Biomedical subjects

M Marincaş

Publications and source records attributed to M Marincaş.

6 recordsLinked to original sources

PubMedDate not supplied

[Controlled stomach fistula for acute operated ulcer. Case report].

The authors analyze the case of a 65 old woman which was hospitalized for sigmoidian stenosant and haemorrhagical neoplasm, confined to the colic wall, without peritoneal or hepatic metastases, and without peritoneal or parietal invasion. Surgical management included sigmoidectomy and termino-terminal anastomosis for reconstructing intestinal transit followed by peritoneal drainage. In early postoperative stage the aspect of generalized peritonitis occurs and there is suspicion of anastomotic fistulae. On surgery, acute and perforated gastric ulcer is found, located in close vicinity to the cardia, on the anterior side of the stomach. Suture of the perforation is undertaken with drainage of the peritoneal cavity, but successfully because fistulization of the sutured perforation followed. Under the given circumstances controlled drainage of the gastric fistulae was carried out, using a Folley probe extended through the fistulae orifice and through the anterior abdominal wall, lateral to the median incision. The blowing of the intragastric balloon and the setting into tension of the gastric wall to the front abdominal wall allowed the sealing of the fistulae route but it took about three months. This technical contrivance has afforded good postoperative evolution and recovery of the patient, who after five years from surgery is in a good condition and has no subjective complaints.

Aged↗

PubMedDate not supplied

[Acute necrotizing enteritis].

The authors present a retrospective clinical study done on a 13-pacients basis diagnosed during surgery with acute necrotizing enteritis. This study follows the complexity of pathogenic factors and the difficulties one confronts with when establishing a diagnosis since the clinical manifestations are non-specifical and shows the contribution of laboratory data to an earliest possible diagnosis. Both medical and surgical treatment are analyzed depending on the results achieved with an attempt to determine a therapeutic approach as beneficial as possible, aiming at making clear either enterectomy or a conservatory surgical decision should be made. Mortality rate under such therapeutical approach was 38%.

Adult↗

PubMedDate not supplied

[Particular evolution of a jejunal tumor in one patient with multiples neoplasia].

The authors present the case of one male patient, 71 years old, known with serial neoplasia (right colon neoplasm 1983, left colon neoplasm 1987) for which there were performed several interventions. The patient was admitted first time in our Department in 1998 for a non specifically symptomatology; in particular anaemic syndrome. The first intervention was performed in June 1998, without finding anything pathological, despite the presumption of a third tumor on the remaining colonic territory, theory that was partially sustained by the paraclinical examinations. The second intervention was performed in February 2001, when it was found and extirpated a jejunal tumor, under Treitz angle, but after 9 months, when a new intervention was performed, we found a relapse tumor which was not extirpable. The aim of this study is to present the unpredictable versatility of small bowels tumors and the difficulty of establishing an early positive diagnose.

Adenocarcinoma↗

PubMedDate not supplied

[The role of laparoscopy in the management of the right iliac fossa syndrome].

Many cases of nonspecific right-sided lower abdominal pain syndromes are still difficult to diagnose regarding the accuracy of identifying which organ is suffering, in spite of the continuous development of various investigations. The aim of our study is to establish the limits of noninvasive explorations and to evaluate the benefits of laparoscopy approach of such cases. 45 patients, admitted and treated for right lower quadrant abdominal pain along 5 years in the Surgical Department of University Hospital "Caritas" Bucharest, were followed up. For all those patients, diagnostic uncertainty indicated laparoscopic exploration. Analyzing the cases, we noticed that the diagnosis was correctly established on the basis of non-invasive preoperative explorations in 13,33% of cases. In 11,11% of cases the diagnosis was completed by laparoscopy approach and in most cases (75,55%) was established by this procedure. The laparoscopic approach allowed diminishing the number of unnecessary appendectomies, detecting and resolving concomitant lesions with minimal parietal trauma and, essentially, avoiding "exploratory laparotomy".

Abdominal Pain↗

PubMedDate not supplied

[Surgical approach in acute necrotising pancreatitis].

Acute necrotising pancreatitis is a dramatic and often life-threatening disease with a high rate of mortality, varying between 30-70% and necessitating heavy medical care. The surgical attitude regarding acute necrotising pancreatitis is disputed between the supporters of drainage with closed abdomen and the supporters of laparatomy with open drainage. The goal of this study is the evaluation of the number of intervention required, the timing of the interventions and the mortality and morbidity in a group of patients with necrotising pancreatitis. The studied group consists in 112 patients with necrotising pancreatitis, treated in Surgical Clinic of Caritas "Prof. Dr. N. Cajal" Clinical Hospital, Bucharest during 1983-2005. Infection of pancreatic necrosis supervened in 55,35% of patients in this group, not any pancreatic necrosis becomes infected. Infected necrosis is not synonymous for abscessed of necrosis, in the same patient pancreatic necrosis, infected pancreatic necrosis and abscessed necrosis may coexist. Clinical and biological criteria are the decisive factors in the indication for surgical treatment, the radiology being decisive in the choice of the laparotomy approach. In the study group 50,89% of patients necessitated only one surgical intervention. Implicitly, more than half of the patients would have been suffered multiple useless planned staged relaparotomies. The mortality in our study group treated by the method of closed drainage was 25,89%.

Anti-Bacterial Agents↗

PubMedDate not supplied

Late choledochal pathology after cholecystectomy for cholelithiasis.

UNLABELLED: After "simple" cholecystectomy for lithiasis, biliary disorders can appear, with the onset more than 3 years postoperative, like cholangitis or transitory jaundice. Meantime, a whole range of congenital abnormalities initially ignored can become manifest: biliary tract congenital dilatations, duodenal para-Vater diverticulum, Oddi stenosis. AIM: to establish the pathological circumstances that determine late choledochal syndrome, including an analysis concerning the therapeutical approach in these cases. Patients with cholecystectomy complains of late biliary disorders (least 3 years symptom-free) between 1997-2005, were retrospectively studied. Exclusion criteria were intraoperative incidents or accidents, recognised incomplete surgical procedure, early difficult postoperative course. Therapeutical approach was endoscopical, surgical or conservative. 46 patients entered the study group; 38 underwent open cholecystectomy. Mean interval between operation and disturbances onset was 10 years. Following etiopathologic causes of late choledochal pathology were recorded: incomplete cholecystectomy, retained or primary common bile duct (CBD) stones, choledochal cyst or stenosis, Oddi stenosis, duodenal para-Vater diverticulum, anomaly biliary tree. Thirty patients undergone successful endoscopic treatment; in 8 cases endoscopy failed, in 2 cases open surgery was the first choice; 5 diagnostic endoscopic cholangiography with conservative treatment were performed; 1 patient refused any procedure. Cholecystectomy indication is regularly based on clinical and ultrasound examination criteria. Even a simple cholecystectomy can be followed after first 3 years by cholangitis, obstructive jaundice, caused by initially ignored biliary tract pathology. To avoid such omissions, routine intraoperative cholangiography and duodenal endoscopy should precede cholecystectomy. On the other side, cholecystectomy itself can cause late complaints: retained CBD stones, gallbladder stump, and iatrogenic stenosis. The duodenal para-Vater diverticulum seems to have a more important role in biliary disturbances, before and after cholecystectomy.

Aged↗