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Biomedical subjects

H Arenas Márquez

Publications and source records attributed to H Arenas Márquez.

8 recordsLinked to original sources
PubMedDate not supplied

[Surgical revision and correction of choledochal cysts].

Choledochal cyst are a rare congenital abnormality, seldom treated by the General Surgeon. We report six cases of re-operation found on a eighth year period. Six cysts type I, and one type II (Todani's Classification) were found. On five of them, an internal derivation had been performed, in one patient only a celiotomy was performed, and in another one a colecistectomy. Complete resection of the cyst was performed in six cases. In one female patient, this was impossible, because a carcinoma was found, she died postoperatively. We recommend external bile duct drainage for those cases where a complete resection can not be performed. This option alleviates the symptoms, allows morphological studies and do not compromise the final procedure which must be the complete excision of the cyst.

Adolescent↗
PubMedDate not supplied

[Complications of the surgical treatment of reflux esophagitis].

The complications presented by 36 patients submitted to anti-reflux procedures that were treated in our Hospital in a 10 year period, from September 1978 to May 1988, are analyzed. The patients were divided in 2 groups depending on the initial treatment being performed inside or outside our Hospital. The indication for the initial operation was reflux esophagitis in all patients, 4 or whom, had developed a shortened esophagus with stenosis. The selected procedures were of several types with a clear predilection for the Nissen type fundoplication with its variants. Different kinds of complications were observed; mortality was associated with gastric or esophageal leak, with a fatal outcome in 11 patients, another one died of postoperative pancreatitis and abdominal sepsis (33.3 percent mortality rate).

Esophagitis, Peptic↗
PubMedDate not supplied

[Artificial nutrition. When? How? What?].

The association of excessive morbidity and mortality with malnourished states has been well documented. Nutritional assessment should now be an integral part of the evaluation of all hospitalized patients, particularly those scheduled for surgical procedures. Determination of the method of feeding the patient depends on the patient's nutritional status, the level of gastrointestinal function and the type and magnitude of treatment which he will undergo. The enteric route is always preferred when it can be used. If oral and enteral feeding are not possible, either peripheral or central nutrition should be employed. To central route is necessary protocol strictly adhered to be Knowledgeable persons. Artificial Nutrition should be instituted before significant protein deficits develop. It is far easier to maintain a patient's nutritional status than it is to repair nutritional deficits.

Anthropometry↗
PubMedDate not supplied

[Massive hemorrhage of the digestive system secondary to ulcerated colonic malacoplakia].

A case of malakoplakia of the colon in a 55-year-old female patient with a massive hemorrhage of the rectum is reported. A barium enema showed polypoid lesions (pseudopolyps). Colonoscopy revealed white-yellowish nodules simulating small pustulae all along the colon at 2 cm from the anal verge. A laparatomy disclosed lobulated intraluminal masses and yellowish lesions in the form of transcolonic plates infiltrating the duodenal wall as well as a fair amount of lymph nodes in the mesentery. We performed a proctocolectomy. The histologic study showed massive infiltrate of histiocytes and numerous Michaelis-Gutmann bodies. This disease is usually found in the urinary tract and rarely found in the colon. The importance of proper histologic examination in order to arrive at a correct diagnosis is emphasized.

Colon↗
PubMedDate not supplied

[Morbidity, mortality, and total parenteral nutrition in esophageal and gastric surgery for benign pathology].

We performed a retrospective study in patients undergoing mayor elective surgery of the upper gastrointestinal tract for benign disease receiving perioperative total parenteral nutrition (TPN). We analyzed the clinical charts from patients admitted to the Hospital de Especialidades del Centro Médico de Occidente for this purpose from January 1983 to March 1987, selecting those who had clinical or laboratory criteria of severe malnutrition. They were divided in two groups depending on whether TPN was being indicated as preoperative preparation and continued through the postoperative period (GE = 32 patients), or initiated after surgery (GC = 13 patients). The results show statistical differences in morbidity (GC = 100%, GE = 27%), mortality (GC = 30%, GE = none), need of reoperation (GC = 30%, GE = none) and costs (higher in GE). Complications related to TPN in GC were 23% and 15% in GE, and there were no deaths related on either group. Based on our results, we consider the need of a good selection of candidates to receive preoperative and postoperative TPN when undergoing major elective surgery, which should be continued until they are able to cover their nutritional requirements by oral or enteral route. This applies whenever there is sufficient clinical and laboratory data of severe malnutrition.

Adult↗