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Biomedical subjects

D Rădulescu

Publications and source records attributed to D Rădulescu.

At least 19 recordsLinked to original sources
PubMed1992

[The timely diagnosis of postoperative clostridial infection].

Authors report a case of clostridial myonecrosis postcholecystectomy. The causes of the occurrence of this severe, frequently lethal complication are reviewed, as well as the difficulties of an early diagnosis, the only factor able to save the patient. The curative treatment of the detected infection requires the initiation of a series of local and general measures and a permanent cooperation between the surgeon, the specialist in resuscitation and the infectionist.

Acute Disease↗
PubMed1991

[Malignant anorectal melanoma. Apropos 1 case].

A case of malignant anorectal melanoma is reported, which was treated by anorectal-sigmoid amputation, operation which did not prevent the occurrence, after 6 months, of metastases in the inguinal lymph nodes. On the basis of the reported case, the main etiological, histogenetic, prognostic and therapeutic aspects of these rare tumours are discussed.

Aged↗
PubMed1991

[Acute cholangiocholecystitis].

In analysis of a group of 48 patients, the authors describe an entity they call acute cholangio-cholecystitis (or acute cholecystitis of choledochal origin) and define it by 4 obligatory criteria: 1. vesicular lesion of acute cholecystitis type; 2. the obstruction of the main bile duct in the direction of its junction with the cystic duct; 3. free duct communication between the gallbladder and the main bile ducts; 4. fluid content (purulent gallbladder) found identical over the whole biliary territory (the gallbladder the main bile ducts the intrahepatic bile ducts). This entity represents 7.6% of the total of acute cholecystitis and was met in 2.8% of the total of the interventions for the main bile ducts obstruction. The deficient biological background of the patients (60% over 60 years old), and other seriousness factors--vesicular destructive lesions associated with biliary peritonitis (7/48), the existence of the duct obstruction, usually calculous (42/48), but also hydatic (3/48) or tumoural (3/48), the multitude and seriousness of the associated lesions are emphasized. The surgery, performed in over 80% emergent cases, was directed to the decomprimation of the main biliary axis to which the increase of the gangrenous cholecyst, treatment of the duct obstructive factor, repair of the internal biliary fistulas, treatment of the consequent peritonitis were added. The results, very often good (71%), were shadowed by a series of complications (29%) which ended in deaths (14.5%). The paper pleads for the early surgery of the lithiasic biliary disease, before the appearance of the inevitable complications.

Acute Disease↗
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

Jejunoileal alveolar rhabdomyosarcoma. A case report.

Intestinal localization of rhabdomyosarcoma is exceptional, this case is the first to be published in the world literature. A 35-year-old patient with abdominal pain, fever, was found to have an infiltrative white-grey tumour, involving 20 cm the jejunoileal wall and also the surrounding mesenterium up to the origin of upper mesenterical vessels and lymph nodes. Histologic examination showed an alveolar type of rhabdomyosarcoma intricated with solid undifferentiated tumoral cells. The presence of multinucleated giant cells and the positivity of protein S 100 reaction was important for differential diagnosis, given the alveolar soft part sarcoma, malignant mesothelioma, malignant melanoma or papillary carcinoma.

Adult↗
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

[Surgical reoperation after vagotomy].

In 39 cases of re-interventions carried out after vagotomy (of which 31 were patients hospitalized in the Clinic and represent 8,6% of the total 358 vagotomies performed), the experience, the viewpoints and the recommendations of the authors are presented. Early re-interventions were necessayr because of complications which are common to abdominal surgery and only in a much lower degree to accidents that can be attributed to vagotomy or the associated intervention. Late re-interventions (26 cases) were necessary in 20 cases for ulcer recidives (13 for vagotomies performed in the Clinic and 7 for vagotomies performed in other units) while late-re-interventions for dumping syndrome, cholelythiasis, etc. represented only isolated cases in these statistics.

Cholelithiasis↗
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

[A rare neurogenic tumor with thoracic growth].

Of 70 operated mediastinal tumors, 15 were neurogenic tumors, one of them clepsydra-shaped, which manifested from the very beginning with spastic paraparesis of the legs. The treatment consisted in a two-steps surgery, the first at the Neurosurgical Clinical of Iaşi (laminectomy and ablation of the rachidian tumor) and the second one, one month later, at the I-st Surgical Clinic of Iaşi (excision of mediastinal tumor and parenchymal bridge within the conjugation hole). The microscopic examination confirmed the diagnosis of neurinoma (schwannoma) Antoni A and B with haemorrhagic areas. Examined at one year interval, the patient was clinically cured with normal thoracic aspect. The clinical peculiarities and therapeutical possibilities of the clepsydra-shaped neurogenic mediastinal tumors are detailed.

Adult↗
PubMedDate not supplied

[Tumors of the upper urinary tract. Apropos 35 cases].

Thirty-five cases of upper urinary tract tumors treated by the authors in an interval of 10 years (1979-1988) are presented. After a detailed analysis of the cases some general considerations on the anatomopathologic forms of upper urinary tract tumors, stage classification, symptoms and clinical and laboratory diagnosis, therapeutical indications are made.

Adult↗
PubMedDate not supplied

[Surgical infections with anaerobic bacteria (splenic abscess ruptured into the peritoneum].

A case is presented, of a patient aged 19, who, in the course of otic suppuration treated by tetracycline administration, developed a septicemic condition with a gigantic splenic abscess followed by generalized peritonitis. The initially unfavourable evolution had an improved course following splenectomy and peritoneal drainage, especially after the identification of the anaerobic germs that determined the infection (Bacteroides clostridii formis and Clostridium bifermentans) and the introduction of an adequate therapy.

Abscess↗
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

[Complications of surgery of cancer of the colon].

In the paper a systematic analysis is carried out of postoperative complications of colon surgery, 118 patients had complications, out of a total of 400 interventions on the colon. The complications are studied in relation with the time of their occurence and the localization of the neoplastic process, as well as from the point of view of the influence exerted by age and the "background" of the patients. A review is also made of the therapeutic attitudes required by the various complications, of the results obtained and finally a detailed analysis is presented of the causes that led to death of operated patients.

Adult↗