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Biomedical subjects

M B Speranzini

Publications and source records attributed to M B Speranzini.

At least 55 records · Page 3Linked to original sources
PubMedDate not supplied

[Treatment of cicatricial stenosis of the proximal common hepatic duct. Study of 11 cases].

Eleven patients with cicatricial stenosis in the junction area of hepatic ducts were evaluated. In all patients the injury occurred during cholescystectomy and no operative cholangiography was performed. In 3 patients the injury was recognized during the initial cholecistectomy. Ten patients had been operated on at least one time to correct the injury in other Services. Four cases had duct or peritoneal drainage. There was an attempt of reanastomosis in two cases. Five patients had a bilio-digestive anastomosis performed in variable occasions. Two patients were reoperated 5 times, one patient 3 times. The others were submitted to one or 2 reoperations. There were a period of 1 to 72 months between the injury and last reoperation. Jaundice was the most common presenting manifestation since it appeared in all patient except one. Five patients had biliary cirrhosis. Roux-en-Y hepaticojejunostomy was carried out in all cases after enlarging the biliar stoma by longitudinal section on the left hepatic duct and performing a termino-terminal anastomosis. The 10 or 12 caliber Kehr drain used was taken out after the control cholangiography, carried around the second postoperative week. Concerning the long term results, one patient died of recurrent cholangitis six months after the 6th reoperation and one patient 14 months after the 4th reoperation of liver failure. Both had biliary cirrhosis. Two patients, remained assymptomatic for 60 months and 3 patients for 24, 37 and 56 months. The importance of preventing this severe complication is stressed by the authors. Patients with such lesions need be referred to specialized centers where well trained surgeons are available. The technique herein presented seems us to be a good option.

Adult↗
PubMedDate not supplied

Bowen's disease: a rare condition in an unusual extension.

The detection of Bowen's disease, a very rare condition in an unusual extension--literally covering the anogenital area--and the successful more conservative way of handling the lesions, through surgical separate steps, prompted the authors to review the literature and to report the case.

Adult↗
PubMedDate not supplied

[Acute emphysematous cholecystitis. Report of a case and review of the literature].

The authors report a case of acute emphysematous cholecystitis (AEC) operated on at the University Hospital of ABC Medical School (São Paulo), with a review of the literature. The infrequency of this finding and the participation of local ischemic factors, associated with secondary infection by gas forming bacteria are pointed out. The authors emphasize the importance of considering this entity potentially more severe than acute non-emphysematous cholecystitis (AnEC) because in AEC gallbladder gangrene is 30 times higher and perforation occurs 5 times more frequently than in AnEC. Besides, the patient with AEC may shows no clinical signs of severity, as in the case reported, where gallbladder gangrene was seen at surgery. In AEC, diagnosis is established usually when the plain abdominal X-ray shows gas within the gallbladder or in its walls. The best results are obtained with cholecystectomy and antibiotic therapy.

Cholecystectomy↗
PubMedDate not supplied

[Leiomyoblastoma. Apropos of a case of jejunal localization].

Jejunal leiomyoblastoma was first described in 1960, and since then many reviews were made because its histological particularity, biological behavior, and rarity. Gastric localization is most common, and only 6 jejunal cases were described. A case of a 48 years old man with tumoral mass localized only on a proximal jejunum loop was operated because of intestinal obstruction due to intussusception of a jejunal leiomyoblastoma. Although the presence of some malignant criteria like lymphnodes and peripancreatic tissue metastasis after one year of follow-up, no sign of disease was present.

Humans↗
PubMedDate not supplied

[Cystadenoma of the pancreas. Various aspects of the diagnosis and surgical management adopted in 3 cases].

The authors report three cases of cystadenoma of the pancreas. Two cases were serouscystadenoma and one case was mucouscystadenoma. The best diagnostic procedures were computed axial tomography and ultrasonography. Decisions regarding operation depend on three factors: the patient's general conditions, site of the tumor and hystologic pattern. In the first case the elderly patient had the tumor in the head of the pancreas which had led to biliary obstruction. To establish satisfactory biliary drainage a biliodigestive anastomosis was used. The other two cases were younger patients with large protruding abdominal mass in the epigastrium and mesogastrium by a tumor of the body and tail of the pancreas. In these cases we opted for body pancreatectomy and splenectomy. Since the serouscystadenoma doesn't have the malignant potential that the mucouscystadenoma has, the surgical procedure can be different from the surgical resection used for the treatment of pancreatic cystadenoma.

Aged↗
PubMedDate not supplied

[Prevention of infection in closure surgery in colostomies. Double-blind study with tinidazole].

A comparative double-blind study of tinidazole vs placebo was conducted in order to assess the prophylaxis of post-surgical abdominal infections in 40 patients undergoing closure colostomy surgery. During three days the patients were kept on a low residue diet, and underwent a colon mechanical cleansing. About 10 to 12 hours prior to surgery the patients were given placebo or tinidazole in tablets of identical appearance; the dose of tinidazole was of 2 g (4 tablets) in a single oral dose. Evaluation performed after surgery showed that in the tinidazole group occurred two surgical mild infections (10%), while in placebo group occurred nine infections (45%)--four of them severe and one very severe, showing a significative difference between the two groups (p less than 0.05). In placebo group 21 bacteria were isolated, 3 of them were anaerobic; only two aerobic species were identified in the tinidazole group (p less than 0.001). No adverse reactions were reported in both groups. The authors concluded that in this study, tinidazole showed a prophylactic effect on post-surgical abdominal infections in patients who underwent closure colostomy surgery.

Adolescent↗
PubMedDate not supplied

[Cystic dilatation of the intrahepatic bile ducts (Caroli's disease)].

Congenital cystic dilatation of the intrahepatic biliary ducts, known as Caroli's disease, is rarely recognized in general surgical practice and often overlooked. Until now little more than a hundred cases have been described although modern diagnostic procedures disclose more frequently new ones. Three patients with this anomaly have been treated by the authors during the past years and the different aspects concerning diagnosis and treatment are discussed and compared with existing information. In all three patients colic pain in the upper abdomen was the first symptom reported in the first years of life. In one patient jaundice and fever were associated with the abdominal pain and cholangitis developed a secondary biliary cirrhosis. Somatic underdevelopment, consequence of the cirrhosis in this child was observed. In two patients an intrahepatic hepaticojejunostomy was performed and a left hepatectomy in the third. In the two older children intrahepatic gallstones were found; in the younger one no stones were found inside the dilated ducts.

Adolescent↗