Biomedical subjects

E Baggio

Publications and source records attributed to E Baggio.

At least 19 recordsLinked to original sources

PubMed2006

[Treatment of celiac trunk aneurysms: personal experience and review of the literature].

INTRODUCTION: Celiac trunk aneurysms represent 4% of all splanchnic artery aneurysms. These lesions are thus extremely rare but yet have a significant clinical importance. Mortality, mainly related to site characteristics, is a significant risk (14%) in the event of rupture. PATIENTS AND METHODS: We put forward our experience in both diagnosis and treatment in three patients, two women and one man (average age 55.3 years, range 35-74), presenting aneurysms involving the celiac trunk. The preoperative diagnosis was established successively with ultrasonography, CT scan and angiography. Two patients were treated via an open surgical approach while endovascular percutaneous treatment was performed for the third patient. RESULTS: Mortality was null at 13 days on average from admission for the surgical patients and 4 days for the patient treated endovascularly. Postoperative complications were modest: pulmonary thickening with pleural effusion for the two surgical patients (spontaneous resolution), while for the third patient treated with an endovascular method, the stent migrated to a splanchnic arterial branch, with no consequence for the spleen. The average follow-up was 19 months (range 14-24). Full exclusion of the aneurysm was maintained at four months for the aneurysm treated percutaneously. A patent celiac was also maintained for the patients treated surgically. CONCLUSIONS: Considering the largely unforeseeable outcome and the high risk of rupture, we suggest that all the patients presenting this type of aneurysmal lesion should be treated. This attitude is widely advocated in the literature. Moreover, we noted null mortality in our small series, with only one percutaneous "re-do" case; resolutive at last control. With the present improvement in stent technology, endovascular treatment should be preferred. Patients should be treated surgically only if a percutaneous procedure would be risky or technically unfeasible due to the size of the aneurysm or its anatomic features.

Adult↗

PubMed2006

[Internal carotid artery aneurisms: two cases].

INTRODUCTION: Aneurysms of the extracranial portion of the internal carotid artery (ICA) are rare (accounting for only 0.1-2% of all surgical procedures affecting the ICA, 0.4-1% of all arterial aneurysms, and 4% of all aneurysms involving peripheral arteries), but they are nonetheless clinically significant because of the high related risk of cerebral thromboembolism. Given the rarity of these lesions, it seems worthwhile to report on two extracranial ICA aneurysms, one of atherosclerotic, the other of fibrodysplastic etiology that came under our observation. PATIENTS AND METHODS: Our experience concerns just two cases, treated at the Department of Surgical and Gastroenterological Sciences of the Policlinico G.B. Rossi in Verona, presenting with very different clinical and instrumental findings, and requiring a different surgical treatment. The former underwent resection of the aneurysm and end-to-end reconstruction; in the latter, we performed a carotid transposition with internalization of the external carotid artery. RESULTS: Neither patient suffered from any major or minor neurological complications during or after surgery, and the follow-up confirmed a normal extracranial carotid patency. CONCLUSIONS: Based on our, albeit limited experience and an analysis of the literature, we make a few points concerning the diagnostic approach (which differs from the case of stenosing carotid lesions), the indications and type of treatment for extracranial ICA aneurysms.

Aged↗

PubMed2005

Managing anomalous splenic artery aneurysm: a review of the literature and report of two cases.

The splenic artery originates from the superior mesenteric artery in approximately 1% of cases, which may explain the extreme rarity of aneurysms involving this anomalous branch, with only five cases reported in the international literature to date. We report our experience of managing two patients with aneurysms involving splenic arteries arising from the superior mesenteric artery, one treated surgically and the other percutaneously. From a diagnostic point of view, the first approach is ultrasound, while computed tomographic (CT) scan and angiography enable a better definition of the lesion and of the anatomical anomaly; CT angiography is currently the method of choice for the preoperative workup. Finding these two anomalies in association is so rare that it is impossible to draw any final conclusions as to the best type of treatment. In the authors' experience, both surgery and percutaneous treatment can prove useful.

Aneurysm↗

PubMed2005

[Cutaneous abnormalities of the eyelid and systemic diseases].

Systemic diseases are unknown diffuse inflammatory disorders. They include systemic and metabolic diseases and connective tissue diseases. Among them, lupus erythematosus, scleroderma, polymyositis and dermatomyositis, Sjögren syndrome, Wegener's granulomatosis, sarcoidosis, Vogt-Koyanagi-Harada's syndrome, and amyloidosis are the diseases encountered most frequently that can manifest cutaneous abnormalities of the eyelids. The main eyelid disorders involved in these diseases are described in this paper.

Connective Tissue Diseases↗

PubMed2005

[Endoscopic diagnosis of the lacrimal drainage system].

Endoscopic study of the lacrimal drainage system is the only way to directly observe the lacrimal sector of the lacrimal drainage system. The first experiments on this subject date from 1979. Recent technological progress has allowed us to test the latest instruments. These experiments have demonstrated the unquestionable progress of endoscopes and their potential contribution to diagnosing lacrimal pathology. However, certain factors still limit their everyday use. Image improvements and low cost will no doubt facilitate its integration in the diagnosis and therapy of the lacrimal drainage system.

Endoscopes↗

PubMed2004

[Surgical treatment of congenital eyelid malpositions in children].

Congenital eyelid malpositions can be isolated or associated with other structures such as the eyeball, ocular muscles, and lacrimal pathways. It is important to separate eyelid malpositions, which are topographical disorders, from eyelid malformations, which are constitutional morphological disorders. Only eyelid malpositions will be described in this paper, with a distinction made between static and dynamic disorders. Static disorders include epiblepharon, congenital ectropion and entropion, epicanthus, telecanthus, and centurion syndrome. Dynamic disorders group ptosis and congenital eyelid retractions. Epiblepharon is characterized by the absence of adhesion between the lower eyelid retractors and the orbicularis-skin layer, which allows the anterior lamella to roll over. Congenital entropion and ectropion are very rare. They most often require surgical treatment. Epicanthus involves a semi-lunar fold of skin extending from the upper eyelid across the medial canthal area to the margin of the lower eyelid. Four types (supra-ciliaris, palpebralis, tarsalis and inversus) of epicanthus are described. Treatment requires surgery. Telecanthus is defined as an increased distance between canthi. Primary telecanthus results from attenuation of the medial canthal tendons and is usually associated with other soft tIssue abnormalities such as epicanthus or blepharophimosis, or is seen after trauma. Secondary telecanthus is caused by underlying bony malpositions with an abnormal separation between the orbits because of an increased thickness of the interorbital bones such as that seen in hypertelorism or in other complex craniofacial syndromes. Euryblepharon is distinguished by an enlargement of the horizontal palpebral fissure associated with enlarged eyelids. The etiology is unknown and patients may benefit from surgery. Congenital ptosis is characterized by a deficiency of the levator muscle. They are most often unilateral and isolated. When associated with other abnormalities such as squint, synkinesis, blepharophimosis, or craniofacial syndromes, surgical treatment may require several-stage procedures. On the other hand, isolated congenital ptosis is usually treated in childhood (3-6 years) in a single stage. Congenital eyelid retractions may affect either the lower or the upper eyelid. They make up a rare condition and most cases are associated with craniofacial syndromes such as Crouzon or Apert syndromes. Upper eyelid retractions may spontaneously improve in some cases, but lower eyelid retractions do not. Treatment requires surgery, depending on the corneal consequences.

Child↗

PubMed2004

[Examination and surgical indications for blepharoplasty].

Cosmetic blepharoplasty has become very popular these last years and can easily be performed with local anesthesia. Its benefits are numerous and side effects minimal. Nevertheless, the different types of eyelid impairment are numerous and the patient is often not aware of them. This paper discusses the importance of the clinical examination targeting proper diagnosis of the type of eyelid impairment so as to recommend the most adapted surgical technique. The different types of cosmetic eyelid impairment are presented.

Blepharoplasty↗

PubMed2003

Treatment of six hepatic artery aneurysms.

Hepatic artery aneurysms are rare lesions but of significant clinical importance because rupture is associated with elevated mortality. Although diagnosis using CT scanning and, more importantly, angiography has been well defined, the therapeutic choices are less clear. We retrospectively selected patients from 1985 to 2000 who were treated with either traditional surgical or percutaneous techniques. In total we treated six patients, four males and two females. This represents 17.6% of 34 patients treated by us for splanchnic artery aneurysms. The treatment was surgical in two cases (33.3%) and percutaneous in four cases (66.6%). All lesions were successfully treated with exclusion/ablation of the aneurysm. Mortality was nil; in one of the surgical cases we reported a transient hepatic failure and in the endovascular group, one right pleural effusion, one small splenic infarction, and one pseudoaneurysm of the gastroduodenal artery. The first therapeutic strategy to be taken into consideration is always the percutaneous approach. However, surgery still has a role in those cases where the lesion cannot be repaired percutaneously. Based on our own experience (good results, no mortality, and few complications) and in accordance with the literature, it is clear that an aggressive approach is warranted in those patients.

Aged↗

PubMed2003

[Surgical treatment of upper lid trichiasis with partial tarsal rotation: a new procedure].

The authors' report a new surgical technique for partial isolated upper lid trichiasis. This ten minutes' time consuming procedure is easy to perform. It allows a fair cosmetic appearance of the operated eyelid and permits a reliable uneventful outcome. The technique consists to severe the lid margin and the tarsal plate on a distance of 3 to 4mm, at each part of it's trichiased area, in order to allow the pathological part of the eyelid to rotate like a shutter. The rotation of the ill eyelid segment is strengthen by a partial resection of the anterior lamella localizated here and there of the lid crease above the trichiased part of the eyelid, which allows to place everting sutures between the superior part of the tarsus and the two edges of the anterior lamella incision.

Adult↗

PubMed2002

[Etiologic causes of ptosis about a serie of 484 cases. To a new classification?].

We have analyzed the etiological causes of ptosis in a retrospective study of 484 cases undergoing operation. This study has confirmed how difficult it is to classify ptosis despite the different existing classifications. Some authors divide ptosis into two groups: congenital and acquired. These classifications seem to have been abandoned now for classifications based on the mechanism that instigates ptosis rather than the moment when the deficit developed. We chose to classify ptosis into five subgroups: myogenic (42% of the cases studied), aponeurotic (35.3%), neurogenic (6.8%), mixed (15.9%), and pseudoptosis (enophthalmos, eyelid tumor, hypotropia, etc.), the latter of which were removed from this series. This classification is based on clinical and surgical criteria. It has the advantages of unity, simplicity, and practicality in terms of establishing a treatment plan for a given ptosis patient. Indeed, each subgroup requires a particular clinical examination and a more stereotyped surgical treatment.

Adolescent↗

PubMed2001

[A new instrument in eyelid surgery: ptosis forceps with a protected lock].

We report on a new instrument in eyelid surgery: the ptosis forceps with a protected lock. This new device helps the surgeon to dissect the levator muscle to facilitate any type of levator surgery. It is particularly useful in the adjustment of the superior lid margin level towards the corneoscleral area in ptosis surgery with levator resection.

Equipment Design↗

PubMed2000

[Analysis of the efficacy of early probing in the treatment of symptomatic congenital lacrimal duct obstruction in infants. Apropos of 92 cases].

INTRODUCTION: Nasolacrimal duct obstruction (NLDO) is a common clinical problem (5 to 6% of newborns). Dacryostenosis is a partial or complete block in the nasolacrimal duct. PATIENTS AND METHODS: The records of 68 patients (92 cases) of NLDO with/without mucocele were reviewed. The probing was performed early and according to the same technique. RESULTS: The age at the time of probing ranged from 0 to 7 months (mean 4.6 months). The cure rate was 91.3% and the failure rate was 8.70%. DISCUSSION: Our results are consistent with other reports in the literature. The cure rate was higher with a earlier probing and was good after a second tentative of probing. A multiple obstruction of nasolacrimal system was cause of a failure. This was not the case with mucocele. The optimal timing of the probing is discussed in this report and we preferred to perform the probing to 4 at 6 months. CONCLUSION: We showed a high cure rate with early probing in our series. These results should be confirmed by a prospective randomised study (in process in our institution).

Age Factors↗

PubMed1999

[Fetal anophthalmos. Problem of the prenatal diagnosis: a case report].

We report a case of anophthalmia discovered after birth and discuss the need to resolve diagnostic difficulties and determine prognosis. This is an exceptional malformation which is particularly difficult to manage. It often occurs in the context of a complex malformation syndrome. Recent imaging techniques including magnetic resonance imaging help determine the degree of malformation and provide useful information for giving genetic advice to parents.

Abortion, Induced↗

PubMed1999

[Carotid lesions and vascular risk factors].

BACKGROUND AND AIMS: Recent studies have underlined a significant incidence of peripheral arterial occlusive disease (PAOD) of the lower limbs in the general population which is often wrongly diagnosed. The "classic" risk factors--like dyslipidemia--are not always present in significant percentages in patients suffering from PAOD of the lower limbs. The aim of this study was to evaluate the incidence of the most common vascular risk factors (smoking, hypertension, hyperglycemia, dyslipidemia) in patients suffering from stenosing lesions of the extracranial carotid axes, comparing the data with similar findings in lower limbs. Moreover, the authors evaluated the association between these risk factors, carotid atheromatous lesions and ischemic cardiomyopathy (CI). METHODS: A retrospective study was performed to evaluate the data from 1643 patients examined consecutively. A total of 636 (age > 40, carotid stenosis > 40%, presence of risk factors) were considered eligible. RESULTS: The results showed that, contrary to the findings in patients suffering from PAOD, diabetes was not among the most frequently associated risk factors, whereas a relatively large number of patients had a history of smoking, including both smokers and ex-smokers. CONCLUSIONS: The difference in the most frequent risk factors identified for PAOD and carotid lesions suggests different etiopathogenetic mechanisms for the two districts.

Aged↗

PubMed1998

[Postoperative ptosis: etiopathogenesis, clinical analysis, and therapeutic management. Apropos of a series of 43 cases].

PURPOSE: Acquired postoperative ptosis (PP) are difficult to situate in the current classification of ptosis. Assessement of the mechanisms, the clinical features and the possible treatments of these PP would suggest a new classification of ptosis. MATERIAL AND METHODS: Among 260 cases of surgically corrected ptosis, 43 cases of PP (16.5%) were detected and analyzed. RESULTS: Forty cases of PP were eligible for this study. Their responsible mechanisms were aponeurotic (57.5%), mixed (aponeurotic and/or myogenic and/or neurogenic) (27.5%) and myogenic (15%). PP was assessed in most cases as being mild (77.5%) and the levator's muscle contraction was most often mildly impaired (77.5%). In these cases, surgical procedure was performed: levator aponeurosis disinsertion repair (85%), Fasanella-Servat procedure (2.5%), frontalis sling (2.5%) and other surgical procedure with synthetic materials (10%). Postoperative complications included 1 case of persistent lid edema and 4 cases of spontaneous suture rupture. Six patients (15%) were secondarily reoperated: 2 for overcorrection (5%) and 4 for undercorrection (10%). The general outcome was good in 90% of cases, insufficient in 5% of cases and unsatisfactory in 5% of cases. CONCLUSION: This study confirms the previously described features of the PP: onset after anterior surgery procedures of usually moderate ptosis, induced by an aponeurotic defect mechanism in most cases. The treatment was exclusively surgical: anterior reinsertion of the levator aponeurosis. For better management, we suggest a new ptosis classification: aponeurotic, myogenic, neurogenic and mixed (aponeurotic and/or myogenic and/or neurogenic) and false or pseudo-ptosis.

Adult↗

PubMed1997

[Morgagni's hernia in infancy].

Morgagni's hernia is an uncommon type of diaphragmatic hernia fairly exceptional in pediatric age. A case of Morgagni's hernia, observed by chance in a 15-month-old infant, is presented. The authors present the fundamental embryogenic stages of the diaphragm and stress the clinical manifestations and diagnostic procedures to reach the diagnosis, as well as the advantages of early treatment in order to prevent possible complications.

Hernia, Diaphragmatic↗

PubMed1996

[Intermittent chyluria in a young man].

Chyluria is the passage of chylus into urine resulting in fistulization through the lymphatic system and the urinary system. This rare condition is usually caused by filaria infestation or malformations, neoplasia or trauma. We report a case of a 18-year-old man. The patient presented milky urine which had appeared after angiography following minor leg trauma. Physical examination revealed asymmetry of the face and cutaneous dyschromia. Blood tests revealed hypogammaglobulinemia and altered CD4/CD8 ratio (0.6). Urine tests showed proteinuria (30 mg/dl), lipiduria (triglycerides 750 mg/dl) and density of 1025. Renal function was normal. Abdomen computed tomography and urography were normal. Cystoscopy revealed the presence of milky urine in the bladder and selective catheterization revealed that the origin was the right ureter alone. Ascendent pyelography did not reveal any malformation of the urinary tract; but after this the chyluria spontaneously disappeared. The patient was rehospitalized 3 months later for recurrence. Lymphography was then performed and revealed a dilated lymphatic network with minute lacunar images projecting into the right kidney. Chyluria again disappeared spontaneously and recurred sporadically over the next two years in a patient who remained in good physical condition. The etiology of chyluria in a patient without filaria infestation is problematic, particularly when the most common causes (tuberculosis, neoplasia, trauma) are excluded as in our case. The asymmetry of the face, together with cutaneous dyschromia and the presence of a subarachnoidea cyst in the right temporal region suggested our patient had multiple congenital malformations.

Abnormalities, Multiple↗

PubMed1996

[Unidentified arteriopathy: an epidemiological study. The preliminary results].

The importance of the social and medical impact of arteriosclerotic disease fully justifies a series of studies focused on improving knowledge of this pathology before symptoms become manifest, so as to orientate treatment increasingly towards prevention. The aim of this study-of which the authors now report the preliminary results-was to establish the incidence of unidentified lower limb arteriopathy in the general population and to evaluate the relations between this and the possible presence of risk factors. The authors therefore decided to evaluate patients attending outpatient General Surgery clinic for symptoms manifestly not related to lower limb vascular pathology (arterial or venous). Patients suffering from any arterial disease were likewise excluded from the study. The importance of performing a large-scale epidemiological study (sample size, stratification of population studied, vast geographic area, etc.) persuaded the authors to adopt a multi-centre structure. Twelve General Surgery departments at hospitals in the Veneto area were involved: each was required to evaluate an average of 150 patients, giving a total of 1950 subjects. The method of study chosen was the residual pressure index (RPI) measured using Doppler velocimetry. Patients were divided into two study groups: patients in Group A (with pathological RPI) were re-evaluated after correction for risk factors, integrated or not by medical treatment. Preliminary results relating to 46% of the total sample show that 26.7% of the subjects present pathological RPI. The evaluation of risk factors and the comparison of their presence in the two groups (A--pathological patients, B--non-pathological subjects) reveals significant differences regarding diabetes and hypertension.

Adult↗