PubMed Health⌕ Search

Biomedical subjects

H Parodi

Publications and source records attributed to H Parodi.

13 recordsLinked to original sources

[Pancreatic and colonic simultaneous or successive resections of tumors in both organs, duodenum infiltrating colon carcinoma and pancreas tail carcinoma invading left colon. Report 10 cases].

Two patients with cancer of the right colon fistulized in duodenum underwent simultaneous right hemicolectomies and cephalic duodenopancreatectomies. There were no important post-operative complications and they are both alive eleven and ten years after surgery. In another case a piece of duodenum adherent to colon was resected and the duodenum was transversally sutured, segments IV and V of the liver were also resected because of a infiltration. The patient is well more than three years after surgery. Another similar patient who underwent resection of a part of the duodenum during a right hemicolectomy due to adenocarcinoma, developed the head of the pancreas ten months later which was resected by means of a cephalic duodenopancreatectomy. He survived the second operation for three years and a half and died with carcinomatosis. A fourth female patient who had been referred due to jaundice caused by cephalopancreatic cancer was reoperated two months later with resection of the tumor Seven months after duodenopancreatectomy she underwent another operation for resection of a bleeding cancer of the rectum by means of anterior resection. She survived for four and a half years. Cancers of body and tail of the pancreas sometimes invade the left colon and make necessary resection in the same operation. This happened in four other cases. In two of them it was necessary to resect stomach and the first jejunal loop. Respective survivals were of two years and nine months in two cases, others are 4111 alive more than two years after surgery. But the fourth case, who had an acinar carcinoma, died a month later with en hepatic metastasis which grew rapidly. The opposite happened to the tenth patient because colon cancer invaded pancreas and stomach, that were partially resected. The patient is alive two and a half years later.

Adult↗

[Analysis of patients with acute pancreatitis (AP), (1984-1994) decade. Comparison with a past series].

Between 1984-1994 records of 190 patients with acute pancreatitis (AP) were reviewed. Diagnosis was confirmed by surgery in 141, by necropsy 1 (75%), and for the remaining patients, by CT and clinical evaluation. Female 122 were female (64%), male 68 (36%), mean age 41 years (range 7-82 years). The etiologic factors were gallstones in 129 (68%) with 4 deaths (3%), alcoholic in 26 (14%) with 5 (19%) deaths, idiopathic in 24 (13%) and miscellaneous 11 (5%), the last 2 without mortality. The overall mortality was 5% (9/190). Surgical treatment was indicated in 141 (74%) and endoscopic treatment in 2 (1%), 47 patients (25%) received only medical treatment. One-hundred and fifty-four patients (81%) were mild forms with a Ranson mean score 2.2 without mortality. In this group, emergency surgery was indicated in 7 (6%), early in 3 (3%), late in 1 (0.9%) and elective in 99 (90%). In the severe group were 36 patients (19%) with a mean Ranson score of 4.2. Nine patients died (25%), 31 were surgically treated, by emergency surgery in 17 (47%), 1 (3%) early surgery and 13 (36%) late surgery. The mortality rate of this group was compared with previous series of the same hospital (1975-1984 series). The 1984-1994 group showed a significant overall mortality decrease 4.7% vs 12.7% (p = 0.0047); 3.1% vs 11.2% (p = 0.0087) for the gallstones group; without mortality in the idiopathic and miscellaneous form compared with 18.7% and 20% respectively of the previous series; no mortality was observed in the mild AP compared with 5% of the previous series. The mortality in the severe form was 25% vs 40.8% (1975-1984 group). We consider that the decreased mortality could be attributed to the improvement in the diagnosis, early recognition of the severe forms, systemic supportive care in the severe forms, the use of antibiotics with wide spectrum and deeper penetration in the pancreas and specially in the change of the surgical timing. Although, in the first period the option was the early pancreatic surgery, in the second this was indicated only in particular cases.

Acute Disease↗

Biliary function studies in patients with celiac sprue.

Eleven patients with celiac sprue were studied. Biliary function in the basal state and gallbladder response to perfusion of the small intestinal mucosa with magnesium sulfate was assessed. It was shown that bilirubin output in basal conditions is decreased in these patients and that magnesium sulfate does not stimulate gallbladder contraction. In addition it was shown that in 4 of the 11 cases studied there was a complete lack of bile reaching the duodenum in the basal state as well as in 7 of 11 cases in the digestive period. That gallbladder function was intact was shown by the normal response to intravenous CCK-PZ administration, and the patency of the common bile duct was demonstrated by intravenous cholangiography. Thus the already impaired fat absorption in celiac sprue is magnified by the lack of bile delivery, and this is probably due to an alteration in the synthesis or release of endogenous CCK-PZ.

Adult↗