PubMed Health⌕ Search

Biomedical subjects

G Sgroi

Publications and source records attributed to G Sgroi.

16 recordsLinked to original sources
PubMed1995

[Choledochoduodenostomy in the treatment of benign disease of the common bile duct: evaluation of long-term results].

The Authors report their experience in the treatment of 36 patients managed by side-to-side choledochoduodenostomy for common bile duct disease and followed for a period of five years. The main indication to surgery was a choledochal dilatation more than 1.5 cm. The surgical technique consisted in a single layer side-to-side choledochoduodenostomy with absorbable suture according to Roessner. There was no operative mortality and few post surgical complications (six patients, 15.78%) were registered; 25 patients (69.45%) were completely asymptomatic at five years, while in six cases (16.66%) significant symptoms were observed. In one case a biliary gastropathy with no metaplasia was documented.

Aged↗
PubMed1995

[Proximal anastomotic pseudoaneurysms].

Abdominal aortic pseudoaneurysms development in patients submitted to endoaneurysmectomy or bifurcated aorto-peripheral by pass was, for a long time, considered a rare complication of aortic surgery. In old papers it was referred prevalence of abdominal PSA which rambled on values less than 1%. The diagnosis was always reached in concomitance with fissurations, ruptures or aorto-digestive fistulas. Recent papers, in which were reported results of accurate instrumental (echo and TC) follow-up of patients with aortic prosthesis, demonstrated a really higher prevalence of abdominal aortic pseudoaneurysms (about 6%). A retrospective analysis of PSA admitted to the General and Cardiovascular Institute of the University of Milan and the First Surgical Division of the General Hospital of Treviglio-Caravaggio (BG), demonstrated a high morbidity and mortality of complicated aortic pseudoaneurysms surgery. Considering the data reported in the international literature and the results of the surgery of complicated aortic PSA, the Authors point out the necessity of accurate periodical instrumental follow-up of subjects with aortic prosthesis in order to identify anastomotic pseudoaneurysm and to evaluate incidental evolution of aneurysmatic disease.

Adult↗
PubMed1995

[Anastomotic pseudoaneurysm, true para-anastomotic aneurysm and recurrent aneurysm following surgery for abdominal aortic aneurysm. Is a unifying theory possible?].

BACKGROUND. Recurrent aneurysms (RA) and true para-anastomotic aneurysms (TPA) are currently reported as anecdotal findings during occasional follow-up of subjects previously operated for abdominal aortic aneurysm (AAA). In several instances concomitant false anastomotic aneurysms (FAA) are found, not attributable to infection nor to suture or graft degradation. PURPOSE. To discuss the possibility that RA of inborn arteries, TPA, and non infectious FAA, when concomitantly present in the same subject, may reflect a peculiar late presentation of multiarterial aneurysmal disease. MATERIAL. Three cases of occasionally discovered concomitant RA, TPA, and FAA in subjects previously operated for AAA are reported. The finding of new aneurysms and FAA in subjects previously operated for AAA may be theoretically justified by the currently recognized pathogenetic mechanisms, molecular, enzymatic or genetically determined, implicated in the formation of AAA. This points out the need for a correct surgical management of AAAs and for accurate accomplishment of follow-up programmes supported by ultrasound echography of graft-arterial anastomoses and of the arteries at risk of aneurysmal disease.

Aged↗
PubMed1994

[A rational approach to cholecystectomy in the patient with an abdominal aortic aneurysm].

A retrospective series of 30 (2.8%) cases of cholelithiasis out of 1064 abdominal aortic aneurysmectomies is presented. 21 subjects underwent aneurysmectomy and prosthetic grafting combined with cholecystectomy. Complications related to the combined operation, early or late (6 months to 8 years follow-up was available for the whole series), were not recorded in this subgroup. 9 (30%) patients with coincidental gallstones underwent simple aneurysmectomy: 2 (22%) patients complained of symptoms of biliary colic, eight and fifteen weeks after operation respectively, and successfully underwent medical treatment. A third patient (11%), operated on urgently for ruptured abdominal aortic aneurysm, developed acute cholecystitis, gallbladder perforation and biliary peritonitis on the 17th day of operation: he died of multiple organs failure on the 8th day of urgent cholecystectomy. Acute alithiasic cholecystitis was recorded only once (0.1%) among the 1034 abdominal aortic aneurysmectomies without gallstones: fatal outcome was ascribed to massive multiple organ cholesterol embolization. If careful asepsis and correct surgical tactics are observed, cholecystectomy can safely be performed in combination with abdominal aortic aneurysmectomy in subjects with a positive history of cholecystitis or in poor general conditions, but it cannot be considered as a prophylactic treatment towards postoperative acute cholecystitis in good-risk subjects with a negative history of cholecystitis.

Aged↗
PubMed1994

A case of asymptomatic giant aneurysm of the common hepatic artery.

The authors are presenting a case of asymptomatic giant aneurysm of the common hepatic artery in a 72 year-old woman. The patient came under our observation with a complete, recent diagnosis. However, two years earlier in another clinic, a para-hilar hepatic mass with partially calcified walls was incidentally found during an abdominal ultrasound. An abdominal TC without contrast medium showed the mass to be hepatic hydatid cysts. TC images after 2 years showed a growth in diameter from 7 to 12 cm. Having undergone an hysterectomy and a rectal prosthesis, technical difficulties occurred because of the aneurysm's characteristics. The authors would like to emphasize that the rarity of the lesion must not exclude it from the diagnostic protocol of abdominal masses: ultrasound must be accompanied by a Doppler and the TC must be made using a contrast medium. Furthermore, revascularization surgery may create difficulties that cannot be previously prevented.

Aged↗
PubMed1994

[Recurrent aneurysmal disease of the native arteries in subjects operated on for abdominal aortic aneurysm].

Abdominal aortic aneurysm repairs are presently increasing in number all over the western countries; long life expectancy and high quality of life, warranted to patients surviving operation, stressed the possibility that aneurysmal disease affects other arteries as well as the para-anastomotic aorta itself. OBJECTIVE. The observation that, in the last four years, five patients were operated on for recurrent aneurysms of native arteries, gives the opportunity to discuss the matter and review the literature on this topic. MATERIAL AND METHODS. Five cases of recurrent aneurysms of native arteries in patients that had undergone abdominal aortic aneurysmectomy 4 to 11 (mean: 8) years before are discussed. A total of 16 new aneurysms were found. Although all these patients regularly attended their clinical follow-up program, these observations have to be considered retrospective and incidental, because B-mode echography was not yet routinely requested by the followup protocol. RESULTS. Neither hypertension nor type of graft implanted in the first operation were correlated to the development of new aneurysms in these five subjects. Rupture as causative of the original aneurysmectomy was recorded in two cases (40%), that developed 8 recurrent aneurysms (50%), one of which ruptured. CONCLUSIONS. Although recurrent aneurysms are occasionally reported in the literature, the lack of prospective follow-up series, based on non invasive serial imaging of the arterial system, prevents clarifying whether these observations are isolated or recurrence is likely to be a long-term outcome of aneurysmal disease.

Aged↗
PubMed1994

[Current knowledge and unresolved problems in the pathogenesis of abdominal aortic aneurysm].

This is a wide literature review on abdominal aortic aneurysm (81 references). The main branches in which research is in progress are presented, and new concepts in pathogenesis are illustrated. These come out of the development of knowledge in basic sciences and their interdisciplinary application to this disease. Biochemistry, pathology, immunology, genetics, mathematics, mechanics, fluidodynamics are the routes now followed in the effort to cast light on the inner mechanism of birth and growth of this disease, presently unpredictable and uncontrollable, but successfully treatable by vascular surgery.

Aortic Aneurysm, Abdominal↗
PubMed1994

[Primary embryonal rhabdomyosarcoma of the breast. Description of a case].

Authors report a case of embryonal rhabdomyosarcoma of the breast occurring in a 16-year-old girl. To date, 26 cases have been described in the literature of which only 4 in girls younger than 16 years. Histological features, immunohistochemical findings and differential diagnosis are discussed.

Adolescent↗
PubMed1994

[Primary aorto-enteric communication].

BACKGROUND: Primary aortoenteric communications are a rare and severe complication of abdominal aortic aneurysms or erosions by neoplastic diseases. Early diagnosis and surgical treatment are crucial. Postoperative morbidity and mortality are high. Diagnosis if often made intraoperatively, because the typical clinical feature (digestive haemorrhage, abdominal aneurysmal mass, abdominal pain) is often incomplete and critically ill patients require quick surgical decision and do not allow the use of sophisticated diagnostic tools. MATERIAL AND METHODS: Eight cases, observed through 13 years, are presented: six males and two females. Mean age was 61 years; male to female ratio was 3:1. In four cases (50%) a herald bleeding occurred during the days preceding hospital admission. Presenting symptoms were haematemesis (63%), melaena (87%), abdominal pain (63%); six subjects (75%) presented hemorrhagic shock. Only three patients (37%) were aware to be affected with abdominal aortic aneurysm before admission. Diagnosis was always made by clinical feature and urgent laparotomy: two preoperative duodenoscopies were not diagnostic. Aortoduodenal communication occurred in six cases: one of these was secondary to erosion of the aorta by a carcinoma of the pancreas. Aortogastric communication occurred once; the remainder case was a communication between a hypogastric artery aneurysm and the last ileal loop. RESULTS: Surgical operation was carried out in emergency in seven patients: the eight (tumour of the pancreas and aortoduodenal erosion) died before operation. Enteric defect repair, aneurysmectomy and aortic grafting was performed in six cases. In the last case (hypogastric-ileal communication) ligation of the hypogastric artery and ileal segmental resection was performed. Thirty days operative mortality was 58%. CONCLUSION: Despite early recognition and operation, primary aorto-enteric communication remains a severe life threatening disease, bringing high mortality rates. These are clearly affected by shock condition, but a correct surgical technique and prolonged postoperative antibiotic medication to avoid graft infection are mandatory to minimize mortality.

Adult↗
PubMed1990

[Latero-lateral choledochoduodenostomy in benign pathology of the common bile duct. A prospective study].

Biliodigestive derivations for benign diseases of the biliary tract are currently accepted in case of extended to recurrent choledochal stenosis, excessive dilation of the choledochus, impacted ampullary stones. This paper concerns 19 subjects that underwent laterolateral choledochoduodenostomy (CDS) according to the Roesner technique over the period January 1986 through December 1987 in order to evaluate long-term functional results of this operation. Hepatic serum enzymes and bilirubin were determined at intervals of two weeks during the first three months and of four weeks until the sixth month postoperatively. At this time a battery of controls was performed, namely standard plain X-ray of the abdomen, hepatobiliary sequential scintigraphy with HIDA, endoscopic examination of the anastomosis. The level of serum enzymes was then determined at 18 months postoperatively and scintigraphy was repeated as well. Based on the results of this study and the review of the recent literature, our opinion is that CDS has shown as a safe procedure with good long-term results in the treatment of benign disease of the biliary tract, mostly if high-risk aged subjects are concerned.

Aged↗
PubMed1990

[Volvulus of the gallbladder. Presentation of a case and review of the literature].

A case of acute torsion of the gallbladder in a 83-year old woman is presented. According to the literature, the pathogenetic mechanism, the anatomical bases and the clinical presentation of this disease are discussed. The age intervals more often affected are the pediatric and teen-ager and, mostly, the elderly over the 70's. The basic anatomical defect is the gallbladder flotation, congenital or acquired. The clinical feature is that of right acute abdomen, and emergency cholecystectomy is the treatment of choice.

Acute Disease↗
PubMed1990

[Surgical treatment of lithiasis of the common bile duct: our experience].

On the basis of their personal experience of biliary pathology, the authors present their opinion of surgical treatment of benign diseases of the common bile duct. From 1980 to 1988 a total of 930 patients were assessed, 140 of whom were affected by choledocholithiasis. Data confirmed that, with the exception of choledochotomy as a direct approach for removing stones, good results were achieved using papillosphincterotomy, since this technique best restores the physiology of the biliary tract. In cases where common duct dilation exceeded 20 mm or where the patient was in poor clinical condition, bile was drained into the gut forming a side-to-side choledochoduodenostomy.

Adult↗
PubMed1990

[Primary carcinoma of the gallbladder].

Primary carcinoma of the gallbladder, while infrequent, is the most representative among the malignant neoplasms of the biliary tract. The diagnosis of carcinoma of the gallbladder was made in 22 out of 1252 operations performed for gallbladder disease (1.8%) since January 1980 through June 1988: only in 9% of the subjects a malignant tumor of the gallbladder was suspected preoperatively. In 21 cases the carcinoma was associated with chronic lithiasic cholecystitis. The 22 cases were assessed according to the classification proposed by Nevin. The operations performed were: 4 routine cholecystectomies (stages I and II) 4 cholecystectomies with lymphadenectomy (stages I and II); 4 cholecystectomies with lymphadenectomy and liver wedge resection of the bed of the gallbladder (stages II, III, IV, V); 7 explorative laparotomies and 3 gastrojejunal anastomoses (stage V). A complete follow-up was available for each of the 22 subjects: cumulative survival rates were calculated according to Kaplan-Meyer. The overall 5-year cumulative survival rate after operation was 19% for the whole group, whereas it reached 76% for the subgroup of 9 patients classified in stages I and II. This analysis reinforces the statement that surgical therapy can achieve excellent results if brought about before cancer overwhelms the muscular layer of the gallbladder wall. Thus, as the preoperative diagnosis of gallbladder carcinoma is extremely difficult and uncertain, any delay in performing cholecystectomy seems to be unwise in all those cases of chronic benign disease of the gallbladder (whether lithiasic in nature or not) that are suspected to be a major risk factor for cancer degeneration because of their frequent association with the carcinoma of the gallbladder.

Adult↗
PubMed1989

[Current indications for percutaneous transhepatic cholangiography (PTC)].

Percutaneous transhepatic cholangiography (PTC) showed its widest diffusion during the late '70s while since the early '80s it was gradually replaced by endoscopic retrograde cholangiopancreatography (ERCP). Anyway, a well definite role for PTC still exists. PTC was performed in 60 of 131 cases of obstructive disease of the biliary tree: the indications are illustrated in detail. The statistical indicators utilized to choose this examination were: echographic determination of the diameter of the biliary tree, bilirubinemia, alkaline phosphatase (ALP) and serum gamma-GT. Data collected during this study showed that biliary dilation has a significant correlation to serum levels of ALP, while bilirubin has not. Biliary dilation is currently well established by echography: in some instances, however, biliary obstruction is earlier suggested by elevated serum enzymes of biliary stasis, while it is clearly demonstrated that biliary dilation is a precursor of jaundice, better defined as an expression of biliary hypertension. Based on these observations and on the review of the literature, the Authors believe that PTC still remains a second choice examination as compared to ERCP: when the latter be not effective for diagnosis or decompression of the biliary tree, then PTC can be resolutive.

Alkaline Phosphatase↗
PubMed1975

Repair of U.V. damages in Bacillus subtilis cultures competent for transformation: difference between competent and non-competent fractions.

The repair of U.V. damages to DNA in B. subtilis cultures competent for genetic transformation has been studied. The comparison of survival curves for competent and non competent fractions shows that: i) excision repair is more effective in competent than in non competent bacteria; ii) recombination repair is more effective in non competent than in competent bacteria. These facts support the hypothesis that metabolic conditions and, very likely, DNA replication play a role in the regulation of the efficiency of the two different mechanisms of repair.

Bacillus subtilis↗