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Biomedical subjects

M Pomata

Publications and source records attributed to M Pomata.

28 records · Page 2Linked to original sources
PubMedDate not supplied

[Left pyo-pneumothorax: a rare complication of colon carcinoma].

A case of pio-pneumothorax complicating a splenic flexure colonic carcinoma is herein presented. The patient was a 58 years old male and was submitted 3 months earlier to a colo-colic bypass for a locally advanced tumor infiltrating stomach, spleen, tail of the pancreas and left emidiaphragm. Few days before the admittance in our ward, he experienced fever, anorexia, and severe dispnoea. Treatment was a water seal drainage of the chest evacuating nearly 8 Liters of purulent material where Escherichia coli was found. Death occurred 2 weeks after drainage. From the analysis of the literature thoracic empyema is an extremely rare complication of colonic carcinoma: 5 other cases have been reported so far. Pathogenesis in half of the cases was due to septicemia and in the others to infectious local spreading.

Adenocarcinoma↗
PubMedDate not supplied

[Lymph node biopsy in the study of lymphomas: from the incisional biopsy to videolaparoscopic lymphadenectomy].

The role of the surgeon in the treatment of lymphoproliferative diseases is mainly addressed to histological diagnosis and staging. The aim of this study was to analyze the results of lymph node biopsies in patients with Hodgkin's disease (HD) and non-Hodgkin's lymphoma NHL). Between January 1992 and March 2003, 37 patients (17 males and 20 females, mean age 57 years, range 17-90) were submitted to a node biopsy to determine type of lymphoma and clinical staging: there were 8 HD and 29 NHL. In a single case laparoscopy was adopted to remove abdominal nodes; the procedure was uneventful and the patients discharged in the third postoperative day. The Authors stress the importance of the minimally invasive approach in the management of lymphoproliferative diseases.

Adolescent↗
PubMedDate not supplied

[Intestinal obstruction due to perforated cecal volvulus. Case report].

Cecal volvulus is an uncommon cause of large-bowel obstruction. Its developement is due to an abnormal mobility of the ileocecal loop because of lacking attachement of ascending colon. Clinical features are frequently aspecific and should be differentiated from sigmoid volvulus and neoplastic obstruction. Therapy depends on visceral circulatory conditions at the moment of diagnosis. Possible options include endoscopic decompression, cecopexy with or without cecostomy, right colectomy with immediate or delayed anastomosis. The present paper reports the case of cecal volvulus in a 44 year old woman, successfully treated with right colectomy and primary anastomosis.

Adult↗
PubMedDate not supplied

Radical treatment of acute pilonidal abscess by marsupialization.

Simple drainage is the most common treatment of pilonidal abscess, but later definitive surgery is often necessary. However, radical treatment can also be performed in a single step by several procedures and even better results. The Authors describe the technique of marsupialization and analyse its long-term outcomes in a retrospective study. Between 1992 and 2001, 43 consecutive patients underwent drainage, curettage and marsupialization for acute pilonidal abscess. The procedure was carried out in outpatient setting (day surgery) after local or spinal anaesthesia. Management of the wound was left to the patient and was periodically checked at our out service. The average operating time was 20 minutes. Complete healing required 4-10 weeks in 95.3% of the patients; a persistent chronic fistula was observed in 4.7%. During the follow-up, 6 recurrences (14.6%) were observed in the healed patients. The treatment was then successful in 81.3% of the cases. Our experience shows that it is possible to carry out a radical management of pilonidal abscess in a single step with a high complete healing rate. Marsupialization proved to be a fast procedure and mainly feasible in the outpatient setting.

Abscess↗
PubMedDate not supplied

Operative cholangiography during laparoscopic cholecystectomy: considerations about routine or selective policy.

Operative cholangiography (OC) during laparoscopic cholecystectomy (LC) is still a matter of debate regarding its routine or selective use. The present report is based upon a series of 30 selective cholangiographies performed in 290 LC during the years 1999-2004. Indications to OC were decided according to clinical data, liver chemistries, ultrasonographic (US) and intraoperative findings. In cases of unequivocal common bile duct (CBD) stones, a preoperative ERCP was performed and OC was not applied to confirm clearing of the biliary tract. OC was successful in 26 cases (86.6%): in 18 cases a normal cholangiogram was obtained and in 3 cases stones were detected into CBD. These patients underwent a postoperative successful ERCP at a variable interval of time. In 4 cases cholangiograms showed a delayed transit and in a single case a lack of contrast into the duodenum. Such occurrence was due to morphine derivatives employed during anesthesia. The Authors evaluate advantages and drawbacks of routine and selective OC according to personal and other Authors experience. Decision on selective or routine policy should be taken according to each surgeon experience and local facilities. Each laparoscopic surgeon must be able to perform and interpret an OC, specially if he has in mind to develop competence in laparoscopic CBD exploration.

Adult↗
PubMedDate not supplied

[Primary acute acalculous cholecystitis].

Acute acalculous cholecystitis (AAC) is a life-threatening condition whose incidence is steadily increasing although still lower than the corresponding lithiasic forms: AAC represents around 5-10% of all cases of acute cholecystitis. The severity of the disease is due to the rapid evolution towards gallbladder necrosis and biliary peritonitis. AAC is more frequently a disease of the critically ill patient arising in postoperative courses or in stressing conditions. Not rarely, however, it may occur with no evident predisposing factors and it seems related, in such cases, to elderly ages and to atheromatous vascular conditions. The authors report two cases of idiopathic AAC in elderly patients: pathogenic and clinical features as well as therapeutic options are analyzed and discussed.

Acute Disease↗
PubMedDate not supplied

[Results of a cytological study of needle aspiration in 85 cases of nodular pathology of the thyroid gland, surgically controlled].

UNLABELLED: The present retrospective study is related to 85 patients with nodular thyroid pathology submitted to surgical therapy. In these patients preoperative cytology, through fine needle biopsy aspiration (FNBA), has been compared with histological examination performed on the surgical specimen. Malignant lesions were detected in 30 cases (35.3%). True positives cases were 14, true negative 48, false positive and false negative (FN) were 2 and 3 respectively. Due to the high number of FN, sensibility of FNBA was only 51.8%, specificity was 96% and accuracy 80.5%. Positive and negative predictive value were 87.5% and 78.6% respectively. CONCLUSIONS: Evaluation of the several sources of error comes to a conclusion that FNBA is certainly the main diagnostic tool in nodular thyroid pathology. Its employment should undergo to a centralized diagnostic evaluation in such a way that cytology is analysed together with clinical and other instrumental data.

Adolescent↗
PubMedDate not supplied

[A case of nodular lymphoid hyperplasia of the small bowel in a patient with intestinal obstruction].

Nodular lymphoid hyperplasia (NLH) represents an uncommon lesion usually related to humoral immunodeficiency conditions. A case of NLH of the small bowel discovered by chance during an emergency laparotomy for an intestinal obstruction is herein reported. Discussion is focused on the main features of NLH which as in the reported case, is likely to be the initial manifestation of an intestinal disease not yet clinically defined.

Adult↗