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L Bonati

Publications and source records attributed to L Bonati.

25 records · Page 2Linked to original sources
PubMed1982

[Case of retrosternal Morgagni-Larrey hernia].

Retrosternal hernia (Morgagni-Larrey) is the less frequent of diaphragmatic defects. Nevertheless its frequency is probably more elevated than commonly believed because very often there is a lack of symptoms. The clinical case which is referred has a typical presentation but it is outlined the difficult interpretation of routine chest x-rays, while a prompt diagnostic suspicion is not always present. Surgical repair is the discussed emphasizing the very good results within a virtual absence of recurrences.

Adult↗
PubMedDate not supplied

[Spontaneous rupture of the ureter].

A case of spontaneous rupture of the ureter initially presented as left acute abdomen in a 71 year old woman is described. A review of the literature has disclosed that in all reported cases a process directly or indirectly leading to the rupture was identified. On the basis of the clinical evolution and the radiological investigations the Authors discuss the diagnosis and the pathogenesis of the observed ureteral rupture.

Aged↗
PubMedDate not supplied

[Our experience with the treatment of duodenal perforation with suture].

The Authors report their experience in the treatment of perforated duodenal ulcer retrospectively analysing 42 patients treated with simple suture on emergency. Morbidity was 30.9% and mortality (operative and postoperative) was 16.6%, both significantly influenced by the age of the patients, the associated medical disease and the presence of shock. Results of the follow up concerning 33 patients are also reported: in 57.5% of the cases simple suture combined with medical therapy was able to resolve the peptic disease. The analysis of the results shows that the procedure is indicated for acute duodenal ulcers and for elderly patients with associated diseases.

Adult↗
PubMedDate not supplied

[Our experience with the surgical treatment of pulmonary hamartochondroma].

Pulmonary hamartochondromas are tumor-like malformations, often presenting as asymptomatic, noncharacteristic masses that sometimes cannot be differentiated from lung carcinomas and metastases, preoperatively. Eleven patients (6 females and 5 males) with hamartochondroma of the lung were treated at this Institute over a 10 years period. Definitive diagnosis was established at thoracotomy, and treatment of choice was wedge resection. Two patients had pleural postoperative complications while the others made an excellent recovery. All patients are still alive (median survival: 56 months) and no recurrences occurred. Several studies showed that CT and transthoracic needle-aspiration biopsy are reliable methods to achieve the diagnosis in such benign lesions and their use allows a conservative approach. Since none of our cases could be diagnosed with certainty by the above procedures we always performed diagnostic and therapeutic thoracotomy with excellent results.

Adolescent↗
PubMedDate not supplied

[Incidentaloma of the adrenal glands: analysis of 9 surgical cases].

In the assessment of incidentally discovered adrenal masses the detection of hormonal activity and the evaluation of benignity or malignity, either primary or metastatic, constitute the most important issues. This article reports 9 asymptomatic adrenal masses: The histopathological diagnosis consisted of cortical adenoma in 5 cases, adrenal metastatic mass in 2, respectively from a pulmonary microcytoma and from a renal carcinoma, a myelolipoma with leukemic infiltration and an hemorrhagic pseudocyst in the remnants. Evaluation of biochemical activity showed no endocrinological abnormality in all patients except in two cases of adenoma: the positivity of the 1 mg dexamethasone test, the low serum DHEAS levels and a concordant scintigraphic uptake were consistent with the pre-Cushing syndrome in the first case, whereas the ACTH inhibition revealed by low serum DHEAS levels without other hormonal alterations were the biochemical pattern in the second. Ultrasonography has been helpful in the diagnosis of adrenal mass in 6 cases, whereas CT scan allowed an etiopathogenetic diagnosis in 8 cases. All patients were submitted to adrenalectomy through the conventional surgical accesses; in 4 cases the adrenalectomy was performed as a associated intervention during vascular or gastrointestinal surgery. No postoperative death occurred. At follow-up ranging from 3 to 6 years, we recorded 4 deaths: the causes were represented by the progression of the primary malignancy in 2 patients that have been operated on for adrenal metastatic tumors, by hemorrhagic shock from an aorto-duodenal fistula and by systemic infectious complications respectively in the remnant two cases. The other patients were well and the endocrinological assessment showed normal findings. The Authors, according with data from literature, suggest an essential biochemical screening to evaluate the adrenal function in case of incidentally discovered mass: it is characterized by determination of plasma and urinary electrolytes, catecholamines, serum DHEAS and 17-OH progesterone levels, dexamethasone suppression test. In case of asymptomatic mass suspect for pheochromocytoma we advocate the MIBG scintigraphy.. The adrenocortical scintigraphy (NP 59) provides both anatomical and functional characterization of the adrenal glands: the concordant or discordant imaging patterns are useful in the diagnosis of benignity or malignancy. Although the management of patients with incidentally discovered masses remain controversial, we advocate adrenalectomy when they are hormonally hypersecreting, increasing in the diameter or malignant and in association with other abdominal operation.

Adenocarcinoma, Clear Cell↗