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Biomedical subjects

I Rathous

Publications and source records attributed to I Rathous.

5 recordsLinked to original sources

[Intestinal ischaemia--consequence of intestinal malrotation].

The subsets of acute intestinal ischaemia include mesenterica arterial occlusion, venous thrombosis and non-occlusive mesenteric ischaemia. Advances in pathophysiology, diagnosis and treatment, prognostic problems are associated still in mortality rates of more than 60%. Early diagnosis is the first in possibility for better prognosis. In our article is case one young man with acute non-occlusive intestinal ischaemia described, diagnosis and treatment. Mucosal surface necrosis and hemorrhage was supposed, sepsis was expected, mucosal regeneration after ten days surprising. While changes on the bowel were hard to decide to resection, there are bioptic picture of mucosal layer in the time described (Fig. 5-9). We have written about similar case of young man with Waldayer hernia in 1999.

Adult↗

[Organ torsion and abdominal symptoms--diagnosis].

The authors reflect on the etiology of torsions of intraabdominal organs and the testes. They mention anamnestic data, which may lead to suspicion of possible organ torsion. They analyze the clinical picture of a patient who suffered such an attack. The authors submit a list of diagnostic possibilities using modern imaging methods: sonography, computed tomography, angiography, scintigraphy and magnetic resonance. They discuss laparoscopy as a diagnostic and therapeutic method.

Abdomen, Acute↗

[Organ torsion and abdominal symptoms--case reports].

Torsions are rare acute abdominal conditions and are mistaken for other more frequent diseases. The present work draws attention to the most frequent diagnostic errors. The authors present three cases of torsions of intraabdominal organs and two cases of testicular torsion. All patients attended their doctor because of abdominal pain. In four of five cases the patients were first treated for an erroneous diagnosis of acute abdomen. In the first case the torsion of the omentum was mistaken for diverticulitis of the sigmoid, later for an intraperitoneal lipoma, in he second case for cholecystitis, in the third case a patient with torsion of a myoma was indicated for surgery on account of acute appendicitis. In the fourth case incomplete torsion of the testis was mistaken for irritation of the appendix. In the fifth case where abdominal symptomatology dominated the correct diagnosis of testicular torsion was made and atypically spontaneous detorsion of the testis occurred.

Abdomen, Acute↗

["Nonsurgical" pneumoperitoneum].

The authors submit case-histories of patients with an X-ray finding of pneumoperitoneum on a native X-ray of the abdomen. Air in the abdominal cavity was proved in the majority of cases also on laparotomy, however, the source of air was not found. The authors mention four cases from their own department. In the first female patient with a generalized gynaecological tumour pneumoperitoneum was diagnosed repeatedly before surgery. In the second case a female patient was involved with an inoperable pancreatic tumour; obstruction of the biliary pathways was resolved by an endoscopically inserted stent. In that case too the pneumoperitoneum was repeatedly detected before surgery. The third patient with a generalized ovarian tumour, acute abdominal pain and pneumoperitoneum died on the second day after operation. Similarly as patient 2 on necropsy thrombosis of the portal vein was found. In the 4th case the finding of pneumoperitoneum was made after diagnostic technically difficult gastroscopy. This patient was not operated. Patients 1-3 were operated without evidence of perforation of the digestive tract. For illustration cases described in the literature are quoted. The causes of non-surgical pneumoperitoneum are classified according to the anatomical site of development. The author describes the assumed mechanisms of development of non-surgical pneumoperitoneum. In the discussion aspects are mentioned which decide on conservative or surgical treatment of pneumoperitoneum.

Aged↗

[Thyroid gland surgery at the 1st Surgical Clinic of the 1st Medical School of Charles University and General Medical School Hospital in Prague--review of problems].

The authors analyze a group of 100 patients indicated for goitrectomy during the period from 1995-1996. The most frequent indication for surgery was an eufunctional polynodular goitre. The group comprised 86 women and 14 men. Their mean age was 47 years, bilateral affections predominated. The most frequent type of operation was total thyroidectomy. Carcinoma was found in three of the operated patients. The mean period of hospitalisation was 6 days. Postoperative complications were more frequent after total goitrectomies, and with the extent of the operation the number of possible complications increased. The most serious complication in the authors opinion was a lesion of the parathyroid glands, observed in 5% of the patients. Permanent unilateral lesions of the recurrent nerve were recorded in 2% of the operated patients. There was no lethal postoperative complication. The largest operated goitre weighed 625 g (photograph 1). The authors conclude that it cannot be stated that the operation of larger goitres is associated with the highest incidence of postoperative complications. The opposite is rather the case.

Female↗