[Fascial and elastic structures of the thoracic wall].
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Biomedical subjects
Publications and source records attributed to F Latteri.
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The clinical case of a patient with sigmoidoduodenal neoplastic fistula is taken as the starting-point for a review of the relevant literature. The great rarity of fistulisation of a sigmoid tumour of the 4th portion of the duodenum is stressed. A clinical definition of the disease is followed by a discussion of the various methods of surgical treatment, with emphasis on the problem presented by reconstruction of the duodenum owing to its anatomosurgical difficulties.
Starting from a case of pure fibroma of the small intestine, which led to ileo-ileo-colic invagination, the Authors review the literature on the subject. The great rarity both of the type of neoplastic pathology found and the type of induced intestinal invagination is stressed. It is concluded by asserting that correct diagnosis, adequate selection of the type of surgery and its efficient performance allow a favourable prognosis in the overwhelming majority of cases.
After reviewing the literature on anatomo-histological lesions of the gastric mucosa in so-called "biliary reflux gastritis", the Authors undertook an experimental study of ultrastructural alterations of the gastric mucosa after cholecysto-gastrostomy operation conducted in the dog. In this preliminary note they report the alterations observed 60 days after the operation and consider it necessary to continue observations for a longer space of time after the operation.
After brief recall of the pathophysiology of cholestasis, the authors describe a technic of internal drainage of lymph from the thoracic duct by an indirect anastomosis created surgically between the latter and the esophaghus. They conclude that the procedure definitely solves certain symptomatologic aspects of cholestasis, but has no effects on the underlying anatomopathological lesion, which does not regress once established.
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A randomized study was conducted to compare the effectiveness of aztreonam plus clindamycin with that of gentamicin plus clindamycin for prophylaxis of infection following colorectal surgery. A total of 138 patients undergoing elective colorectal surgery were randomized to treatment with clindamycin (600 mg) plus either aztreonam (1 g) or gentamicin (80 mg) 30 minutes before and 8 and 16 hours after surgery. The study included 122 patients (88.4%) with colorectal carcinoma. Samples from the abdominal cavity and from the subcutaneous tissues were taken for bacteriologic study. All samples from the abdominal cavity yielded microorganisms; both aerobic and anaerobic bacteria were isolated. Wound infections occurred in eight patients (12.1%) in the aztreonam group and in 12 patients (16.7%) in the gentamicin group. Escherichia coli, Bacteroides species, enterococci, and staphylococci were isolated most frequently from wounds and were often isolated from bacteriologic samples from the abdominal cavity of the same patients. The incidence of septic complications reflected the extent of nutritional and immunologic impairment. No significant differences were found between groups in the rate of urinary tract or lower respiratory tract infections. Aztreonam/clindamycin appears to be a valid alternative to gentamicin/clindamycin for the prophylaxis of infections following colorectal surgery.