[Pasteurella multocida as a cause of spontaneous bacterial peritonitis in a cirrhotic patient].
Explore the source record for details and available documents.
Ascitic Fluid↗
Biomedical subjects
M García Montero
Publications and source records attributed to M García Montero.
[Pseudotumorous hepatic tuberculosis: laparoscopic appearance].
Local hepatic tuberculosis without active pulmonary or miliary tuberculosis is an uncommon diagnosis. Even less common is the finding of a nodular form of local hepatic tuberculosis. There is a growing incidence of the disease related to human immunodeficiency virus. The authors report a case of pseudotumoral hepatic tuberculosis in a patient without AIDS, manifesting as prolonged fever, diagnosed previously as metastatic liver. Imaging studies of the liver and laparoscopic findings suggested metastatic disease. The correct diagnosis was made by histology of biopsies obtained in laparoscopy, which is an easy and cheap method, with less morbidity and mortality than surgical intervention. The case report illustrates the difficulty in reaching the correct diagnosis, most often confused with carcinoma of the liver, primary or metastatic. A greater awareness of this rare clinical entity may prevent needless surgical intervention since the majority of patients respond well to antituberculous chemotherapy.
Aged↗
[Wegener's granulomatosis with gastrointestinal involvement].
Wegener's granulomatosis is a necrotizing granulomatous vasculitis often characterized by involvement of the upper respiratory tract, lungs and kidney, although any organic system can be affected. We present the case of a female patient with Wegener's granulomatosis diagnosed by biopsy of the kidney, and severe gastrointestinal bleeding with fatal course. Endoscopic findings of the colon and the histopathology of the biopsy are discussed.
Acute Disease↗
[Emergency laparoscopy. A 20-year experience].
We revised 7988 laparoscopies over twenty years. Three hundred and ninety three were urgent laparoscopies: 325 patients with acute spontaneous abdomen and 68 acute traumatic abdomen. Emergency laparoscopy is made in patients with, both spontaneous and traumatic acute abdomen, when diagnosis is not made in 8 hours with the usual clinical and imaging methods. Acute diffuse peritonitis was the commonest finding in the first group (21%) and splenic rupture in the traumatic group (34%). There were two severe complications (0.5%): pulmonary oedema in a patient with myocardial disease and a respiratory failure in a old patient, which were resolved. We had two deaths related to laparoscopic diagnosis: massive mesenteric thrombosis and fecal peritonitis. There are few contraindications and tolerance is very good. This study shows a sensitivity of 98%, a specificity of 90%, a predictive positive value greater than 98% and a negative predictive value of 100%. In summary, the present study demonstrates that emergency laparoscopy is a effective diagnostic method in acute abdominal pain of uncertain aetiology.
Abdomen, Acute↗
[Laparoscopic diagnosis of hepatic angiomas after erroneous imaging techniques].
Hemangiomas are de most frequent benign liver tumours. Their clinical relevance is small but they can cause to the patient and/or the physician a great worry because can be indistinguishable from hepatic malignances. From 1991 to 1994 five patients with liver hemangiomas were diagnosed by laparoscopy after a erroneous and/or contradictory interpretation by various imaging techniques. In four cases hemangiomas resembled metastatic carcinoma of the liver, and in the other patient hemangioma was interpreted as focal nodular hyperplasia. Diagnosis and treatment are discussed.
Carcinoma↗
[Retrospective study of Crohn disease at a hospital in Andalucía (1978-1988)].
We reviewed 46 cases of Crohn's disease diagnosed during the period between 1978-1988, with the intention to analyse the age, sex, presentation, evolution, complications and diagnosis. The majority of patients were women, with a mean age of 39. In the last years we have seen an increment in our number of cases. The mean time to diagnosis was about 3.5 years. The main symptoms were abdominal pain, diarrhoea and loss of weight. The complications was of 40% in colonic disease and 75% when the affection was in ileum and colon. During the evolution 4 patients died, 2 of them from their Crohn's disease. One patient had a colonic carcinoma. In 15% of the cases there was a previous appendectomy. The most frequent radiological findings were in the small intestine: lack of haustration and cobblestone appearance. In the colon: lack of haustration and ulceration. The most frequent endoscopical findings were ulcers and a cobblestone appearance.
Adolescent↗
[Retrospective study of ulcerative colitis at an Andalusian hospital].
We reviewed 96 cases of ulcerative colitis diagnosed during the period between 1970 and 1988, with the intention of analysing the presentation, complications, evolution and diagnosis aspects. The most frequent presentation symptoms were mucoid and bloody diarrhea (91.3%) and abdominal pain (84%), isolated rectal bleeding being predominated in distal type. The frequency of complications were 17.14%. X-ray findings were the lack of haustration and ulcers, the rate of normal barium enema being of 27.27% (without double contrast). Rectum was not affected in 6.8%. The endoscopy showed an edematous and congestive mucosa, ulcer with normal barium enema. The most significant anatomopathological findings were the lymphoplasmocyte and polynuclear infiltration of the proper lamina and epithelial ulcer, with a lack of cripta and absence of metaplasia of Paneth's cells. In our area, we have to use colonoscopy to diagnose the disease, because the double contrast barium enema is not performed as a routine. Only a few (5) of our patients needed surgical treatment.
Adolescent↗