Biomedical subjects

R Famà

Publications and source records attributed to R Famà.

10 recordsLinked to original sources

PubMed1995

[Rupture of the duodenum caused by closed abdominal trauma].

A duodenal lesion due to blunt abdominal trauma is an infrequent eventi which makes important diagnostic and therapeutic problems. The preoperative diagnosis is not always easy, especially with retroperitoneal lesion or in injured patients. A plain abdominal radiography or a duodenal radiography with soluble contrast medium helps to achieve a proper diagnosis. Prognosis strictly depends on time between injury and surgical procedures. We report two successfully treated lesions of fourth duodenal due to a blunt abdominal trauma.

Abdominal Injuries↗

PubMed1994

Bleeding peptic ulcer occurring in hospitalized patients: analysis of predictive and risk factors and comparison with out-of-hospital onset of hemorrhage.

We reviewed 84 consecutive cases of peptic ulcer hemorrhage, which occurred, in an area of 270,000 people, from 1986 to 1988, in patients already hospitalized for other diseases (in-bleeders). These subjects were compared with a prospective series of 386 patients who initially bled as out-patients and were then admitted (out-bleeders). Of 84 hemorrhages in hospitalized patients, 41 followed major surgery, while 43 were associated with other severe conditions. Bleeding site was duodenal in two thirds. Mean age was 67 +/- 15 years versus 59 +/- 15 among out-bleeders. Fifty percent of in-bleeders had recently received nonsteroidal antiinflammatory drugs (NSAIDs), and one third were on anticoagulants and 10% on corticosteroids; in 39 (46%) bleeding was shown to be persistent or recurrent, 5 (5.9%) underwent endoscopic and 18 (21%) surgical therapy; 29 died (34%). The corresponding figures among out-bleeders were: further bleeding 80 (20.7%), endoscopic therapy 12 (3.1%), surgery 25 (6.5%), deaths 17 (4.4%). As regards in-bleeders, only active bleeding and endoscopic stigmata emerged as statistically significant risk factors for further bleeding. The latter was shown to be significantly related to mortality. The most relevant finding was, however, that NSAIDs and anticoagulants, in association with stress and aging, are very frequently involved in peptic ulcer bleeding of hospitalized patients. The fatal outcome of one third, despite all available treatments, highlights the importance of prevention against drug- and stress-related mucosal damage in in-patients suffering from severe diseases.

Aged↗

PubMed1994

[Intestinal obstruction due to endometriosis of the ileocecal valve].

Intestinal endometriosis can rarely show itself bowel obstruction. An accurate anamnesis, radiological tests and endoscopy are of some use for correct diagnosis. Frequently however, differential diagnosis with others of pathology is not possible either in preoperative or in postoperative management, but by means of histological finding. We present here a case of acute bowel obstruction secondary to ileo-cecal endometriosis.

Acute Disease↗

PubMed1992

[Gastrointestinal hemorrhage from a duodenal diverticulum].

Duodenal diverticuli are often asymptomatic and are occasionally found during the course of X-ray tests or autopsy. They are sometimes manifested in the form of symptoms related to a complication (hemorrhage, perforation, occlusion). The paper reports a case of gastrointestinal hemorrhage caused by a duodenal diverticulum which was then successfully operated. The Authors affirm that in these cases the resection of the portion of the duodenum with the diverticulum (provided the papilla is not affected) is preferable to direct hemostasis or duodenocephalopancreatectomy.

Aged↗

PubMed1992

Splenic torsion: a rare cause of splenomegaly.

The authors report a rare case of splenomegaly, caused by recurring splenic torsion in a 31-year-old patient. On the basis of this experience and literature data, pathogenetic, symptomatological, diagnostic and therapeutic aspects are discussed. Analysis of the clinical history and diagnostic procedures confirm the difficulty in ascertaining this condition preoperatively. In any case, splenic torsion should be considered in the differential diagnosis of painful splenomegalies.

Adult↗

PubMedDate not supplied

[Rupture of the cervical esophagus. Apropos of a case of perforation by a foreign body].

The Authors describe a case of perforation of the cervical oesophagus by a foreign body (dental prosthesis). After outlining the clinical and instrumental elements which may be useful in the diagnosis, the Authors go on to tackle the topic of the most appropriate choice of therapy in the course of foreign-body perforation and in perforation of the oesophagus in general.

Aged↗

PubMedDate not supplied

[Retroperitoneal liposarcoma].

Liposarcoma is the most frequent histotype of the rare and malignant retroperitoneal tumours. This neoplasm has a remarkable tendency to recurrence after surgical excision, rarely to metastasize. Recurrence usually shows a more aggressive behaviour than primitive disease with a higher tendency to penetrate into adjacent organs. The symptomatology often appears late and the first sign is frequently a palpable abdominal mass. Preoperative study involves using CT and MRI. The surgical resection is the only tool able to modify natural history with regard to survival and local recurrence. Prognosis is severe, with a survival of 5 years, variable from 12 to 50% in the different series. A very important prognostic factor is the degree of tumour and radical surgical treatment. From 1990 to 2001, 32 operations for malignant retroperitoneal tumors were performed by our surgical unit in 19 patients; in 7 of them the tumor was a liposarcoma (4 male and 3 female). Total operations for retroperitoneal liposarcoma were 15, in 4 patients a second operation was performed for recurrence, in 3 a third operation and in 1 a fourth. Eleven cases out of 15 have undergone exeresis of sarcoma. Average survival consisted in 4 years and 2 months. Intraoperative radiotherapy, performed in 3 patients, perhaps is able to offer some advantages in relation to local control of the disease and of the survival. A possible resection of eventual recurrence justifies a early follow up with CT and MRI.

Female↗

PubMedDate not supplied

[Gastrointestinal stromal tumors].

Gastrointestinal stromal tumors (GIST) are generally found in the stomach or small intestine and less commonly in the colon or rectum. Complete surgical removal remains the best current therapy for GISTs. The treatment of advanced GIST patients is with imatinib, a selective tyrosine kinase inhibitor. In our series, 23 patients observed between 1994 and 2004 and affected by GIST were treated with complete negative margin resections (three cases by laparoscopy).

Adult↗

PubMedDate not supplied

[Hemorrhages of the lower digestive tract: the diagnostic and therapeutic approach].

The authors describe their experience with colo-rectal haemorrhage. They stress the tendency towards spontaneous arrest of such haemorrhages (92.6% of cases) as the usefulness of emergency colonoscopy in diagnosing the cause and/or site of the haemorrhagic lesion (85.7% of positive results in the present series). Therapy may be conservative (endoscopic or in the course of angiography) or surgical. Surgery is indicated in cases failing to respond to conservative therapy and in cases of unarrestable haemorrhage and usually consists in segmental resection of the portion of the intestinal tract involved.

Adolescent↗

PubMedDate not supplied

[Perforation of the colon by a foreign body].

Perforation of the colon carries a high mortality and morbidity. Perforations caused by foreign bodies are relatively rare and appear to be less often associated with postoperative complications than perforations due to organ disease. Depending upon the extent of the perforation and its anatomical site, as well as on the basis of the presence of diffuse or circumscribed peritonitis, the treatment of foreign-body perforation will vary from simple suturing, with or without a protective colostomy, to exteriorization in the form of a colostomy, and the Hartmann operation.

Colonic Diseases↗