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Biomedical subjects

C Tombazzi

Publications and source records attributed to C Tombazzi.

10 recordsLinked to original sources

Schistosomiasis mansoni in low transmission areas: abdominal ultrasound.

In endemic areas with low prevalence and low intensity of infection, the diagnosis of hepatic pathology due to the Schistosoma mansoni infection is very difficult. In order to establish the hepatic morbidity, a double-blind study was achieved in Venezuelan endemic areas, with one group of patients with schistosomiasis and the other one of non-infected people, that were evaluated clinically and by abdominal ultrasound using the Cairo classification. Schistosomiasis diagnosis was established based on parasitologic and serological tests. The increase of the hepatic size at midclavicular and midsternal lines (in hepatometry) and the hard liver consistency were the clinical parameters able to differentiate infected persons from non infected ones, as well as the presence of left lobe hepatomegaly detected by abdominal ultrasound. The periportal thickening, especially the mild form, was frequent in all age groups in both infected and uninfected patients. There was not correlation between the intensity of infection and ultrasound under the current circumstances. Our data suggest that in Venezuela, a low endemic area of transmission of schistosomiasis, the hepatic morbidity is mild and uncommon. The Cairo classification seems to overestimate the prevalence of periportal pathology. The specificity of the method must be improved, especially for the recognition of precocious pathology. Other causes of hepatopathies must be investigated.

Abdominal Cavity↗

Hepatic fascioliasis: case report and review.

A well documented case of hepatic fascioliasis (HF), successfully treated with triclabendazole, is reported. Predominant clinical manifestations were fever, marked eosinophilia and abdominal pain. Triclabendazole was given as two single oral doses of 10 mg/kg each. Neither side effects nor clinical or parasitological relapses were seen after three months of follow up. Based on this experience and few other similar reports in the literature, triclabendazole might be a valid therapeutical alternative in the treatment of human fascioliasis.

Administration, Oral↗

[Hemobilia. Its clinical presentation and diagnosis].

Hemobilia is a rare cause of upper GI bleeding that must be suspect in order to make an early and precise diagnosis, that permits to decrease the high rate of mortality. We present our experience in three cases and analyze the clinical manifestations, diagnostic methods and follow-up.

Abdominal Injuries↗

[Complications of laparoscopic cholecystectomy].

The laparoscopy cholecistectomy is a surgical procedure described in 1987, and it has had an important apogee and it's had substitute to open procedure. Between its advantages is notable, the postoperatory evolution without pain, paralytic ileus and the short time of hospitalization besides the patient can go away the same day in some cases. In Venezuela, the procedure has been received with enthusiasm by the surgeons with prefer this procedure however, there are complications derived in part for the lack of experience in the first cases, but occur non related of the experience. The quantization of the complications is not simple to realize for different reasons. We present twelve complications, two belong to patients intervened in the Hospital Universitario de Caracas and ten belong to patient transferred from other center. The complications were: pseudoaneurism of hepatic artery, hematoma of the wall, cutting of common bile duct, section the right bile duct, abscess of vesicular bed in two cases, retropneumoperitoneum, ascites by biliary fistula and four biloma. The treatment varied in every case and the utilization of radiologic technique with percutaneous drainage were useful in five cases. We conclude: first, this technique is not free of complications. Second, the percutaneous drainage (abscess, biloma), endoscopic procedure (biliary prosthesis) in fistulaes and arteriographics (arterial embolization), are useful in some cases, and could prevent the surgical reintervention.

Cholecystectomy, Laparoscopic↗

[Endoscopic retrograde cholangiopancreatography in hepatic fascioliasis].

We present a 60 years old female with a history of upper right quadrant pain, fever and eosinophily. We made the diagnosis of fasciolasis on clinical, parasitology studies and radiological findings. In the endoscopic retrograde cholangiopancreatography (ERCP) we found the bile duct of normal caliber, but with many filling defects. Fasciola eggs were found in the bile. This is the first case with endoscopic retrograde cholanglopancreatography and the fourth case of fasciolasis in Venezuela.

Cholangiopancreatography, Endoscopic Retrograde↗

[Epidemiology of viral hepatitis in Venezuela: preliminary results of phase 1. Prevalence in the metropolitan area].

Two different areas of metropolitan zone in Venezuela were studied in relationship to the immunological condition associated with A, B, C and D viral hepatitis in 557 healthy subjects. We performed clinical history with personal information, that was subsequently correlated with results of the hepatitis markers. General results show prevalence different from previous reports: Anti-HAV: 90.84%, HBsAg: 1.62%, Anti-HBc: 10.6%, Anti-HCV: 0.36% y Anti HDV: 0%.

Adolescent↗

[Metabolic markers of chronic liver disease].

The association between chronic liver disease and plasmatic lipids and glucidic metabolism was studied. The liver was evaluated with biochemical variables, ultrasound and upper gastrointestinal endoscopy. 12 chronic liver diseases patients and 10 normal were studied. 83.3% of patients showed lipidic abnormalities, 66.6% on the cholesterol levels and 41.7%, reduced HDL. When patients received 100 gr of glucose the response was abnormal in 83.3%. These results were compared with other "liver function test". 75% had abnormal bilirubin, 58.3% abnormal albumin, prothrombin time 58.3%, aminotransferases 75%. Esophageal verices were found in 75% of cases and ultrasound abnormalities in 91.6% (27.3% cirrhosis, 54.4% diffuse abnormal patter and 18.2% splenomegaly). These findings show that lipidic and glucidic metabolism, and ultrasound, in chronic liver diseases are the more frequent abnormalities.

Adult↗

[Biliary cystadenoma. Report of a case].

Biliary Cystadenoma are rare benign neoplasms that occurs mainly in young women. Clinical features includes abdominal pain and biliary obstruction. The diagnosis is for clinical features and radiologic method, but require the pathological report. The treatment is surgical. We report a 30 years old woman, with biliary obstruction and radiological findings of a neoplasm located in the left hepatic duct, that was surgically removed. The pathological report was a biliary cystadenoma. We discuss the clinical radiological and pathological tindings.

Adult↗

[Accessory spleen: compensating hypertrophy after of splenectomy. A case report].

The prevalence of accessory spleens has been reported to be about 7.1% in infants. When these patients undergo splenectomy without removal of the accessory spleen, the latter develop hypertrophy later in life and can reach the size of a normal spleen, with clinical manifestations similar to the ones before surgery. We report the case, of fourteen-old boy, who had splenectomy 7 year ago, for refractory and recurrent thrombocytopenia, who had splenectomy at age 7 years because of persistent thrombocytopaenia, resistant to non-surgical treatment, and who was found by conventional ultrasound study, doppler duplex color and selective angiography to have a hypertrophied spleen with sings of portal thrombosis and portal hypertension.

Adolescent↗

[Intrahepatic lithiasis].

The intrahepactic lithisis is unusual in the Occidental hemisphere. The prevalence in Venezuela in unknown. We study all the edoscipic retrograde cholangiography carried for lithiasic pathology, in the Servicio de Gastroenterología, Hospital Universitario de Caracas, since January 1993 until April 1995. Over 342 patients, 9 were intrahepatic lithisis (1.16%). Seven cases of Caracas and two refered of the rest of the country. The sex was female in seven patients and males in two. The age range was 15 to 67 years old. The clinic feature much frequent was abdominal pain. The diagnosis was ultrasound and endoscopic retrograde cholangiography. The treatment was endoscopic with sphincterotomy and removal stones and surgical with resection in two cases, and choledocotomy in the other four cases.

Adolescent↗