Biomedical subjects
Publications and source records attributed to R Lombrozo.
Laparoscopy using carbon dioxide has been a standard gynecological procedure for many years. During the past 3 years, it has become commonly used in general surgery as well. Laparoscopic cholecystectomy is rapidly spreading world-wide. Although minor and major complications have been attributed to this procedure, their frequency is low. We report a case of subcutaneous emphysema following laparoscopic cholecystectomy.
The efficiency of magnetic resonance imaging (MRI) and that of transrectal ultrasound (TRUS) were compared in preoperative staging of 15 patients with rectal cancer and in postoperative follow-up of 12 patients. Thirteen of the 15 patients evaluated for preoperative staging were operated on. Preoperative staging and pathologic finding were identical in 11 patients (84.6 percent) examined by TRUS and in 10 patients (76.9 percent) examined by MRI. Recurrent cancer was detected in 3 of 12 patients in the follow-up group. MRI was able to diagnose correctly 10 of 12 patients (83.2 percent), one patient was misdiagnosed, and in one patient the MRI could not distinguish between fibrous tissue and recurrent cancer. TRUS diagnosed correctly only 5 of 12 patients (41.6 percent). One was falsely diagnosed, and, in 6 patients (50 percent), this examination could not differentiate between fibrous tissue and recurrent tumor. According to our results, both MRI and TRUS have a place in the preoperative staging of patients with rectal cancer. The main differences between the two methods were in the differential diagnoses of fibrous tissue and recurrent cancer. MRI being more specific in detection of recurrence.
The installation of the ventriculo-peritoneal shunt (VPS) is on the rise in the pediatric age. Its obstruction is a major cause for further deterioration of the already present hydrocephalus. Distal VPS obstruction may be due to a pseudocyst, an infected pseudocyst or an abscess-formation within the peritoneal cavity. These pathologies are identified through an abdominal radiograph and ultrasonography. The sonographic signs are described and its differential diagnosis is discussed in relation to 6 diagnosed cases. One VPS was obstructed by Ascaris lumbricoides clinging to its tip within an abscess.
Early recognition and adequate treatment of neutropenic enterocolitis, a life-threatening complication of aggressive chemotherapy for leukemia, lymphoma or other malignancy, may offer a favorable outcome. Three cases are presented, including the first reported occurrence in a child with osteogenic sarcoma. Two patients were treated surgically and the third conservatively.
In a premature infant documented to have oesophageal atresia laparotomy revealed the additional findings of segmental dilatation of the small intestine as well as duodenal atresia, the coincidental occurrence of which is extremely rare. Resection of the dilated segment was performed with end-to-end one-layer anastomosis and side-to-side duodeno-duodenostomy and a feeding gastrostomy was created. Three months later end-to-end oesophago-oesophagostomy was successfully performed via a right thoracotomy. During the 8 years since then the child's growth and development have been normal.
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In a 7-day-old infant referred because of bile-stained vomiting, jaundice and lack of meconium, radiological examination revealed the 'double-bubble' sign of duodenal atresia as well as dextrocardia. This infant also had a strawberry haemangioma on the right shoulder. Operation disclosed situs inversus and a preduodenal portal vein as well as duodenal atresia. A side-to-side duodeno-jejunostomy was performed successfully without damage to the anomalous vein. The history of polyhydramnion during gestation, the presence of other anomalies, the rapid onset of bile-stained vomiting and the classic 'double-bubble' sign, together appeared to indicate that the duodenal atresia was intrinsic and not due to the external pressure of the anomalous vein on the duodenum.
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We describe a patient in whom retroperitoneal dissection of an infected pseudocyst of the pancreas into the left inguinal region imitated an incarcerated hernia. The high level of diastase (32,000 units/ml) in the fluid from the inguinal region and the roentgenologically demonstrated communication between the pancreas and the left inguinal region proved that the source of the fluid was the pancreas. The appearance of a mass in the inguinal region in an alcoholic patient who has recently had pancreatitis should arouse suspicion of an origin in a dissecting pseudocyst of the pancreas.
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