PubMed Health⌕ Search

Biomedical subjects

R Blanco-Benavides

Publications and source records attributed to R Blanco-Benavides.

At least 19 recordsLinked to original sources
PubMed1994

Construction of a new intestinal valve.

PURPOSE: A surgical technique is presented which creates an intestinal valve. METHODS: In six dogs, the terminal ileum and the ascending colon were removed and the valve was made. The valve has been constructed in eight humans, three of them were cases of short bowel syndrome with resection of the ileocecal valve and five cases were right hemicolectomies attributable to a carcinoma of the cecum and ascending colon. RESULTS: The dogs were observed for a period of four to six months, during which time the animals stayed healthy. In the cases of short bowel syndrome in humans, the valve reduced the number of evacuations, in the five cases of right hemicolectomies the evolution was without complications. CONCLUSION: This surgical technique can be useful in the management of patients with morbidity by resection of the ileocecal valve.

Animals↗
PubMed1990

[Surgical treatment of amebic liver abscess].

Results of surgical treatment of hepatic amebic abscess in three hospitals during last three years are presented. Seventy four percent of patients admitted with complications of amebiasis have liver abscess. Of them 22% require surgical treatment and mortality is 8%. Nineteen years ago the amount of patients admitted with amebic complications was greater and a larger number of patients were operated; however mortality has not changed.

Combined Modality Therapy↗
PubMed1983

Treatment of bleeding esophageal varices. A new technique.

A technique for the treatment of bleeding esophageal varices has been described. It is based on an increase in the periesophageal pressure and the creation of an antireflux mechanism that modifies the pathogenic factors of the bleeding. It has been utilized in 17 high-risk patients with satisfactory results.

Abdomen↗
PubMed1982

Esophagocardioplasty with gastric pouch. An experimental study in dogs.

In 18 dogs esophagocardioplasty was performed through an abdominal incision with a gastric patch taken from the minor curvature of the stomach. In four dogs the mucosa was removed from the gastric patch and in six dogs a Nissen fundoplication was done. The dogs were observed for 1 year. All dogs showed macroscopic and microscopic signs of esophagitis with ulcers; three had esophageal perforation and two dogs had esophageal stenosis. We found that gastric patches with peptic acid secretory mucosa in dogs cause grave esophageal lesions.

Animals↗
PubMedDate not supplied

[Dynamic pancreatography: the diagnosis of pancreatic necrosis and the identification of the risk factors of severity].

BACKGROUND: Dynamic pancreatography (DP) can establish the development of tissue damage and demonstrate pancreatic necrosis (PN). OBJECTIVE: To prospectively evaluate the usefulness of DP in patients with acute pancreatitis (AP), analyzing its capabilities for determining the incidence of necrosis, and as a prognostic predictor. MATERIAL AND METHODS: All patients with AP seen at our department during 4 years were included. All patients were scheduled to DP. Findings were classified in five groups: I, interstitial AP; II, secondary fluid collections; III, peripancreatic necrosis; IV, pancreatic necrosis < 50% and pancreatic necrosis > 50%. Also included for analysis were: demographic variables, etiology, APACHE-II score, and Ranson's signs; when infection was suspected, cultures were done. PD and operative findings were correlated to calculate sensibility (S), specificity (Sp), positive and negative predictive values (PPV, NPV), and the diagnostic accuracy (DA) of the test. Correlation between severity/mortality and morphologic alterations according to the classified group were also performed. RESULTS: 244 patients. Biliary associated pancreatitis in 47% and alcohol induced in 37%. DP in 207 patients showed, 34 patients in group I; 36 in group II, 67 in group III, 47 and 60 in groups IV and V, respectively. Secondary pancreatic infection was present in 48%. One hundred seventy-two patients underwent surgery; the surgical indication was to interrupt the pathogenesis of complications in 52%. DP correlated with the prognostic signs and APACHE-II score as predictors of complications with an overall (S) of 93%, (Sp) 98%, (PPV) 91%, (NPV) 98%, and (DA) 97%. Greater scores values are all directly proportional with PD necrosis findings (P < 0.05). There was not PD related morbidity. CONCLUSIONS: We found correlation between PD classification and prognostic factors. Morphologic alterations were accurately identified. PD as preoperative work-up allows surgeons design operative strategies and as is useful follow-up of the patients after necrosectomy.

APACHE↗
PubMedDate not supplied

[Gastrointestinal neurofibromatosis. A rare cause of abdominal surgery].

OBJECTIVE: Report two cases of gastrointestinal neurofibromatosis that required surgical intervention for their resolution. BACKGROUND: Neurofibromatosis is a congenital disease which is classified in two types. In neurofibromatosis type 1 or Von Recklinghausen's disease the patients have some classical manifestations as cafe au lait pigmentation, bony abnormalities and neurofibromas of both peripheral and central nerves. In up to 25% of the patients with neurofibromatosis 1, the gastrointestinal tract is involved. The most affected organs are the stomach and the jejunum. The symptoms of the patients with gastrointestinal neurofibromatosis are related to gastrointestinal bleeding or obstruction. METHOD: Two patients with gastrointestinal neurofibromatosis that required surgical intervention for the resolution of their manifestations. RESULTS: Two cases of gastrointestinal neurofibromatosis, one of them had as her main clinical feature gastrointestinal bleeding, and the other patient intestinal obstruction. They were submitted to exploratory laparotomy finding gastrointestinal neurofibromatosis in both as the cause of their symptomatology. CONCLUSIONS: The management of gastrointestinal neurofibromatosis could need surgical intervention, and when this is done the postoperative evolution is satisfactory.

Adult↗
PubMedDate not supplied

[Acute mesenteric ischemia. Profile of an aggressive disease].

Acute mesenteric ischemia is an abdominal emergency due to inadequate tissue perfusion with a mortality rate between 60 and 100%. Intestinal damage by ischemia depends on general circulation, collateral blood flow, response of the mesenteric vasculature to autonomic stimuli, circulating vasoactive substances, local humoral factors, and the normal and abnormal products of cellular metabolism before and after reperfusion of the ischemic segment. Four physiopathologic phenomenon are present: superior mesenteric artery embolism; superior mesenteric artery thrombosis; non-occlusive acute mesenteric ischemia, and superior mesenteric venous thrombosis; embolism event is the most frequent. The injury observed after 3 of ischemia (blood flow reduced to 20% of normal) and 1 of reperfusion is more severe than 4 of ischemia. Clinical diagnosis of mesenteric ischemia required a high suspect index, specially in elderly patients with cardiovascular problems. Abdominal pain and hemodynamic and/or metabolic changes are the most frequent symptoms. Although some authors have questioned the need for angiography, this study is the key not only to making a diagnosis of acute mesenteric ischemia before bowel infarction and prior to laparotomy, but also to initiate intra-arterial mesenteric angiography therapy with vasodilators. Patients who persist with acute abdomen will require exploratory celiotomy and vascular exploration. The outcome depends on early diagnosis and therapy to avoid ischemia progression and reperfusion injury.

Humans↗
PubMedDate not supplied

[Transmesenteric intestinal plication for intestinal occlusion secondary to disseminated adhesions. A 12-year experience].

OBJECTIVE: To report the experience with intestinal plication in patients with adhesive intestinal obstruction that was followed up to 12 years. BACKGROUND: To diminish the high recurrence rate of adhesive intestinal obstruction, there are surgical techniques of intestinal plication. In 1977 Blanco modified a pre-existing transmesenteric technique that is the used in our institution. METHOD: We studied the medical records of 32 patients who underwent intestinal plication using the transmesenteric technique. The postoperative evaluation was based in recurrence and mortality. RESULTS: There were 32 patients, 56% women and 44% men, with a mean age of 50 years. All patients had a history of intraabdominal surgical procedures. The postoperative evaluation was satisfactory. The success rate was over 90%. The recurrence rate was 9.3% and we had no mortality. The mean follow-up was 3.5 years (median 3 [range 1-12] years). There were no significant differences between this technique and the Noble and Childs-Phillips plication techniques. CONCLUSIONS: This technique of intestinal plication is useful in the surgical management of patients with adhesive intestinal obstruction.

Adolescent↗
PubMedDate not supplied

[Retrograde intussusception posterior to gastrojejunal anastomosis. Report of a case].

OBJECTIVE: We report a case of retrograde jejunogastric intussusception in a patient with previous gastric surgery who required surgical treatment for its resolution. BACKGROUND: While intussusception is relatively common in children, it is infrequently seen in adults. Five percent of all cases occur in adults and in 90% of these, there is a lead point, a well-definable pathologic abnormality. Retrograde jejunogastric intussusception is a rare complication after gastrojejunostomy. The most common symptoms are pain, nausea, vomiting and blood per rectum. Diagnosis of adult intussusception is often difficult and is base in clinical suspicion and noninvasive techniques. METHOD: A case of a retrograde intussusception in a patient after gastric surgery who presented with abdominal pain and gastrointestinal bleeding. RESULTS: The patient underwent surgical treatment with reduction of the intussusception. The postoperative evolution was satisfactory. CONCLUSIONS: Management of intussuception in adults is usually laparotomy and in 90% of cases, a pathologic lesion will be identified. Retrograde jejunogastric intussusception is also managed surgically and simple reduction is the accepted form of treatment in most cases.

Aged↗
PubMedDate not supplied

[Esophageal perforation caused by balloon dilatations in a patient with achalasia].

OBJECTIVE: To present a case of esophagic perforation due to a pneumatic dilatations of the cardias in a patient with achalasia. BACKGROUND: Achalasia of the esophagus is a primary motor alteration with an unknown cause. The principal characteristics are the lower or absent peristaltic waves in the esophagic body and the impared lower esophagic sphincter relaxation during deglution. The management is palliative with pneumatic dilatations, pharmacologic therapy or with surgery. When a esophagic perforation occurs, it must be diagnosed and treated as soon as possible because a delay in diagnosis and management affect directly the patient prognosis. METHOD: To present a case of esophagic perforation due to pneumatic dilatations of the cardias in a patient with achalasia. CONCLUSIONS: An useful palliative management for achalasia is the pneumatic forceful dilatation, however it carries some risk of perforation; in every patient who was treated with dilatations is mandatory to think in perforation when the clinical condition is different after the procedure. The success of surgical management of the perforated esophagus and the control of sepsis and mediastinitis depends directly of the clinical condition of the patient and the time within perforation and surgical therapy.

Aged↗