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Biomedical subjects

G W Drago

Publications and source records attributed to G W Drago.

At least 19 recordsLinked to original sources
PubMed1997

[Gallbladder torsion. A case report].

INTRODUCTION: The unusual anatomical position of the organ, generally suspended by a mesentery, allows the rare possibility of its torsion with necrosis and even perforation. CASE REPORT: A woman, aged 78, who presented signs and symptoms similar to those of severe acute cholecystitis: abrupt onset of pain and a large palpable mass below the right costal margin. Immediate laparotomy with detorsion and easy cholecystectomy was performed. CONCLUSIONS: Should a greatly enlarged mass be palpable below the right costal margin within a few hours from the abrupt onset of unremittant abdominal pain the possibility of torsion should come to mind not to delay operation in the supposition of acute cholecystitis.

Abdominal Pain↗
PubMed1995

[A case of perforated diverticulum of the right colon].

Diverticulum of the right colon is a rare disease which is often wrongly diagnosed and asymptomatic. It affects young individuals and is manifested by symptoms similar to appendicitis. The paper reports a case of a young man with an isolated perforated diverticulum of the right colon which was clinically manifested as acute appendicitis with peritoneal reaction. It is extremely difficult to make a preoperative diagnosis of cecal diverticulitis. Even the anatomosurgical appearance sometimes makes it difficult to distinguish from neoplasia. For this reason the most frequent operation is right hemicolectomy which is however well tolerated by young patients.

Acute Disease↗
PubMed1994

[Vesico-vaginal fistula after abdominal hysterectomy. Use of the Legueu technique].

Vesicovaginal fistulas are commonly seen as a complication of abdominal (or vaginal) Hysterectomy. The signs and symptoms of a vesicovaginal fistula depend upon its size and location. Identification of a vesicovaginal fistula includes an intravenous urogram; cystoscopy may be performed in order to evaluate the possibility of immediate or delayed repair. Case report. Principles of surgical repair. The principles of surgical closure are similar: 1) total separation of the tissues comprising the wall of the vagina and the wall of the bladder; 2) sharp excision of the fistulous tract between to two structures; 3) closure of the defects with non-overlapping suture lines; 4) where possible, interposition of alternative tissue between the two suture lines. The intervention proposed by Legueu allows an abdominal transperitoneal approach to the fistula and is comprehensive of these principles. With such a procedure we have treated successfully two cases which required surgical closure. CONCLUSIONS. In patients who develop vesicovaginal fistulas as a complication of abdominal hysterectomy, we have applied the intervention proposed be Legueu, which allows closure of the fistula via a transperitoneal route. Preliminar diagnostic evaluation and following of the foundamental principles of correct surgical closure are indispensable to accomplish a successful intervention.

Adult↗
PubMed1994

[Retroperitoneal abscesses: clinical and therapeutical aspects].

The authors explain the clinical and anatomical features of retroperitoneal abscesses, which occur less commonly than peritoneal infections. Retroperitoneal abscesses arise chiefly from injuries in adjacent structures, but they may be primary when caused by hematogenous bacterial spread. The pyogenic bacteria have replaced Mycobacterium tuberculosis as the major causative organism. Retroperitoneal abscesses may be symptomless, but fever and abdominal pain are prominent features. The differential diagnosis includes retroperitoneal tumors and hematomas. These lesions are best delimited by CT scanning which localizes them accurately. The treatment consists in a prompt and adequate drainage and systemic antibiotics therapy. Drainage by catheter, however, has a lower success rate than the surgical approach. The surgical mortality rate is about 25%.

Abscess↗
PubMed1994

[Postoperative pulmonary thromboembolism].

The authors report their finding concerning the frequency of postoperative pulmonary thromboembolism in an autopsy series of subjects who had died with 15 days of surgery. In all cases the relationship was evaluated between death and age, sex, the underlying pathology and the type of surgery.

Adolescent↗
PubMed1994

[Use of ultrasonic surgery in laparoscopic cholecystectomy].

INTRODUCTION: Laparoscopic cholecystectomy now represents a valid alternative to traditional surgery in the treatment of gallstone diseases. For the past twenty years laparotomic cholecystectomy has represented the golden standard of gallstone treatment given its extremely low mortality rate (0.5%) and equally acceptable morbidity rate. Laparoscopic cholecystectomy now appears to have taken over the position of elective treatment. Sophisticated techniques, such as ultrasound scalpels make this form of surgery particularly safe. MATERIALS AND METHODS: The authors report a series of 50 patients who underwent laparoscopic cholecystectomy in which ultrasound surgery was used in 40 cases using the CUSA system. The gallbladder hilus is prepared using ultrasound manipulation following the secure identification, respect and clipping of the cystic artery and duct. DISCUSSION AND CONCLUSIONS: Laparoscopic cholecystectomy appears to be the ideal treatment for gallstone diseases. In the series reported here the use of the ultrasound scalpel allowed the gallbladder hilus to be reach skeletization, preserving the main structures and keeping the operating field clean and blood-free, without increasing operating times. The possibility of severe accidents, such as vascular lesions to the hepatic artery or vena portae, or damage to the common bile duct or other abdominal organs are reduced using this technique.

Adult↗
PubMed1993

[A bleeding jejunal schwannoma. The complications of a rare neoplasm of the small intestine].

The authors report a rare case of jejunal Schwannoma which appeared as hematemesis and melaena. No preoperative test, even selective angiography, enabled a correct clinical diagnosis to be made. Only after explorative laparotomy and careful palpation of the small intestine was the bleeding lesion located. Resection and termino-terminal anastomosis were then performed. The preparation of immunohistochemical reactions now allow forms which were previously diagnosed in different terms to be precisely classified.

Adult↗
PubMed1990

[Endoscopic resolutions of volvulus of the sigmoid colon].

The flexible colonoscope has brought considerable advantages to the diagnosis and nonsurgical treatment of volvulus. In the case of repeated recurrences that make surgery vital because of the onset of signs of vascular trouble on the twisted ansa, preoperative resolution permits correction of hydroelectrolytic imbalances and the preparation of the colon with the possibility of operating with no need for protective colostomy. It also allows resolution of the acute situation in the presence of contraindications to intervention.

Adult↗
PubMed1990

[La Peyronie's disease. Our experience].

Following an aetiopathogenetic review of I.P.P., diagnostic and therapeutic possibilities are assessed. Medically, stress is laid on the value of orgotein, an SOD which, used in time, reduces pain and penis curving and permits satisfactory sexual activity. In the case of inveterate forms or of large plaques, the use of a silastic prosthesis is proposed. This support enables a normal sex life to be continued, so resolving psychological and family stress.

Adult↗
PubMed1989

[Use of intraoperative transcystic choledoscopy in calculosis of the main bile duct].

Choledochoscopy is complementary to peroperative cholangiography in exploration of the main biliary way. Transcystic access is proposed in choledocholithiasis. The cystic duct, in fact, is frequently transitable owing to the dilatation produced by the migration of gallstones and because of the increasing miniaturisation of instruments. This examination of the MBW is less traumatic and risky than transcholedochotomic choledochoscopy.

Endoscopy↗