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Biomedical subjects

I Juvara

Publications and source records attributed to I Juvara.

18 recordsLinked to original sources
PubMedDate not supplied

[Diverticula of the duodenal orifice].

The authors present a synthesis of data from the literature, as well as of particularities that have confronted them in connection with 16 observations of mucous diverticuli of duodenal windows (of which 7 were interposed and 9 were juxtaposed). After a definition of the window diverticuli, of their types and of their repercussions, clinical data are commented upon, the possibilities offered by paraclinical investigations and by the intra-operatory methods, as well as the different therapeutical procedures. In relation with the clinical manifestation the diverticuli may be latent (or asymptomatic), they may be accompanied by direct signs of stasis and inflammation, or with biliary and pancreatic signs--an expression of the unfavourable influence exerted by the diverticuli on the biliary and pancreatic transits. The choice of the therapeutical procedure depends on the type of the diverticuli, the modality of the clinical expression and the bilio-pancreatic effects determined by them. Direct interventions can be performed on juxtaposed diverticuli, although this implies considerable risk, but indirect interventions are to be preffered, in which, in relation with the particularities of the case, the biliary transit is derivated or the duodenum is excluded from the digestive pathways.

Adult↗
PubMedDate not supplied

[The use of 10-percent mannitol solution in colonic surgery].

Based on the experience acquired in 20 cases the authors discuss the use of the mannitol solution in the surgery of the colon. The colic voiding was evaluated in 19 cases as very good, a fact that stresses the efficiency of this method of mechanical preparation of the colon. The method is very well tolerated by the patients, and the secondary biological modifications are not significant. Contraindications are limited to the very aged (above 75 years), in patients with cardiac disease, or in those with hepatic and renal diseases, as well as in those with occluding forms of neoplasies.

Adult↗
PubMedDate not supplied

[Atypical postoperative peritonitis].

In the present conditions of development of the medical sciences the wide and varied use of pre- and postoperative antibiotherapy, to which is added the complex therapy carried out in the intensive-care unit, have changed the course of the dramatic postoperative peritonitis that at present do not develop any more according to the classical symptomatology. The key to success in these cases is the discovery as rapidly as possible of the moment when peritoneal infection has started to develop in view of applying the only correct treatment--reintervention. The present study makes an analysis of 32 cases and stresses the atypical evolution of postoperative peritonitis: contracture, pain, high fever and hyperleukocytosis cannot be considered any more as constant and certain signs. Meteorism and gastric stasis that is prolonged or that developes after 4-8 days following surgery are the most frequently encountered of the signs and are considered to be the most important. Exploratory laparotomy is the most correct attitude in dubious cases.

Humans↗
PubMedDate not supplied

[Complications of splenectomy].

The present study is an analysis of complications developing after a total of 200 splenectomies carried out for various indications: primary hypersplenism (83), secondary hypersplenism following portal hypertension (72), diseases of the hemopoietic system (24), parasitic and infectious splenomegalies (13), rupture of the spleen or of splenic artery aneurisma (8). A number of 68 patients (34%) had a total of 73 complications following surgery. Of these 60 have recovered (30%) while 8 (representing 4% of the total), died. A total of 22 local or general septic complications were noted, as well as 20 complications generated by disturbances of the balance of fluids and/or of the coagulation system, 19 pleuro-pulmonary complications, 6 complications that were not specific for splenectomy, 5 pancreatic complications and 5 cases of hepatic failure.

Hemorrhage↗
PubMedDate not supplied

[An autochthonous case of amebic hepatic abscess with pleural dissemination].

The present paper reports on the first autochtonous case of amoebic hepatic abscess in Romania in a patient in which the epidemiologic survey showed that there had been no possible import infection. The amoebic abscess was located in the superoexternal area of the right hepatic lobe. Subsequently a major complication developed: a tendency to pleuropulmonary invasion with the formation of fluid in the right pleural cavity. The diagnosis, suggested by the aspect of the abscess cavity, was established by the presence of the parasite in the flaky pleural exudate obtained by puncture, by cultures in Loeffler medium and by serum immunofluorescence. The abscess was evacuated surgically and a specific treatment with Chloroquine and Metronidazol combined with antibiotics and a symptomatic medication was prescribed. The patient recovered and was discharged 51 days after surgery.

Humans↗
PubMedDate not supplied

[Surgical rehabilitation of nonfunctioning bilio-digestive shunts].

The authors consider the internal biliary derivations as a choice procedure for the resolution of various pathological conditions of the biliary pathways and of the pancreas. They are based on the experience accumulated in the course of a total of 416 derivations performed in the last 10 years. The confrontation with particular problems raised by 40 re-interventions for failure of internal biliary derivations has determined an analysis of causes, clinical manifestations and possibilities to solve the disturbances. Categories are discussed, in which these patients can be classified and clinical observations are presented, in connection with the etiopathogeny of the non-functioning of the derivations. Possibilities are also presented for the resolution of the problems in each particular case. Two technical possibilities are presented for the correction of non-functioning biliary-digestive anastomoses, by performing bilio-biliary anastomoses.

Adult↗
PubMedDate not supplied

[Surgical reoperation after vagotomy].

In 39 cases of re-interventions carried out after vagotomy (of which 31 were patients hospitalized in the Clinic and represent 8,6% of the total 358 vagotomies performed), the experience, the viewpoints and the recommendations of the authors are presented. Early re-interventions were necessayr because of complications which are common to abdominal surgery and only in a much lower degree to accidents that can be attributed to vagotomy or the associated intervention. Late re-interventions (26 cases) were necessary in 20 cases for ulcer recidives (13 for vagotomies performed in the Clinic and 7 for vagotomies performed in other units) while late-re-interventions for dumping syndrome, cholelythiasis, etc. represented only isolated cases in these statistics.

Cholelithiasis↗
PubMedDate not supplied

[Postbular duodenal ulcer. Problems of diagnosis and treatment. Role of vagotomy in surgical treatment].

A number of 43 cases is presented, of post-bulbar duodenal ulcers in which surgery has been performed between 1965 and 1974, of which 30 were located in the first portion of the duodenum, in the postbulbar area, and 15 in the second portion, above the ampula of Vater. Problems of terminology and pathological anatomy are discussed, especially in connection with the symptomatology, complications, methodology of investigations and treatment of post-bulbar ulcers. The particular frequency is stressed, of complicated clinical forms, with stenosis and hemorrhagies, and a detailed description is made of atypical forms, with misleading, predominantly biliary or pancreatic symptomatology. Conditions are stressed, of the radiologic gastroduodenal exploration, of major importance in the diagnosis preceding surgery, as well as of pre- and intra-surgery cholangiography. The risk must be carefully evaluated, in the choice of the surgical method, and exeresis of the ulcer must be balanced with the risk of its continued presence. Priority should be given to th risks entailed by surgery. The choice solution in many cases is vagotomy associated to exclusion resection or to gastric derivation.

Adult↗
PubMedDate not supplied

[Pancreatic fistulas].

Based on 17 observations the authors review the major etiopathogenic, evolutive, clinical and therapeutic aspects of pancreatic fistulae. In 14 cases the cure was achieved by medical treatment while surgery was resorted to in only three cases. The medical measures are discussed, as well as the indications for surgical treatment.

Adult↗
PubMedDate not supplied

[Complications of surgery of cancer of the colon].

In the paper a systematic analysis is carried out of postoperative complications of colon surgery, 118 patients had complications, out of a total of 400 interventions on the colon. The complications are studied in relation with the time of their occurence and the localization of the neoplastic process, as well as from the point of view of the influence exerted by age and the "background" of the patients. A review is also made of the therapeutic attitudes required by the various complications, of the results obtained and finally a detailed analysis is presented of the causes that led to death of operated patients.

Adult↗
PubMedDate not supplied

[Multiple colonic cancers: simultaneous and successive].

The authors attempt an approach of a controversial problem of contemporary surgery and stress the following significant aspects:--the frequency of multiple colon cancers is of 3%, approximately 25% of the cases being associated with benign proliferative lesions:--the intra-operatory diagnosis of multiple colon cancers is difficult (3 out of 12 cases); intrasurgical exploration may give rise to problems in connection with the insufficiency of the exploration, or the inaccessibility of unique tumors, thus existing the risk of leaving in place a developing tumor, that can be discovered at a new intervention (one case); the operability of multiple colon cancers is similar to that of the unique malignant lesions, depending on the extension, the variety and the focal distribution of the neoplastic lesions.

Colonic Neoplasms↗