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F Vietri

Publications and source records attributed to F Vietri.

63 records · Page 4Linked to original sources

[Morgagni-Larrey hernia: 2 clinical cases].

The authors report two cases of hernia of Morgagni, respectively observed in a 42-year-old man and in a 16-year-old boy. In the first case the diagnosis was previous (20 yrs.) to surgical treatment. On the contrary, in the second case the diagnosis was not possible before surgery because of the patient's young age and mild symptoms. Surgical treatment, through thoracotomy in the first case and laparotomy in the second one, was able to repair the diaphragmatic gap.

Adolescent↗

[A rare case of a giant intra-abdominal mesocolic liposarcoma].

Intra-abdominal liposarcomas (IALS) represent a rare localization compared to other liposarcomatous (LS) sites such as the lower extremities and the retroperitoneum. The authors report their experience in a case of giant liposarcoma (weight: Kg 8.2) presenting a massive intra-abdominal extension. Diagnostic and therapeutic problems related to this type of neoplasm as well as a literature review are reported.

Aged↗

[Primary space-occupying lesions in the mediastinum].

Authors report four cases of mediastinal tumors. X-rays, CT scan, bronchial endoscopy, angiography and mediastinal endoscopy can be useful to diagnose this kind of neoplasms. Surgical treatment and, further, radio or chemotherapy are used in case of mediastinal neoplastic lesions. Unfortunately, lifetime longer than five years is observed just in 50% of the patients.

Adult↗

[Acute ischemia of the lower limbs].

One hundred nineteen patients operated upon for acute ischemia of the lower limbs have been retrospectively reviewed, in order to evaluate the influence of the condition on outcome, and the patterns of treatment. Fifty six per cent of the patients were males and 42% females, 68.4% had an history of aorto-iliac obstructive disease; 51.2% of the ischemias were due to arterial thrombosis and 48.8% to embolism, in 12.5% of the cases etiology was unknown. Thrombosis were more frequent in younger patients' population (mean age 59.8 years) compared to embolism (mean age 69 years), even if the mean age of patients bearing an ischemia of embolic type has risen, in the last 10 years: 62.1% were due to atrial fibrillation and 50% occurred on pathologic arteries, patients with arterial obstructive disease presented a higher incidence of arrest of embolic material at the common femoral artery bifurcation. Women's mean age was significantly higher then that of men (70.9 vs. 59 yrs.). Embolism was more frequent in women than in men (64 vs 42.2), whereas thrombosis was more frequent in men than women (57.8 vs 36%). There were more deaths in women than men (30.8 vs 20.8%), but more amputations in men than women (37.3 vs 17.3%). Embolism of arterial origin include 15.2% of all acute ischemias and 31% of all embolisms, and their site of origin is often unknown, particularly when it is located in the thoracic aorta, which mandate a complete arteriography and eventually a CT-Scan of the thorax and the abdomen. A lower limb phlebitis, associated with an acute ischemia mandates the search of a patent foramen ovale, and an heparin induced thrombocytopenia. Surgical treatment is directed towards obstruction removal (embolectomy, by-pass) and towards the treatment of the causative agent (aortic endarterectomy, caval filter, anticoagulants). Post-operative thrombolysis may be beneficial in case of distal residual thrombus after embolectomy. An higher mortality rate has been observed in acute ischemias due to embolism rather than thrombosis (31 vs 19.6%) and more major amputations in thrombosis than in embolism (37.7 vs 17.2%). Overall mortality rate has been of 25%, with an amputation rate of 28%. Present results have been compared with those of the literature, both agree on some changes over the last 20 years, concerning the incidence of different mechanisms of acute ischemias and their prognosis.

Acute Disease↗

Infectious arterial aneurysms: patterns and treatment.

PURPOSE: To evaluate patterns and evolution of treatment of infectious arterial aneurysms in a 15 year period. MATERIAL AND METHOD: Eight patients bearing 8 arterial aneurysms: 4 aorto-iliac, 1 of the internal carotid, 1 of the posterior tibial, 1 of the cubital, 1 of the internal carotid artery. For the aorto-iliac aneurysms treatment consisted in resection extra-anatomic by-pass in 2, "in situ" prosthetic grafting in the other 2. Extra-abdominal aneurysms were treated by excision/"in situ" vein grafting in two cases and simple resection in other two cases. RESULTS: One post-operative death occurred, due to rupture of a ligated aortic stump. No death or major complication occurred after "in situ" treatment of aorto-iliac aneurysms and, overall, in extra-aortic aneurysms. CONCLUSIONS: Staphylococcus and miceti have become the most frequently encountered causative agents. "In situ" grafting together with aggressive antibiotic therapy became the preferred method in the recent years and yielded good results.

Adult↗

Transcranial Doppler validation of hemodynamic vertebrobasilar insufficiency diagnosis.

Transcranial Doppler (TCD) can be useful in the diagnosis and validation of surgical treatment of vertebrobasilar insufficiency (VBI). A case is reported in which TCD confirmed the diagnosis of vertebrobasilar insufficiency and validated the indication of surgery by detecting a bidirectional flow in a stenotic and compressed vertebral artery. In the postoperative period and at late follow-up TCD demonstrated a restored antegrade flow, as a consequence of a well functioning revascularization. Surgical indication of VBI is rare and TCD can be proposed as part of routine patients' study before a surgical decision is taken.

Aged↗

[Variations in the origin of the artery of Adamkiewicz].

Variations of the origin of the medullary artery. The purpose of this study was to define the origin of the medullary artery through medullary angiography in order to prevent paraplegia during surgery of the thoraco-abdominal aorta. Twenty-eight patients, candidate to thoracoabdominal aorta operations, have been studied for the study of the origin of the medullary artery and its eventual reimplantation during surgery. The artery has been localized in 24 of the 28 patients. In 22 cases (78.6%) it originated from an intercostal artery between D8 and D12, while in 6 cases (21.4%) it originated from a lumbar artery between L1 and L2. In 23 (82.1%) cases it originated from the left side, while only in 5 (17.9) from the right side. Although medullary artery originates more frequently at the thoracic level, particularly from the left D9 and D10, its variability is important, and its localization before thoraco-abdominal aortic surgery is often desirable.

Adult↗

Surgical treatment of digestive arteries aneurysms.

Eight patients of a mean age of 56.4 years, have been operated on for 9 digestive arteries aneurysms in a 7-years-period. Sites of aneurysmal disease included 3 splenic, 3 superior mesenteric, 2 hepatic, and 1 left gastric arteries. Five patients (62.5%) were asymptomatic, while 3 (37.5%) presented with symptoms. Three patients (37.5%) presented associated aortic lesions consisting in 2 infrarenal aneurysms and 1 aorto-iliac stenosis. Of the 9 arteries treated, 5 were revascularized. Restaurative operations included 1 reconstructive endoaneurysmorraphy, 3 retrograde by-pass grafts (2 Dacron and 1 PTFE), and 1 antegrade by-pass graft (Dacron) from the coeliac aorta. There were no post-operative deaths. Mean length of follow-up was 47.8 months. No patient presented with late intestinal or operation related problems.

Adolescent↗

Calcified retroperitoneal fibroma.

A case of 31-year-old male with a retroperitoneal tumor is described. Abdominal ultrasound revealed a left para-aortic calcific mass, adjacent to the left lobe of the liver and to the upper pole of the left kidney. A CT-scan of the abdomen showed the mass to originate from the left adrenal gland. At operation, a large, retroperitoneal mass, adherent to the left kidney and the spleen, but not infiltrating, was excised. Histologically the tumor was diagnosed as a calcified osteo-producing fibroma. Benign retroperitoneal tumors represent about 25% of all retroperitoneal neoplasm. This reported case represents a retroperitoneal tumor of slow growth and benign clinical course whose characteristic consists of the heavy calcifications which are normally absent in a fibroma type mass.

Adult↗