Biomedical subjects

F Cardì

Publications and source records attributed to F Cardì.

21 records · Page 2Linked to original sources

PubMedDate not supplied

[Role of ultrasonography in abdominal surgical emergencies. Our experience].

OBJECTIVE: To assess the sensitivity, specificity, and predictive value of ultrasonography in surgical patients in abdominal emergency in regard to the indication for immediate operation, delayed abdominal exploration, or conservative treatment. DESIGN: A retrospective study was conducted after consecutive sampling of 98 patients in a control trial. SETTING: The study was conducted at the University Hospital of Catania (Italy), which serves as a general community hospital. PATIENTS: All patients with acute upper abdominal pain or blunt abdominal trauma were eligible for the study. A total of 110 patients were observed from 1990 to 1994, after plain X-ray of the abdomen in 12 patient was diagnosed visceral perforation and they went for immediate operation. The remaining 98 patients were divided into two groups: acute upper abdominal pain (56 patients) and blunt abdominal trauma (42 patients). INTERVENTION: Ultrasonography in the emergency department. MAIN OUTCOME MEASURES: Conservative or operative treatment based on ultrasonographic and clinical findings. RESULTS. Ultrasonography showed a sensitivity of 100%, a specificity of 52.6%, a positive predictive value of 100%, and a negative predictive value of 100% in regard to the indication for surgery in cases of surgical abdominal emergency. CONCLUSION: Ultrasonography saves time and money, can be performed in the emergency department, shows high sensitivity and specificity, and is the method of first choice in the evaluation of blunt trauma.

Abdomen, Acute↗

PubMedDate not supplied

[Treatment of the residual pancreatic stump after pancreatoduodenectomy: pancreatogastrostomy].

In the last few years more and more often the use of pancreaticogastrostomy (PG) for reconstruction after pancreatoduodenectomy (PD) has been reported. Aim of this paper is to review pertinent Literature and to try to define, on the basis of Authors' experience, the role this technique may have in reducing morbidity and mortality of PD. From January 1993 to June 1995 nine pancreaticogastrostomies were performed. Five patients had an adenocarcinoma of the papilla, two had a carcinoma of the distal choledochus and two had a carcinoma of the head of the pancreas. Major complications in this series were one operative death unrelated to PG and a massive bleeding from the gastric site of the anastomosis occurred 3 days after the operation, associated to a partial dehiscence of the anastomosis, treated surgically. Reported results after pancreaticogastrostomy seem to demonstrate a dramatic decrease in morbidity and mortality after PD, however, the real value of this technique will be established only after a greater clinical experience and, when possible, wider randomized prospective studies.

Adenocarcinoma↗

PubMedDate not supplied

[Biliary surgery in the aged].

Between 1980 and 1995 in the Section of General and Oncological Surgery of the Department of Surgery of the University of Catania, on a total of 1715 biliary surgical procedures, 926 were performed on the elderly patients, 287 of which in emergency. Cholelithiasis (469 cases) morbidity 4.5%, mortality 0.4%; acute colecystitis, (247 cases) morbidity 21%, mortality 12%. Choledocholithiasis (122 cases) surgical treatment (51 cases) morbidity 21.6%, mortality 3.9%; endoscopic treatment (71 cases) morbidity 9.4%, mortality 0%. Neoplasms of the biliary tract (48 cases) diagnostic laparotomises 9, surgery (27 cases) morbidity 37%, mortality 11%; endoscopy (12 cases) morbidity 33%, mortality 0%. Acute obstructive cholangitis (34 cases), surgical drainage (9 cases) morbidity 55%, mortality 33%; endoscopic drainage (22 cases) morbidity 14%, mortality 4.8%; transhepatic drainage (3 cases) morbidity 66%, mortality 33%. Acute biliary pancreatitis (6 cases) surgery (2 cases) morbidity 100%, mortality 50%; endoscopy (4 cases) morbidity 25%, mortality 0%. This experience confirms that in elderly patients the treatment of choice for cholelithiasis is cholecystectomy and for acute colecystitis is early cholecistectomy. The preferred treatment of choledocholithiasis and severe acute biliary pancreatitis is endoscopic sphincterectomy. Endoscopic or radiologic drainages are the choice for acute biliary pancreatitis. In conclusion elderly patients with surgical biliary problems should be treated by a surgical, endoscopic and radiological team, taking in account all the available procedures.

Acute Disease↗