[Sequential revascularization bypass of the aorto-iliac-femoral axis].
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Aorta↗
Biomedical subjects
N Gullà
Publications and source records attributed to N Gullà.
[Technic of banding the aortic anastomosis].
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Aorta↗
Adenocarcinoma arising from a recurrent fistula-in-ano.
Anal fistulas are frequent events which often recur after an inadequate surgical treatment. Nevertheless their evolution into malignant diseases is infrequently observed. The authors report one case of mucinous adenocarcinoma arising out of a recurrent, long-lasting fistula-in-ano. As reported, abdomino-perineal resection combined with radiotherapy can be the choice treatment. The difficulty is to obtain a reliable differential diagnosis. No imaging technique nor histologic examination can establish a definitive reliable diagnosis; nevertheless, as the risk of adenocarcinoma developing from a long-lasting recurrent fistula-in-ano, although small, is real, authors believe that operative exploration and biopsy of recurrent abscesses and fistulas should be recommended.
Adenocarcinoma↗
[Transperitoneal anterior access in video-laparoscopic adrenalectomy].
BACKGROUND: The more wide spread laparoscopic technique to operate on the adrenal gland is transabdominal approach with a lateral flank adrenalectomy. However, the transabdominal anterior approach can be a sure and safe alternative in selected patients. METHODS: From 1997 to 1999, 18 selected patients underwent laparoscopic anterior adrenalectomy. Mean age was 43 years (range 25-63) with a male/female ratio of 1:1. Indications were Conn's adenoma in 10 patients, pheochromocytoma in 3 cases, Cushing syndrome in 1 and incidentaloma in 4. All the procedures were carried out laparoscopically and only one patient required conversion to an open adrenalectomy for clear signs of malignancy. The mean time for adrenalectomy was 140 minutes and the shorter times were recorded in the right-sided procedures (mean time 84 minute). Estimated blood loss was minimal and no transfusion was done. There were no postoperative complications related to the surgical technique and the hospital stay was 4 days in average. RESULTS: Our data confirm, according with other authors, that this method is feasible in selected patients. Longer times recorded for the left-sided lesions were due to the more difficult dissection required to gain the left adrenal gland. CONCLUSIONS: Transabdominal adrenalectomy with patient in the supine position is feasible, but its use is restricted to the cases with suspect bilateral or multifocal pheochromocytoma, to patients with concomitant abdominal pathologies that can be operated on laparoscopically, to surgeons who prefer to have a frontal view of the operative field.
Adenoma↗
A case of "silent" pheochromocytoma presenting as spontaneous retroperitoneal hematoma.
Pheochromocytoma of the adrenal gland can be the cause of massive and lethal retroperitoneal haemorrhage presenting as acute abdomen. Here we report a case of retroperitoneal hematoma, with concomitant peritoneal spillage, due to the spontaneous rupture of a silent pheochromocytoma. The main clinical findings of this disease will be described. Therapy and prognosis will be also discussed.
Abdomen, Acute↗
[Aberrant pancreas: description of a clinical case and review of the literature].
Aberrant pancreas is a rare finding pathology. Authors reviewed this problem after their personal observation of a specific case, pointing out the behaviour of the disease, particularly the difficult for a careful preoperative diagnosis. They also point out the necessity to make a diagnosis of "suspect" in presence of a symptomatology with the referred characters and when there aren't instrumental findings for evident pathologies.
Adolescent↗