Biliointestinal bypass: another surgical option.
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Adult↗
Biomedical subjects
G Pieri
Publications and source records attributed to G Pieri.
Ultrasonography of extremity lymphedema.
Ultrasonography of the extremities was performed in 91 patients with unilateral or bilateral peripheral lymphedema of the arms or legs. Linear 3.5 to 10 mHz ultrasonographic linear probes were used in accordance with standardized procedure. The data demonstrated a volumetric increase of the lymphedematous limb with increased thickness of both the subcutaneous and subfascial (muscular) compartments consistent with fibrosclerosis in both compartments with chronic disease. Whereas dermal thickening was minimal, subcutaneous and subfascial changes were more prominent in primary than secondary lymphedema. By providing information about the volumetric and structural alterations with chronic lymphedema, ultrasonography safely and simply supplements conventional and isotopic lymphography in assessing patients with chronic lymphedema.
Adult↗
Ultrasonographic evaluation of the cervical lymph nodes in preoperative staging of esophageal neoplasms.
BACKGROUND: The detection of cervical lymph node metastases plays an important role in staging of patients affected by esophageal cancer to perform the best therapeutic approach. METHODS: We report our experience concerning the ultrasound evaluation of the cervical area in 174 patients with esophageal cancer. Ultrasonographic evaluation of the neck can be done with a 7.5- or 10 MHz transducer in all cases, with selective scanning of the lymph node chains of the internal jugular veins and supraclavicular regions. The short-to-long axis ratio (S/L) was a useful way to detect lymph node metastasis. Histopathologic diagnoses were obtained by sonographically guided fine-needle aspiration biopsy. RESULTS: At ultrasound examination, we found 18 (10.3%) patients with metastatic cervical nodes. Of these, 17 (94.4%) had metastatic cervical lymph nodes confirmed by cytology from fine-needle biopsy. Lymph node exceeding 5 mm in long axis and with an S/L over 0.5 showed a higher incidence of metastasis than those with an S/L under 0.5. Our experience shows a high incidence of lymph node metastases in patients with esophageal cancer localized to the thoracic supracarinal tract and in patients with cervical and lower esophageal cancer. CONCLUSION: In the ultrasound evaluation of nodes, the most useful parameters are size of nodes, heterogeneity of internal echoes, morphology of the margins, and the deformation caused by compressive instrumental manipulation. These criteria, indicated by the Japanese Society for Esophageal Diseases, yield a high sensitivity and diagnostic specificity when the ultrasonographic studies are performed.
Adult↗
[Adhesion of the labia minora in children].
Vulvar agglutination or vulva connivens in childhood is a common disease and an important source of anxiety for parents. The Authors report on the anatomic classification, the etiology and the prevalence of this genital anomaly in the pediatric age. In the 2021 patients of our series examined in the Department of Pediatrics in Poggibonsi and in the Department of Pediatric Surgery of the University of Siena during a period of 7 years and revisited in the period between January 1995 and December 1996 (follow-up: max 7 years) no cases were observed in the first month of life (793 newborn infants) and this fact might help to exclude a congenital origin. The incidence of vulvar agglutination in 1228 children was 9.8%; in the 3.6% of cases vulvar agglutination was complete, while in the 6.1% it was incomplete. 60% of complete vulvar adhesions were in 3-6 years old patients, while the incomplete one was prevalent during the first 3 years of life. In our series vulvar adhesion was more common than in other studies, but the Author report no cases of correlated urinary or genital infections. It is important to reassure parents and to maintain a conservative approach to this anomaly. Estrogen therapy in this study was applied only in a few cases, because almost all the patients healed before puberty; the surgical division was applied only in case of recurrence.
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Ultrasonographic imaging of neoplasms of the cervical esophagus.
BACKGROUND/AIMS: We studied the effectiveness of ultrasonography in evaluating the cervical esophagus for the presence of large masses arising from the esophageal wall and consequently, the modifications of the visceral lumen. MATERIALS AND METHODS: The cervical esophagus can be evaluated by ultrasound with longitudinal and axial scans, using the left thyroid lobe as an acoustic window. The cervical esophagus can be visualized from the C5 to D2 vertebrae. From November 1992 to July 1996, 220 patients with esophageal cancer and 120 subjects without esophageal disease (control group) were examined with ultrasonography. Examination of the cervical esophagus was performed with a linear high definition small parts probe with a frequency of 7.5-10 Mhz. RESULTS: In all 31 patients with cancer of the cervical esophagus, ultrasonography of the cervical region showed the presence of an expanding mass from the esophageal wall as well as the modifications in the visceral lumen. The neoplasm of the cervical esophagus was visualized when its diameter exceeded 5 mm. CONCLUSIONS: The experience of the authors shows that, during ultrasound examination of the cervical region, it is possible to accurately evaluate the cervical esophagus, either morphologically or functionally.
Aged↗
Evaluation of leiomyoma of the esophagus with endoscopic ultrasonography.
Fourteen patients with suspected leiomyoma of the esophagus were studied by endoscopic ultrasonography, computed tomography, endoscopy and barium swallow. The results were correlated with the histology of the resected specimens: in 2 patients with a peduncolated leiomyoma originating from the second echographic layer, endoscopic resection was performed. Endoscopic ultrasonography was superior to other imaging techniques in detection and staging of leiomyoma because it can determine the layer of origin, the direction of the growth and the consistency of the tumor.
Adult↗