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M Tomescu

Publications and source records attributed to M Tomescu.

13 recordsLinked to original sources
PubMedDate not supplied

[Acute necrotizing pancreatitis following abdominal trauma].

We present 11 cases of acute necrotizing pancreatitis following abdominal trauma operated in our clinic during the last five years. All patients except one were male. All of them had obvious symptoms of acute diffuse peritonitis when they came to hospital. The diagnosis was established by CT scan in four observations. All operations were performed during 12-36 hours after they came. During surgery, there was complete pancreatic necrosis in seven cases and incomplete in the other four cases. Associated injuries following trauma were represented by: hemothorax--two cases, spleen injury--one case, lesion of mesentery--one case, intestinal lesion--one case. In all cases we performed a wide opening of the lesser sac, pancreatic capsulectomy, necrosectomy and multiple drainage of the pancreatic side (behind the peritoneum) and peritoneal cavity. The postoperative outcome was difficult in all cases. Postoperative morbidity recorded pancreatic leakage (three cases), pseudocysts (two cases) and a perforation of gastric wall. There were 10 cases cured and one patient died.

Abdominal Injuries↗
PubMedDate not supplied

[Ascites--a complication of chronic alcoholic pancreatitis].

We present the case a 44 year old patient previously diagnosed with chronic alcoholic pancreatitis with pancreatic ascites during hospitalization in the Gastro-Enterology department. As the conservative therapy performed for 21 days was not effective in diminishing the ascites, the patient was admitted in our Surgical Department and scheduled for surgical intervention. He was operated and we discovered a small dimension cyst (7/4 cm) developed in the body and tail of the pancreas, fistulized in the peritoneal cavity through an outlet positioned below the insertion of the mesocolonum transversum, fairly close to the duodeno-jejunal angle. We executed a cysto-jejunal anastomosis by using the first loop of the jejunum, secured with a politer drainage positioned as in WITZEL technique and drive out in the left upper quadrant. The postoperative evolution of the patient was difficult, but constantly positive. The patient left the hospital 32 days after the intervention. The clinical and ultrasound follow-up after three months were normal.

Adult↗
PubMedDate not supplied

[Surgical treatment of great median upper and/or lower abdominal incisional hernias with mesh placed in the rectus sheath(behind the muscle)].

We present our experience concerning surgical treatment of great upper and/or lower abdominal incisional hernias, by the technique using a mesh placed in the rectus sheath. Durind 5 years, we operated 42 cases. The features of our trial were: average age--56 years; female prevalence--40 cases (95%); great obesity rate (15 observations--35%). The early postoperative morbidity was represented by (number of cases): thrombophlebitis (2), prolonged postoperative ileus (3), seromas (7), prolongs hemorrhagic drainage (3), hematomas (2). We recorded no death. The late postoperative morbidity (number of observations) recorded granulomas (3) and recurrency (2). We obtained good and very good results in 37 cases (88%).

Adult↗
PubMedDate not supplied

[Gall bladder carcinoma].

The study comprises a lot of 989 cholecystectomies for gall bladder lithiasis performed in the First Surgery Clinic of the University Emergency Hospital of Bucharest throughout three years and a half (2000-June 2003). Half out of them--493 cases (50%)--were laparoscopic interventions. All of the organ material was submitted to pathological examination. In 4 cases (0.4%), all females, the pathologist surprisingly unveiled the diagnosis of gall bladder carcinoma in the 3rd stage of evolution for all of them. None of the observations presented beforehand or per operative hints suggestive for a malignant affliction. Three patients associated multiple pathology such as acute pancreatitis (obs No2), common bile duct lithiasis (obs No3) and cholecysto-duodenal fistula (obs No4). The postoperative evolution of gall bladder neoplasia of the 4 cases studied was extremely fast, the patients soon being readmitted in our clinic for jaundice, subhepatic tumoral mass and liver metastasis, on average after 31 days after cholecystectomy. That was why the reinterventions were confined to limit at exploratory laparotomies only.

Aged↗
PubMedDate not supplied

The value of echocardiography in the early diagnosis of myocardial impairment due to connective tissue diseases.

The study comprised 14 patients with systemic lupus erythematosus (SLE) and 12 patients with diffuse scleroderma. Echocardiography ascertained 5 cases of congestive and 1 case of restrictive cardiomyopathy among the patients with SLE, as well as 6 cases with restrictive cardiomyopathy among those with scleroderma. The authors specify two important echocardiographic variables: the E-septum distance and the septal and wall motion after amyl-nitrite test, which reveal the intrinsic contractile properties of the myocardium, allowing an early diagnosis of myocardial impairment, as well as the selection of patients for an efficient treatment with vasodilator drugs.

Cardiomyopathy, Dilated↗