Biomedical subjects
Publications and source records attributed to R Rivetti.
The Authors report some observations on gallbladder calcification with the presentation of two clinical cases. The pathologic anatomy and the clinical aspects of this infrequent affection are described. The Authors underline the importance of surgical treatment, considering the frequency of carcinoma in porcelain gallbladder.
The Authors report a case of carotid bifurcation endarterectomy under loco-regional anesthesia. Despite a stump pressure of 44 mmHg, considered by the most of the Authors, the borderline value for carotid endarterectomy without shunt, the patient had a cerebral ischemic attack after 30 seconds of carotid clamping. So, the local anesthesia represents a valid alternative in order to detect an intolerance to clamping and underlines the importance of cerebral protection in this kind of surgical approach.
Sixty consecutive cases of tumor of the right colon operated upon between 1981 and 1991 are reviewed. Age and sex distribution, clinical findings, preoperative diagnostics and system used staging, TNM classification, surgical management, operative mortality, follow up and survival were analyzed. Results are discussed and compared with published data. In the second of the two 5-year period considered an increased incidence of right-sided carcinoma compared with tumors of the left colon and rectum was observed. According to the TNM classification, more than 50% of patients were in stage III. Operative mortality was 5%. The overall 5-year survival rate was 58%, while the survival rate of patients treated with radical intent was 70%.
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The Authors report a case of coeliac axis atheromatous obstruction, with superior mesenteric artery steal. The coeliac axis, stopped up the origin was indirectly revascularized by hepatic artery. The early diagnosis of chronic intestinal ischaemia should avoid the intestinal infarction. The development of intravenous digital angiography will certainly help an early diagnosis.
A case of emergency revascularisation of the hepatic artery for liver necrosis following its forced ligature during corpo-caudal pancreatectomy for cancer of the pancreas in referred. Necrosis protection mechanisms, namely higher portal flow, increase in O2 extraction and collateral circulation are analysed. The therapeutic aids for preventing this serious event are presented. It is considered that peripheral expansion of the hepatic artery thrombosis prevented the installation of a valid collateral circulation, although the hypothesis of a reduction in portal flow should not be ignored.
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