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Biomedical subjects

M Rengo

Publications and source records attributed to M Rengo.

At least 19 recordsLinked to original sources

[Compartment syndrome or gas gangrene? A case report].

A case of forearm compartment syndrome due to a minor trauma is reported. The severe clinical conditions due to a shock state lead to an initial misdiagnosis of clostridial myonecrosis. The patient, 68 y-old woman, was admitted to the intensive care unit of Authors' hospital for a traumatic injury of the right forearm. A diagnosis of gas gangrene due to clostridial myonecrosis was done and forearm amputation suggested. In spite of this indication a decompression fasciotomy of the forearm compartments was performed as well as a hyperbaric oxygene therapy. Since culture of necrotic tissue samples did not demonstrate any bacterial growth, the Authors decided to avoid amputation and perform a radial arteriovenous fistula to improve venous return and reduce distal edema and continuous bleeding, with a complete recovery within 40 days. Good evaluation of patient with suspected compartment syndrome means correct and not delayed treatment, avoiding invalidating outcome.

Aged↗

[Laparoscopy in emergency: treatment of choice in acute abdomen].

From 1992 to November 1999, 225 consecutive cases of acute abdomen were observed: 163 suspicious acute appendicitis, 7 ovarian cysts with suspect torsion, 4 intestinal occlusions, 1 digestive hemorrhage due GIST (Gastro-Intestinal Stromal Tumor), 1 case of hemoperitoneum after laparoscopic appendectomy and 49 cases of acute cholecystitis. In the 225 cases of emergency laparoscopic operations for acute abdomen the diagnostic accuracy has been of 99.5%, with only one case of conversion in to laparotomy for diagnosis. The conversion from laparoscopic to laparatomic surgical technique was registers in 2 cases (1%). The realimentation started in all the cases with a liquid diet as soon as 6 hours after the operation and with solid foods the following morning. The Authors haven't registered wound contaminations. The patients of working age rehabilitated in 8 days (between 7 and 21 days). In the athletic patients the average rehabilitation time was 15 days. On the base of the results obtained with their video-laparoscopy experience in acute abdomen emergency surgery, the Authors confirm that this technique can be advised as Emergency Surgery's first choice treatment.

Abdomen, Acute↗

[A rare case of gastric bleeding due to left-sided portal hypertension].

The authors report an uncommon gastric bleeding rate due to splenic hilum compression by a pancreatic cyst. The syndrome to be brought back to some sectorial portal hypertension form (left-sided portal hypertension) is difficult to diagnose because of absence of esophageal varices and other portal hypertension signs in an unchanged liver functionality patient. To put a correct diagnosis about gastric bottom bleeding varices without hepatic origin, the authors recommend to use arteriography and CT. Surgical treatment is proved to be the election one because of useless attempt of bleeding control through hepatic artery endoscopic sclerosis or embolization.

Diagnostic Errors↗

[Renal oncocytoma: its differential diagnosis and the indications for surgical treatment].

The authors report an uncommon renal oncocytoma rate stressing difficulties that modern diagnostic modalities meet in a correct preoperative differential diagnosis with nephrocarcinoma. Oncocytoma is a low multifocal involvement. Surgical treatment is the primary choice, nephrectomy about localized monofocal lesions in advisable, with short and long term positive outcomes. In ambilateral involvement case without malignancy evident signs (scarce likelihood to infiltrate nephritic capsule, without lymphoadenopathy) conservative operations with partial resections are suggested with a five years survival from 84 to 96%.

Adenoma, Oxyphilic↗

[Current therapeutic orientation toward testicular germ cell tumors].

Personal experience in a case of primary germinal tumor of the testis in advanced state is described. The initial treatment was chemioterapy: the patient received four complete cycles of cisplatin-based chemoterapy (PEB scheme). A surgical treatment consisted of a radical inguinal orchiectomy with high ligation of the spermatic cord at the deep inguinal ring associated with interaortocaval lymphonodes dissection. Actually, after two years from the beginning of treatment, the patient is well, without signs of neoplasm disease.

Adult↗

[Mechanical endarterectomy: review of the literature and description of an original device].

The Authors, after a Literature review on endovascular invasive procedures used for inferior limbs obstructive arteriopathy, describe the use of a new device for mechanical endarterectomy. Through the latest acquired experience the importance of dissecting progressively the single layers of the atheroma plaque without arriving to a complete denudation of the arterial wall, so avoiding the risk of myointimal hyperplasia reactions, is outlined. The possibility of using endoarterial stents in case of more indaginous recanalization is also stressed.

Angioplasty, Balloon↗

[Surgical treatment of spontaneous rupture of the esophagus: case report].

Boerhaave's syndrome is a rare and severe syndrome, with a mortality rate around 40%. The Authors report a case recently observed and through a Literature review stress the importance of an early diagnosis and quick surgical treatment as far as quoad vitam prognosis is concerned.

Esophageal Diseases↗

[Diagnostic and therapeutic approach to kidney injuries].

The Authors report a wide review of the literature on open and blunt renal traumas. All the problems related to this pathology as well as all the instrumental and laboratory tests currently available for the correct diagnosis are illustrated. Both conservative and surgical management are also discussed.

Humans↗

[Aneurysm of the celiac trunk: review of the literature and report of a clinical case].

After reviewing current and past medical Literature regarding celiac axis aneurysms the case of a 70 year-old emphysematous patient with an aneurysm of the celiac axis measuring 6 cm in diameter is reported. The patient's pulmonary function testing status strongly precluded a surgical option. Angiographic embolization of the aneurysm was then performed. The Authors observed that embolization with immediate occlusion of all afferent vessels of the celiac axis leads to no serious short or long-term consequences as long as an adequate collateral hepatic circulation is maintained through the gastroduodenal and inferior pancreaticoduodenal arteries. This case would appear to be the first described in the Literature and the Authors hold this technique to be a valid alternative whenever a surgical procedure would be difficult or impossible to perform.

Aged↗

[Electrohydraulic intracorporeal lithotripsy in the treatment of "difficult" calculi of the common bile duct. Report of a caseload].

The Authors report their experience in 38 cases (January 1990-Septembre 1994) of "difficult" gallstone disease of the main bile duct treated with electrohydraulic intracorporeal lithotripsy. Nineteen patients were affected with giant stones of the biliary tree, 6 with multiple stones of the main bile duct, 13 with stones of one or both hepatic ducts. The approach to the biliary tree was peroral transpapillary in 16 patients and transhepatic in the remaining 22. Twenty-five patients were previously submitted to surgery of the biliary tree (13 hepaticojejunostomy, 8 choledochoduodenostony, 4 papillostomy), while 5 had required a cholecystectomy, and 6 a gastroresection according to Billroth II. In 80% of the cases two lithotripsy sessions were enough to achieve the complete clearing of the bile duct. There was no mortality and morbidity was 5.3%. Total clearing was obtained in 97.4% of the cases. 6-48 months after treatment 37 patients still do not show clinical, laboratory or echographic signs of gallstone stasis or disease relapse.

Adult↗

[Mechanical staplers in colorectal surgery].

The results obtained with manual and mechanical suturing are compared on the basis of a review of a personal colon-rectum series. The advantages offered by staplers in this type of surgery are pointed out in agreement with reported data.

Anastomosis, Surgical↗

[Mechanical endarterectomy using an original device. Preliminary experimental results].

A prototype for the performance of mechanical thromboendarterectomy was constructed following various experimental designs and applications. The study was carried out on 25 aortobifemoral segments presenting typical obliterating arteriosclerotic lesions. The equipment consists of a flexible probe whose distal end was represented by a screened helical cutter and whose proximal end by an inlet and washing chamber. At the centre of these chambers and of the probe, a steel tube sets the cutter rotating at an adjustable speed. Good recanalisation was achieved in all vasal segments treated without damaging the vessel's wall. Although encouraging, results thus far are preliminary and require verification.

Aorta, Abdominal↗

[Risks and complications of total parenteral nutrition. Personal experience].

Total parenteral nutrition is now a broadly used method whose efficacy is confirmed, even if it is still not free from risk of complications. The Authors report their own clinical experience on 130 cases in the period 1981-1988. Complications were registered in 4.6% of the observed cases. They underline the problems relating to this subject.

Humans↗