A series of cases of acute pancreatitis treated between 1-XI-1972 and 1-XI-1975 is presented. A division is made between cases acute ab initio and postoperative pancreatitis, the latter further subdivided into pancreatic necroses, oedemas, and slight affections. The question of diagnosis is examined and elements indicative of prognosis are stressed. Results obtained in the surgical and medical management of 59 ab initio, 3 necrosis, 11 oedemas, and 79 slight involvement cases are described.

Acute Disease↗

PubMed1976

[Alithiasic cholecystopathies. Clinical, diagnostic and therapeutic aspects].

The frequency of alithiasic cholecystitis is considered and the various forms are subdivided into diffuse and localized dyskinesia. Symptomatology is described and the former are indicated as being electively medical and the latter surgical forms whether the condition is congenital or acquired. The various forms of cholecystosis are also distinguished with full documentation. Symptomatological techniques and diagnostic conclusions are illustrated for all forms and personal experience with their therapy reported.

Cholangiography↗

PubMed1976

[Our experience in the surgery of bile ducts].

After a brief review of modern techniques for correct diagnosis and therapy of bile duct pathology, a personal series of 955 operations (between 1-XI-1972 and 30-X-1975) is presented. The need for routine peroperative control of VBP and the usefulness of respecting the papilla where it is anatomo-functionally undamaged are stressed. Personal experience shows that the most rational methodology is after papillotomy the application of a prepapillary Kehr incision through a choledochotomy because this presents fewer complications than the transpapillary Kehr incision in calculosis or stenosis of the VBP where bile duct suture is not advisable. With regard to bilio-digestive anastomosis, indications and limitations are discussed and it is suggested that where the patient's general and local states permit, choledochojejunal anastomosis should permit, choledochojejunal anastomosis should be used, with choledocho-duodenostomy only in special cases. Cholecysto-gastro and cholecystoduodenostomy should be reserved for patients in very serious conditions.

Bile Ducts↗

PubMedDate not supplied

Spasm of arm arteries due to ergotamine tartrate. A case report.

Ergotamine tartrate and caffeine has been widely prescribed for the prevention and treatment of migraine headaches. Rarely the ergotamine can cause symptoms of peripheral vascular insufficiency, often concerning the lower extremities. A case report of bilateral severe ischemia to the upper limbs, caused by a chronic assumption of ergotamine tartrate is presented.

Arm↗

PubMedDate not supplied

[Loco-regional thrombolysis in deep venous thrombosis].

Anticoagulation, by means of heparin and warfarin is, till now, the most common treatment in deep venous thrombosis. Although thrombolytic agents have been available for over 10 years, their use remains quite low, ranging from 15 to 20% of deep venous thromboses. This is due to the relatively high incidence of contraindications as well as to the fact that the potential advantages versus heparin are diminished by the increased bleeding risk and by the potential risk of pulmonary embolism (migration of partially lysed thrombi). Following the example of the "triple armed therapy" proposed by Rosenthal for the treatment of pulmonary embolism, we will evaluate if loco-regional thrombolysis, with the catheter wedged against the thrombus, associated with a temporary vena cava interruption by means of an intraluminal filter, can achieve a better lysis of the thrombus without pulmonary embolism. In our Unit 18 patients affected by proximal deep venous thrombosis were submitted to thrombolytic therapy, 6 to systemic treatment, 3 to local treatment and the last 9 to loco-regional thrombolysis, using recombinant tissue-type Plasminogen Activator. We obtained 10 complete lyses, 1 with systemic and 9 with loco-regional treatment. There were no major complications. Thus, we think that venous loco-regional thrombolysis with rt-PA at lower doses, associated with temporary caval interruption, can probably achieve a better lysis than systemic treatment without risk of pulmonary embolism and with a very low haemorrhagic risk, as in arterial loco-regional thrombolysis. Furthermore, loco-regional thrombolysis, by means of a faster thrombus dissolution, could better prevent post-phlebitic syndrome.

Catheterization, Peripheral↗