Biomedical subjects

M A Machado

Publications and source records attributed to M A Machado.

At least 91 records · Page 5Linked to original sources

PubMedDate not supplied

[Total regression of advanced gastric lymphoma after drug therapy].

Primary gastric lymphoma is a relatively rare entity that may have several different methods of treatment, including surgery, chemotherapy and radiotherapy. We describe a case of advanced primary gastric lymphoma treated with chemotherapy. A 51-year-old male patient underwent total gastrectomy after two cycles of chemotherapy. The histologic examination of the gross specimen revealed total regression of the lymphoma. Literature review of this condition and a discussion about the diagnosis and treatment are presented.

Antineoplastic Combined Chemotherapy Protocols↗

PubMedDate not supplied

[Duodenal ulcer clinically simulating pancreatic neoplasm].

A small fraction of solid mass in the head of the pancreas are inflammatory rather neoplastic in origin. The failure to recognize the true nature of a solid tumor in the head of pancreas may lead to an incorrect treatment strategy. This is a report of a patient with clinical history of pancreatic cancer which computed tomography showed a mass in the head of the pancreas with radiologic characteristics of malignancy. The patient underwent exploratory laparotomy with the finding of a mass in the head of the pancreas. The inflammatory palpable characteristic of the mass led to a intraoperative biopsy to confirm the preoperative diagnosis. With the benign result of the biopsy, the final diagnosis was duodenal ulcer which penetrates in the pancreatic parenchyma.

Diagnosis, Differential↗

PubMedDate not supplied

[Cervical esophageal membrane and Plummer-Vinson syndrome: report of a caseload and review of the literature].

Esophageal webs are an uncommon group among esophageal diseases. We report our findings in ten patients with membranes in the upper esophagus; seven of them were women. The median age was 48.5 years (range 24 to 73 years). Dysphagia was the main symptom in all patients and anemia was found in six cases. Radiologic and endoscopic studies provided the diagnosis. All patients underwent endoscopic dilatation and/or debridement and good results with this management were achieved. A review of literature of this condition and a discussion about the diagnosis, treatment and etiopathogenesis are presented.

Adult↗

PubMedDate not supplied

[Pseudotumor of the stomach: study of 10 cases and review of the literature].

Pseudotumoral form of gastric ulcer is an infrequent clinical presentation of peptic disease. We present the findings in ten patients with this variety of gastric peptic ulcer treated in the last five years. All records including preoperative radiological and endoscopic examinations are reviewed. Five patients were women and five were men. The median age of patients was 62.1 years (range, 45 to 79 years). Epigastric pain was the main symptom in 90% of patients and weight loss in 70%. Six patients underwent surgical treatment. There was no perioperative mortality. A review of literature of this condition and a discussion about the differential diagnosis are presented.

Adult↗

PubMedDate not supplied

[Rectal endometriosis].

Colorectal endometriosis is a relatively rare entity that may have a wide array of clinical symptoms and radiographic findings. A 42-year-old female patient with rectal endometriosis treated with danazol under CA 125, CA 19-9 and estrogen monitoring is described. The treatment was successful and the patient underwent excision of reproductive organs without colorectal excision.

Adult↗

PubMedDate not supplied

[A fatal case of lower gastrointestinal hemorrhage: report of case and review of the literature].

Gastrointestinal hemorrhage continues to be a major medical problem. Even with improvements in both diagnostic and therapeutic, a significant number of patients still require surgical intervention for control of hemorrhage. When the source of persistent lower gastrointestinal hemorrhage is unknown, subtotal colectomy is a conceptually rational management choice. The authors present a case of massive lower gastrointestinal hemorrhage with unusual fatal outcome. A review of literature of this condition and a discussion about the diagnosis, treatment and etiopathogenesis are presented.

Angiography↗

PubMedDate not supplied

[Gallbladder injury in abdominal trauma: analysis of 32 cases].

Gallbladder lesion is infrequent, occurring in approximately 0.5 to 8.5% of all patients with blunt and penetrating abdominal trauma. The incidence of gallbladder injury in such cases is low. This study reviewed 32 patients with gallbladder injury due to abdominal trauma over a 6-year period to determine the complications, associated injuries, and mortality rate.

Abdominal Injuries↗

PubMedDate not supplied

[Conservative treatment of pseudomyxoma peritonei].

Pseudomyxoma peritonei is a clinical entity characterized by gelatinous ascites. It is most often due to a mucinous cystadenocarcinoma of the appendix or ovary. These patients die frequently of bowel obstruction after multiple surgical procedures. A case of pseudomyxoma peritonei treated successfully with intraabdominal infusion of a 2.5% solution of dextrose is reported.

Aged↗

PubMedDate not supplied

[Risk factors in emergency surgery relaparotomy].

Reintervention in abdominal surgery involves the difficulty of precise indication and the limitations of surgical technics during the operation. It may bring to evidence professional errors. It presents a very high morbimortality index. In order to establish risk factors and death rate, we comparatively analysed the initial diagnoses, the number, the cause and the time of relaparotomy, the existence of associated diseases, the age and the illness severity, using APACHE-II after the first surgical intervention. During a two years period starting 1990 we retrospectively analysed charts of 40 patients submitted to relaparotomy in the Emergency Service of Hospital das Clínicas of Medicine University of São Paulo.

Abdomen, Acute↗

PubMedDate not supplied

[Transformation of hepatic adenoma into hepatocellular carcinoma in patients with prolonged use of oral contraceptives].

Liver cell adenomas were relatively rare until the use of oral contraceptives. Most of these tumors have occurred in otherwise healthy young women who have been exposed to oral contraceptives. The treatment of this condition remained controversial for a long time. However, bleeding is still a frequent complication and can lead to a significant mortality rate. The better surgical results in hepatic resection, due to technological advances, has contributed to the indication of surgical management as therapeutic option in hepatic cell adenoma. Some authors believe that liver cell adenomas were potentially premalignant and could degenerate into hepatocellular carcinoma but there is very few well documented reports of this transformation. We report our experience in the management of liver cell adenoma.

Adenoma, Liver Cell↗

PubMedDate not supplied

Bilateral diaphragmatic injury diagnosed by laparoscopy.

Rupture of the diaphragm from blunt trauma is uncommon, but greatly improved prehospital care and transportation of victims has increased the frequency at which patients who sustain this injury arrive at the emergency room alive. We report a case of bilateral diaphragmatic rupture from blunt abdominal trauma in a 33-year old man. Diagnosis was established by laparoscopy after suggestive chest X-rays, liver scintigraphy, CT scan and magnetic resonance imaging. The methods used to diagnose this condition are analyzed.

Accidents, Traffic↗

PubMedDate not supplied

[Conservative treatment of severe liver trauma: report of a case and review of therapeutic methods].

The emergency surgical treatment of severe hepatic traumas still carries a high mortality risk. We report a case of severe blunt trauma to the liver managed without surgery under CT guidance. This attitude requires haemodynamic stability of the patient, close monitoring in a surgical intensive care unit and repeated CT scans. Laparoscopy was used to the management of hemoperitoneum due to rupture of hematoma and diagnosis and treatment of bile leakage. Conservative treatment is a reasonable option in selected hemodynamically stable patient with severe hepatic trauma.

Adult↗

PubMedDate not supplied

[Traumatic right diaphragmatic hernia: report of a case and review of the diagnostic methods].

Rupture of the right hemidiaphragm from blunt trauma is uncommon. Better management and more rapid transportation of victims has increased the frequency with which patients sustaining this injury are arriving at the emergency room alive. A case of right-sided diaphragmatic hernia from blunt trauma in a 36-year-old man is reported. Diagnosis was established by chest x-ray, CT scan and digital exploration after unsuccessful thoracoscopy. The methods used for diagnosis of this condition are analysed.

Adult↗

PubMedDate not supplied

[Tissue necrosis: a side effect of sodium diclofenac: report of cases and discussion of the physiopathology].

Diclofenac sodium is a non-steroidal anti-inflammatory widely used drug both in the treatment of the rheumatic diseases and as analgesic. The fact that is a potent analgesic spread its use to almost all fields in medicine, increasing the reports of adverse effects associated with it. The main complications reported are gastrointestinal, dermatological and of the central nervous system. The authors present seven cases that developed tissue necrosis as a result of the intramuscular injection of diclofenac sodium. Because of the low incidence or this adverse effect, a review is carried out and the physiopathologic mechanisms likely to be involved are discussed. Our aim is to warn against the indiscriminate intramuscular use of this drug.

Adult↗

PubMedDate not supplied

[Simultaneous injury of 4 iliac veins by firearm: report of a case and review of the literature].

Iliac vessel injuries constitute approximately 10 percent of all vascular traumatic lesions. The high mortality rate is due to the massive exsanguination and the high frequency of associated injuries. Iliac vein injury occurs either isolated or in association with the arterial lesion. Multiple injuries of iliac veins are uncommon and frequently fatal. An unusual case, in which there were injuries of the four iliac veins by gunshot is described. A review of literature of this condition and a discussion about the diagnosis, treatment and factors affecting mortality rate is presented. No other such case has been found reported.

Adolescent↗

PubMedDate not supplied

[Results of conventional cholecystectomy. Experience in a university hospital].

The experience with open cholecystectomy in an university affiliated hospital is documented in this report. We studied retrospectively 221 patients operated between 1987 and 1992, type of surgery, morbidity and mortality were analyzed. There were 171 (77.3%) cholecystectomy alone and 50 (22.7%) cholecystectomy with other biliary surgery (BS). Pulmonary, urinary and wound complications were the most common. Overall incidence of complications was 7.2%. For patients with cholecystectomy alone morbidity was 3.5% and for patients with BS morbidity was 20% (p < 0.002). There were no mortality in this group of patients.

Adolescent↗

PubMedDate not supplied

Pyogenic liver abscess: the role of surgical treatment.

MATERIALS AND METHODS: We present an analysis of 48 patients with pyogenic liver abscess (PLA) that were treated according to a protocol between 1975 and 1993. In this period, 35 patients with PLA were treated by surgical drainage (SD). The indication for surgical treatment of the abscess were patients in septic conditions, underlying intra-abdominal surgical disease and the failure/contraindication of other therapeutic methods. Thirty-one patients were submitted to surgical treatment as the initial procedure and four patients unsuccessfully treated by percutaneous drainage, underwent SD. RESULTS: The surgical approach was indicated in patients with severe disease and presented 91.5% of good results, and a mortality rate of 8.5%. CONCLUSIONS: These results suggest that surgical treatment is a good alternative as a first step not only for the treatment of the primary cause of the abscess but also in septic patients with severe disease where a delay in adequate drainage, frequent in percutaneous management, can lead to high morbidity and mortality rates.

Adolescent↗

PubMedDate not supplied

[Laparoscopic treatment of duodenal obstruction in a patient with pancreatic cancer].

We present a case report of laparoscopic gastrojejunostomy in a patient with duodenal obstruction from unresectable cancer. We performed an side-to-side intracorporeal gastrojejunostomy using endoscopic stapling devices. The patient had no morbidity and he was discharge on fourth postoperative day. Laparoscopic gastric bypass is an alternative to open procedure in well selected cases.

Anastomosis, Surgical↗