

The present study is an analysis of complications developing after a total of 200 splenectomies carried out for various indications: primary hypersplenism (83), secondary hypersplenism following portal hypertension (72), diseases of the hemopoietic system (24), parasitic and infectious splenomegalies (13), rupture of the spleen or of splenic artery aneurisma (8). A number of 68 patients (34%) had a total of 73 complications following surgery. Of these 60 have recovered (30%) while 8 (representing 4% of the total), died. A total of 22 local or general septic complications were noted, as well as 20 complications generated by disturbances of the balance of fluids and/or of the coagulation system, 19 pleuro-pulmonary complications, 6 complications that were not specific for splenectomy, 5 pancreatic complications and 5 cases of hepatic failure.

Hemorrhage↗
PubMedDate not supplied

[Surgical rehabilitation of nonfunctioning bilio-digestive shunts].

The authors consider the internal biliary derivations as a choice procedure for the resolution of various pathological conditions of the biliary pathways and of the pancreas. They are based on the experience accumulated in the course of a total of 416 derivations performed in the last 10 years. The confrontation with particular problems raised by 40 re-interventions for failure of internal biliary derivations has determined an analysis of causes, clinical manifestations and possibilities to solve the disturbances. Categories are discussed, in which these patients can be classified and clinical observations are presented, in connection with the etiopathogeny of the non-functioning of the derivations. Possibilities are also presented for the resolution of the problems in each particular case. Two technical possibilities are presented for the correction of non-functioning biliary-digestive anastomoses, by performing bilio-biliary anastomoses.

Adult↗
PubMedDate not supplied

[Postbular duodenal ulcer. Problems of diagnosis and treatment. Role of vagotomy in surgical treatment].

A number of 43 cases is presented, of post-bulbar duodenal ulcers in which surgery has been performed between 1965 and 1974, of which 30 were located in the first portion of the duodenum, in the postbulbar area, and 15 in the second portion, above the ampula of Vater. Problems of terminology and pathological anatomy are discussed, especially in connection with the symptomatology, complications, methodology of investigations and treatment of post-bulbar ulcers. The particular frequency is stressed, of complicated clinical forms, with stenosis and hemorrhagies, and a detailed description is made of atypical forms, with misleading, predominantly biliary or pancreatic symptomatology. Conditions are stressed, of the radiologic gastroduodenal exploration, of major importance in the diagnosis preceding surgery, as well as of pre- and intra-surgery cholangiography. The risk must be carefully evaluated, in the choice of the surgical method, and exeresis of the ulcer must be balanced with the risk of its continued presence. Priority should be given to th risks entailed by surgery. The choice solution in many cases is vagotomy associated to exclusion resection or to gastric derivation.

Adult↗
PubMedDate not supplied

[Pancreatic fistulas].

Based on 17 observations the authors review the major etiopathogenic, evolutive, clinical and therapeutic aspects of pancreatic fistulae. In 14 cases the cure was achieved by medical treatment while surgery was resorted to in only three cases. The medical measures are discussed, as well as the indications for surgical treatment.

Adult↗
PubMedDate not supplied

[Acute non-lithiasic cholecystitis].

The authors present 7 cases of acute non-lithiasic cholecystitis, representing 1.5% of the total number of acute cholecystitis cases in their personal statistics. The determining factor of the acute inflammatory process of the gallbladder was represented in 6 of the cases by non-lithiasic obstruction of the cystic duct. In the last case there was acute segmental cholecystitis secondary to a gallbladder septum, probably of congenital origin. Clinical and anatomo-pathological aspects are discussed, of acute non-lithiasic cholecystites, the origin of which is located in the diverticular apparatus of the biliary pathways. From the therapeutical viewpoint cholecystectomy is the most indicated attitude in such cases.

Abscess↗