Biomedical subjects
Publications and source records attributed to G Lucca.
The aetiology, the epidemiology and the pathogenesis of poisoning by viper bites in Italy are outlined. The symptomatology and therapy are also described, and it is noted that antivenom must be reserved for some selected cases.
The Authors have collected during 28 years 26 cases of acute perforation, in free peritoneum, of gastrojejune ulcers in subjects who, in precedent times, had been operated for gastro-duodenal ulcer. In 24 cases the rafia has been practised, with 5 deceased: in two cases immediate resection has been practised, with two recoveries. The Authors do some considerations about the aetiopathogenesis of peptic post-resection ulcer and about its perforative complication, and also about the urgent surgical therapy that, except exceptional cases for special anatomic-pathological conditions, must be limited to the simple rafia, referring to futher time radical gastro-jejune-resection.
Description of a total of 236 cases of intestinal volvulus of which, 141 cases concerning the small intestine, 2 of the transverse, 13 of the caecum and 80 of the sigmoid. Detailed discussions are made on each type of volvulus, the etiology, pathogenesis, pathological anatomy, while particular extensions is given to the description of the results obtained that are compared with the data found from the examination of the literature. A separate treatment is reserved to the anaesthesia in the cases of intestinal acute volvulus and particularly to some technical measures to which is to be submitted the patient who suffers from mechanical occlusion with serious intestinal ache.
The clinical and anatomo-pathological patterns of Crohn's ileitis are reported and the various etiopathogenetic hypotheses are briefly considered. The acute forms of Crohn's ileitis are then described: appendicular, peritonitic, occlusive and toxic forms. The study is based on 68 personal cases.
Our experience with 26 Patients who sustained traumatic laceration of the diaphragm caused by blunt forces is described. Automobile accidents were the most frequent cause of rupture and young adult males the most vulnerable. The left hemidiaphragm is most frequently injured, but with sufficient force significant tears in the right hemidiaphragm will occur. Most of these patients sustained injury to multiple organ systems. The preoperative diagnosis of traumatic diaphragmatic hernia is based on a high index suspicion, close and continued observation of the patient, and correct interpretation of roentgenograms of the chest. The mortality rate is high owing to the magnitude of the injuries.
The Author describes 151 cases of acute cholecystitis in patients ranging from 70 to 95 years of age. He examines then the literature on the subject paying attention to the treatment of cases of acute cholecyst disease in aged patients. The Author shows the outstanding features of these cases in synoptic tables and discusses them making a comparison with the materials and results of the colleagues. Leaving necessarily aside the urgent operations a discussion is made on the choice between a cholecyst extirpation and a cholecyst anastomosis. On course, advantages and disadvantages of such operations in aged and weakened patients are taken into account. Death percentage results to be equal to 26,4%, a figure which is not far from that furnished by other statistics, bearing in mind the age of the patients.
The problem of early re-operations in urgent surgery of the abdomen is taken into account in the light of a wide range of cases admitted into the urgent surgical ward of the Ospedale Maggiore "Cà Granda" in Milan. These cases refer to the 1950-1975 period necessitating repeated operations. The Author, after analysing the different and most important pathogenetic mechanisms, examines each case tabulating them. In the cases reported, the percentage of the re-operations is less than 20% with a total mortality rate of 33,3%, values which do coincide with the observations of other Authors.
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