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R Colović

Publications and source records attributed to R Colović.

At least 19 recordsLinked to original sources
PubMed2001

[The Mirizzi syndrome--from the first description until today].

Pablo Luis Mirizzi was the first to describe an obstructive jaundice caused by compression of the common hepatic duct by the stone in the cystic duct or the neck of the gallbladder in 1948. McSherry et al in 1982. described a new type of Mirizzi's syndrome calling it type II. Csendes et al in 1989. gave a new classification in four types. According to it, type II of Mirizzi's syndrome was devided in three types depending on the size of the destruction of the common hepatic duct. We previously described a subtype of Mirizzi's syndrome in which besides very wide cholecystohepatic fistula, a combined fistula with duodenum was developed. Nagakawa et al in 1997. described a new type of Mirizzi's syndrom and gave their classification of syndrome in four types. In the present article the authors proposed a combined classification which takes into account not only all described variant of the syndrome but possibilities of operative reconstruction. Type I would be the same as in all previous classifications. Type II would correspond to the cholecystohepatic fistula in which a primary repair is possible. Type III would correspond to the cholecystohepatic fistula in which a primary repair is not possible so that biliodigestive anastomosis has to be carried out. Subtype IIIa would correspond to the same situations but complicated with fistula with the duodenum which has to be repaired as well. A Type IV of Mirizzi's syndrome would correspond to the inflammatory obstruction of the common hepatic duct as described by Nagakawa et al.

Cholelithiasis↗
PubMed2001

[The development of anatomy].

Doctors, particularly surgeons, realise the enormous importance of good knowledge of human anatomy today. It was not so in the past when doctors showed little or no interest for human anatomy for centuries. Dissections of the human body, necessary to study human anatomy, were either forbidden or limited to the corpses of criminals on whom capital punishment was carried out. The authors give a chronology of the development of human anatomy until 19. century when dissections of the human body became almost universally regulated with positive legislation. After the "golden age of surgery" began in 1870. surgeons gave an enormous contribution to anatomy.

Anatomy↗
PubMed2000

[Acute lung injury related to blood transfusion].

Transfusion-related acute lung injury (TRALI) is a second most serious complication of the blood transfusion. It is a group of symptoms and signs such as dyspnoea, hypotension, cyanosis, cough, elevated temperature, fever and lung oedema that usually develops within an hour or two after transfusion. The full stage clinical presentation is developed between 4th and 6th hours after transfusion. The syndrome is caused by leucoagglutinins or by other lymphocytotoxic antibodies specific for some antigens present on the donor's leukocytes. Alveoles of the lung are the main place of the pathological changes such as intra-alveolar oedema, haemorrhage, hyaline membrane formation, alveolar cell hypertrophy and scant interstitial inflammation. Chest X-ray showed bilateral pulmonary infiltrates but without vascular congestion and with normal cardiac silhouette comparing to the status before transfusion. The syndrome has to be distinquished from pulmonary oedema caused by acute cardial insufficiency, overhydration, trauma and sepsis.

Acute Disease↗
PubMed1999

Hepatosplenic candidiasis after neutropenic phase of acute leukaemia.

Hepatosplenic candidiasis following granulocytopenic periods is a relatively recently recognised problem in immunocompromised patients, particularly in those with acute leukaemia. We present three patients in whom diagnosis of hepatosplenic candidiasis was suspected on the basis of ultrasonographic (US), computed tomographic (CT) findings and confirmed by laparoscopy and biopsy of liver lesions. All three patients were successfully treated briefly with amphotericin B, followed by a longer period of fluconazole. In one patient laparotomy and surgical evacuation of abscesses was performed. This condition could be more often recognised by careful follow-up of liver function test, C-reactive protein level, ultrasonography, CT and MRI after recovery from chemotherapy-induced neutropenia.

Adult↗
PubMed1999

Primary MALT lymphoma of the kidney.

A primary mucosa associated lymphoid tissue tumor (MALT) of the kidney in a 50-year-old man who suffered from on therapy resistant high blood pressure over 15 years period is presented. A mass in the right kidney (6x5x3 cm) during routine check up was discovered on ultrasonography and confirmed on CT scan and NMR. The patient was submitted to nephrectomy. A mass involving kidney, pyelon and upper part of the ureter was found. Histology showed low grade non-Hodgkin B-cell lymphoma of MALT type. The neoplastic cells were positive for monoclonal antibodies CD20, CD79alpha, surface and cytoplasmic and IgM immunoglobulins and showed light chain restriction (kappa+). After histology was available, a careful staging was performed. The disease was not found anywhere else. It was concluded that the patient belonged to the stage IE of primary kidney MALT lymphoma. Gastroscopy showed signs of chronic superficial gastritis. Urease test was positive and IgG antibodies against Helicobacter pylori in titer 421 were found as well. Except for Helicobacter pylori no additional therapy was given.

B-Lymphocytes↗
PubMed1999

Cystadenomas of the pancreas.

Cystadenomas of the pancreas are rare tumors. They represent about 10% of the pancreatic cystic masses. Several hundred cases seem to have been reported so far. These tumors appear as serous and mucinous. Over 13 years period (1983-1996) we treated 22 patients for cystadenoma of the pancreas. All patients were women. There were 6 serous and 16 mucinous cystadenomas. The average age in the serous group was 31 years (ranging from 23 to 42 years) and 43 years (ranging 17-64) in mucinous group. Two patients had tumor in the head, 20 others in the tail and body of the pancreas. The diameter of these tumors varied from 3.5 to 17.0 cm (average 9.6 cm). The leading symptoms were epigastric or left subcostal pain in 19 patients, palpable mass in 10, weight loss in 5, vomiting in 5, and melena in one patient. Tumor was accidentally found in a women undergoing abdominal operation for enteric fistula after hysterectomy. Serum amylase was moderately elevated in two patients. Diagnosis of pancreatic cystadenoma was proposed preoperatively in 16 patients (72.7%). In other cases, diagnoses of pancreatic cysts in 5 patients or hydatid cyst in 1 patient were made. An ideal operative removal (excision) was done in 7 patients, both excision of the tumor and splenectomy in 2, while distal pancreatectomy and splenectomy were carried out in 13 others. There was no mortality. One female patient developed left subphrenic abscess and left pleural effusion which were successfully treated by drainage and thoracocenthesis. One patient developed transient pancreatic fistula. All patients have been under close follow-up from 6 months to 13 years and all stayed symptom free so far.

Adult↗
PubMed1995

[Ectopic spleen--2 case reports].

Wandering spleen occurs consequently to the embryonal disturbances in the development of ligaments connecting the spleen with surrounding tissue. It is rarely the cause of abdominal discomfort, which is usually mild, but nevertheless it can be expressed within the signs of acute abdomen. In our study, two cases of wandering spleen are presented, the diagnosis was put according to the intermittent pain in lower abdomen, echotomography, radionuclide imaging and selective angiography. Splenectomy revealed subjective discomfort. In women, wandering pelvic spleen might be mis-diagnosed as a gynecological disease.

Adult↗
PubMed1995

[Liver injuries].

Liver is, after spleen, the second most frequently injured organ in the blunt abdominal trauma. Liver trauma is often associated with injuries to other viscera and the mortality may be even more dependent on the severity of those injuries then on the liver injury itself. New imaging techniques provide an accurate assessment of the extent of liver injury and so more appropriate surgical technique. They provide that certain number of patients, under precisely defined conditions may be treated nonoperatively. A success in establishing a stable hemostasis and debridement of devitalised tissue is mandatory for a favorable outcome. Different methods of surgery are discussed.

Humans↗
PubMed1994

[Surgical treatment of peroperative injuries of the duodenum].

Operative duodenal lesions are rare, but often fatal complications of certain abdominal procedures. This was reported in small series with an incidence of 0.2% of all abdominal operations. The management of these injuries requests the surgeon to be familiar with a number of specific operative approaches, which are to be used according to the operative situation. In the 1985-1992, year period, 21 cases of the operative injury of duodenum were managed without mortality, and with 3 cases of transient postoperative fistula, which healed spontaneously. The most important factors in the management of this complication are the early operative recognition of duodenal injury, or early reoperation, if, in a case of duodenal fistula, distal outflow is considered insufficient. The particularities of the duodenal suture and perioperative treatment are to be well understood. Roux en Y covering of the duodenal defect by open jejunal loop is the best method in management of these injuries.

Adult↗
PubMed1994

[Leiomyosarcoma of the duodenum (case report)].

Leiomyosarcomas of the duodenum are rare tumors, usually presented with gastrointestinal bleeding and/or symptoms of duodenal obstruction, rarely with obstructive jaundice. If successfully removed, these tumors have better prognosis than carcinomas of duodenum or head of the pancreas. A 62 year old man in whom leiomyosarcoma of the duodenum was successfully removed by cephalic duodenopancreatectomy (Whipple's procedure) is presented.

Duodenal Neoplasms↗
PubMed1991

Use of endoscopy to diagnose symptomatic duodenal duplication cyst in an adult.

The case of a female patient with a symptomatic duodenal duplication cyst diagnosed on endoscopy is reported. It is very important to discriminate between this rare anomaly and choledochocele as the treatment differs. Ultrasonography and ERCP are useful for the differential diagnosis. This rare anomaly is more often diagnosed in children. In adults duodenal duplication cysts may cause obstructive jaundice. The endoscopic finding of a cystic lesion in the medial wall of the second duodenal section at the papilla Vateri should be interpreted as a sign of the disease.

Adult↗
PubMed1991

Splenic vein thrombosis. Diagnosed with Doppler ultrasonography.

The case of a 31-year-old pregnant woman with an isolated splenic vein thrombosis, diagnosed with Doppler ultrasonography is presented. Routine ultrasound examination in the fourth month of the pregnancy revealed massive splenomegaly of unknown origin. Doppler ultrasonography subsequently revealed splenic venous thrombosis with absence of blood flow. Noteworthy gastric varices were present at the endoscopic examination. On splenectomy, a spleen weighing 2,600 was removed, and numerous venous collaterals were found in the perigastric region. The postoperative course was satisfactory, pregnancy evolved normally, and a healthy female baby was delivered at term. The patient remained in excellent health with normal clinical and laboratory data.

Adult↗
PubMed1991

[Injury of the left hepatic vein by a large hepatic echinococcal cyst].

While different sorts of affection of the biliary tree by the hydatide cysts of the liver are frequent (20-30%), vascular complications are rare. That is why serious peroperative bleedings are usually caused by surgical mistakes. Bleeding caused by hydatide cyst itself is very rare, sudden, abundant, dramatic and usually lethal on the operative table. We present a 76-years-old man in whom during the operation of a huge hydatide liver cyst, sudden and abundant bleeding from the defect (2 x 0.5 cm) of the left hepatic vein caused by the cyst itself, appeared. The bleeding was successfully solved by direct suture of the defect. Three months later hepatitis B viral infection manifested apparently after numerous blood and plasma transfusions during surgery, and patient died in hepato-renal syndrome.

Aged↗
PubMed1990

[Duodenal obstruction caused by gallstones (Bouveret syndrome)].

Gallstone obstruction of the duodenum (Bouveret's syndrome) is a very rare complication of biliary calculosis. A great biliary calculus with long-term persistence causes cholecystoduodenal fistula and after passing through this fistula into duodenum, subsequent duodenal obstruction develops. The authors present a 73-years-old woman with Bouveret's syndrome. She was admitted to the Institute of digestive diseases with clinical signs of high intestinal obstruction. Preoperative radiographic examination detected gallstone obturation of the duodenum. At operation, two large gallstones were extracted from the duodenum, a thickened gallbladder was removed and duodenal suture was done. Post-operative course was delayed, due to respiratory complications and the patient went home on the 37th day after the operation in good condition.

Aged↗
PubMed1990

[Diffuse adenomyomatosis of the gallbladder].

Adenomyomatosis is a rare benign proliferative disease of the gallbladder characterized by epithelial proliferation and formation of mucosal pouches through the thickened muscular layer of gall bladder wall. It appears in three different types: diffuse, segmental and localised adenomyomatosis. Diffuse type is the rarest. Etiology is unknown. Patients sometimes feel a dull pain in the upper right abdominal quadrant. Preoperative diagnosis is based on cholecystography and ultrasonography. Cholecystectomy is a method of treatment. Diagnosis is confirmed on histology. Very rarely, adenomyomatosis seems to bee a premalignant condition. We present four patients treated during the last two years, a woman and three men, 27-41 years old (average 37 years). All these patients had a dull pain in the right subcostal region, approximately 6 months before the diagnosis was established. One patient had chronic alcoholic pancreatitis with dilated pancreatic duct. Diagnosis of diffuse adenomyomatosis was made preoperatively on ultrasonography in all patients. Cholecystectomy was carried out Diagnosis was confirmed on histology. There was no carcinoma. In a patient with chronic pancreatitis Wirsungojejunostomy (Puestow) and choledochojejunostomy were also carried out.

Adenomyoma↗
PubMed1990

[Biliary ileus].

In the period 1946-1987 at the former Second Surgical Clinic of the Medical Faculty in Belgrade 25 patients with a biliary ileus were Surgically treated, 20 females (80%), and 5 males (20%), aged from 53 to 87 years, (mean 67 years). Six patients were decade, 7 in 7th, 9 in 8th, and 3 in 9th decade. In only 8 patients biliary calculosis had been confirmed earlier. Preoperative troubles in the Bowel Passage lasted 1-7 days, (mean 3 days), mostly as in incomplete gut occlusion. Preoperative diagnosis of the biliary ileus, using x-ray, was exact only in 3 cases (12%), while other remaining patients underwent Surgery diagnosed as ileus of the small bowel or acute abdomen. In 7 patients a stone obstructed the jejunum, in 6 ones its widpart and in 10 cases the terminal ileum. In 23 patients an enterotomy distally to the obstruction with an expulsion-extraction was done, in one patient a partial resection of the gut and in another patient a manual stone expulsion into the colon, with no enterotomy, was carried out, and after operation the stone was removed from the rectum. The Bilio-digestive fistula was never treated either the surgery itself, or later. Complications arised in 13 patients: wound infection in 11, deep thrombophlebitis in one and a pneumonia in two patients. An average hospitalization was 27 days, and all patients Survived.

Aged↗
PubMed1989

[Chylous lymphangioma of the pancreas (case report)].

We presented a 47 year old lady in whom, during the investigation for unstable arterial hypertension and lumbar pain, ultrasonography and computed tomography showed a polycystic mass retroperitoneally in the level of the pancreas. During operation a chylous lymphangioma of the pancreas was found and was almost entirely excised. The remaining mass was opened and left to drain into abdominal cavity. The recovery was uneventful. Hystology confirmed chylous limphangioma. The patient stayed symptom-free with normal clinical, ultrasonographic and laboratory data for more than a year after surgery. Lumbar pain disappeared and blood pressure became normal.

Chyle↗