Biomedical subjects
Publications and source records attributed to S Kandylakis.
Gastric outlet (GO) obstruction in an adult is usually caused by intrinsic gastric or duodenal lesions or pancreatic tumours. This study describes a case of a 77-year-old man who developed GO obstruction due to extrinsic compression from a large gastroduodenal artery aneurysm under rupture. This cause of GO obstruction has never previously been reported in the literature.
Laparoscopic surgery has opened a new era in the management of surgical diseases. But, on the other hand, has created problems relating to the technological and to the technico-surgical aspects. In the preoperative evaluation of laparoscopic cholecystectomy candidates it is very important to know about the pathological state of the gallbladder, which may become the cause of very difficult or impossible laparoscopic operation, and the convert in an open procedure will be forced. Recurrent gallbladder inflammations provoke alterations of the normal structure of the wall (oedema, fibrosis) and normal elasticity and contraction after stimulation is last. Adhesion with neighbouring organs hinder contraction as well, and surgical difficulties increase. Choledocholithiasis must be known before operation, to plan surgical strategy. The presence of choledochus disease does that allow us to modify its calibre after stimulation. 100 patients who underwent laparoscopic cholecystectomy, in our Department, were evaluated before with dynamic ultrasonography (DUS), and the results were compared with operating finds. In this paper are exposed the used method of evaluation and the results of this work. These results allow as to state that the method is effective and trustworthy.
Usually, pneumoperitoneum is due to perforation of a hollow abdominal organ. In the absence of peritoneal symptoms, pneumoperitoneum may be due to other causes. Two patients with pneumoperitoneum without perforation were treated in our department. A 41-year-old female patient was admitted to our hospital with abdominal pain for 12 hours, without vomiting. On abdominal examination fullness of the liver was absent, the abdomen was not distended and there were no signs of peritoneal irritation. The roentgenogram showed free air under the diaphragm. Laparotomy was performed because of the abdominal complaints. No perforation could be found. A 70-year-old female patient was admitted to the hospital because of mild abdominal pain. For a week she had a severe attack of coughing due to bronchitis. Big capacity of air had been blown in the stomach without abnormalities in the roentgenologic examination. The treatment was conservative. Both patients left the hospital in good health. More knowledge of the less frequent causes of pneumoperitoneun without perforation can possibly contribute to to refraining from exploratory laparotomy in these cases.