Biomedical subjects

Spiros Rizos

Publications and source records attributed to Spiros Rizos.

10 recordsLinked to original sources

PubMed2006

Desmoid tumor in Gardner's Syndrome presented as acute abdomen.

BACKGROUND: Gardner's syndrome can occasionally be complicated with intra-abdominal desmoid tumor. These tumors usually remain asymptomatic but can exhibit symptoms due to intestinal, vascular and ureteral compression and obstruction. CASE PRESENTATION: A rare case of a 41-year-old male patient with Gardner's syndrome complicated with intra-abdominal desmoid tumor, which first presented as acute abdomen, is presented. CONCLUSION: Extra-abdominal manifestations of Gardner's syndrome along with a palpable abdominal mass would raise suspicion for the presence of a desmoid tumor in the majority of cases. In life-threatening cases, surgical treatment should be considered as a palliative approach, though the extent of excision remains debatable.

Journal Article↗

PubMed2006

Anorectal incontinence. pathogenesis and choice of treatment.

Fecal incontinence represent a complex and multifactorial disorder. Although the condition is widely accepted as belonging to the elderly, it is now becoming apparent that younger adults are also frequently affected. Its incidence is estimated at 2% of the general population, while in the elderly it may increase up to 60%. Despite the considerable advances that have been made in the evaluation of anorectal incontinence during the past decades, the cause of this entity still remains obscure. The patient's history, the physical examination, and specialized investigations are essential for the diagnosis and the selection of the appropriate treatment. In clinical practice the most useful tests are the anorectal manometry, the anal endosonography and the pudendal nerve latency. Complete functional and anatomical assessment of the anorectum, the anal sphincters, and the pelvic floor is mandatory in all patients with fecal incontinence for the appropriate diagnosis and identification of the cause, the type of incontinence and the selection of the appropriate treatment.

Anal Canal↗

PubMed2005

A rare case of ascending colon actinomycosis mimicking cancer.

BACKGROUND: Actinomycosis is a rare inflammatory disease caused by an anaerobic bacterium that can rarely affect the large intestine. CASE PRESENTATION: We present a rare case of a cecum and ascending colon actinomycosis in a 72 years old woman, mimicking clinically a malignant inflammatory tumor of the right colon. The patient complained of right lower quadrant pain. Although our first thought was a peri-appendiceal abscess, CT scan suggested a right colon tumor. The patient underwent a right colectomy and the histological examination of the specimen revealed colon actinomycosis. CONCLUSIONS: Preoperative diagnosis in colon actinomycosis is difficult to achieve. Treatment of choice is antibiotics administration. A review of the possible pathogenesis and therapeutic modalities is also presented.

Actinomycosis↗

PubMed2004

Rupture of totally implantable central venous access devices (Intraports) in patients with cancer: report of four cases.

BACKGROUND: Totally implantable central venous access devices (intraports) are commonly used in cancer patients to administer chemotherapy or parenteral nutrition. Rupture of intraport is a rare complication. PATIENTS AND METHODS: During 3 years period, a total of 245 intraports were placed in cancer patients for chemotherapy. Four of these cases (two colon cancer and one each of pancreas and breast cancer) had rupture of the intraport catheter, these forms the basis of present report. RESULTS: Mean time insitu for intraports was 164 (35) days. Median follow-up time was 290 days and total port time in situ was 40180 days. The incidence of port rupture was 1 per 10,000 port days. Three of the 4 cases were managed by successful removal of catheters. In two of these the catheter was removed under fluoroscopic control using femoral route, while in the third patient the catheter (partial rupture) was removed surgically. One of the catheters could not be removed and migrated to right ventricle on manipulations. CONCLUSION: Port catheter rupture is a rare but dreaded complication associated with subcutaneous port catheter device placement for chemotherapy. In case of such an event the patient should be managed by an experienced vascular surgeon and interventional radiologist, as in most cases the ruptured catheter can be retrieved by non operative interventional measures.

Journal Article↗

PubMed2004

Modified capitonage in partial cystectomy performed for liver hydatid disease: report of 2 cases.

BACKGROUND: Several techniques have been described in liver hydatid disease surgery, with most well known partial cystectomy, capitonage and introflexion. METHODS: We present a technical modification on open partial cystectomy for liver hydatid disease. We performed this operation in 2 patients with liver echinococcosis. The cyst is being unroofed and evacuated from the daughter cysts. The identified bile vessels ligated. The remnants of the anterior wall (capsule of the cyst) are anchored with sutures in the posterior wall in a manner that the cavity of the cyst disappears. RESULTS: In both patients the disease eradicated. No postoperative complications were observed including bile leaking and/or abscess formation. CONCLUSIONS: Our technique helps in the fast, and effective mobilization of the patient, as well as in the minimization of postoperative bile leaking.

Albendazole↗

PubMed2004

Primary combined intra- and extra- abdominal actinomycosis. A case report.

Actinomycosis is an infrequent chronic progressive granulomatous and suppurative disease. This infection is caused by Actinomyces israelii, normally present in healthy individuals. We present a rare case of a combined intra- and extra- abdominal actinomycosis in a 50 year old female patient, with no underlying predisposing factors. The patient complained of a right lower quadrant pain. Although we first diagnosed a peri-appendiceal abscess, the CT scan suggested a right colon tumor. The patient underwent segmental colectomy and the histological examination of the specimen revealed colon actinomycosis. A review of the possible pathogenesis and therapeutic modalities is also presented.

Abdomen↗

PubMed2004

Sport related plantar fasciitis. Current diagnostic and therapeutic advances.

UNLABELLED: Plantar fasciitis is the most common diagnosis for pain in the inferior aspect of the heel among runners, accounting for 10% of injuries that occur in connection with running. The etiology of pain is multifactorial. The aim of the present study is to report our experience in the treatment of plantar fasciitis in athletes and compare our diagnostic strategy and treatment modalities with the current practice. MATERIAL AND METHODS: We treated 32 athletes with plantar fasciitis from 1997-2002. The diagnostic procedure included detailed history, clinical examination and imaging techniques. Conservative treatment consisted of anti-inflammatory drugs, stretching exercises, suitable training routines and special orthotic insoles, which offer a good chance of complete resolution of symptoms. Surgical fasciotomy should be reserved for use in patients in whom conservative measures have failed. RESULTS: Conservative treatment consisting of rest, anti-inflammatory medications, stretching exercises and special orthotic insoles was efficient in 26 patients (81%), while only 6 (19%) had to be treated surgically. CONCLUSION: Plantar fasciitis is a common disorder among athletes. Patient's history, clinical examination and common imaging techniques help to make the correct diagnosis. The patient should be treated conservatively at first and only in severe cases surgically.

Adult↗

PubMed2004

Electrocardiographic changes after laparoscopic cholecystectomy.

AIM: To determine whether ECG changes observed after laparoscopic cholecystectomy could be correlated with procedure characteristics. MATERIAL AND METHODS. We studied prospectively 500 patients who underwent laparoscopic cholecystectomy for documented gallstones and prior history of cardiovascular disease, volume of carbon dioxide insufflated in the peritoneal cavity, duration of the procedure and intra-abdominal pressure created. RESULTS: We found that 9 (1.8%) patients developed LV strain, 2 (0.4%) patients--atrial fibrillation, 2 (0.4%) patients--tachyarrhythmia in the presence of AF, 1 (0.2%) patient--RBBB and 1 (0.2%) patient--myocardial ischemia with ST depression regarding these ECG leads. Statistical analysis of the data was performed using multifactorial logistic regression analysis. These changes were not correlated to the above referred procedure characteristics. CONCLUSION: We conclude that ECG changes are frequent events after laparoscopic cholecystectomy (3%) but are not correlated to prior history of cardiovascular disease, the duration of the procedure, the volume of carbon dioxide insufflated and the intra-abdominal pressure.

Arrhythmias, Cardiac↗

PubMedDate not supplied

Fournier's gangrene. Immediate diagnosis and multimodality treatment is the comerstone for successful outcome.

BACKGROUND: Fournier's gangrene is a synergistic necrotic fasciitis or myositis of genitalia, perineum and abdominal wall. Several etiologic factors have been reported, microorganisms isolated and co-morbidity factors identified. Immediate and accurate diagnosis decreases mortality rate, which ranges from 3-67%. Aggressive resuscitation and surgical debridement consist the appropriate treatment. MATERIAL AND METHODS: Six cases of Fournier's gangrene treated the last ten years were reviewed. Three of them presented with mild infection while the other three with severe. The mean time interval between first symptoms and initial treatment was 2.1 days. The diagnosis was set immediately and the treatment included fluid-electrolyte resuscitation, aggressive surgical debridement, and broad-spectrum antibiotics administration. RESULTS: All patients survived. The defects healed by second intention in four patients and only in two patients specific plastic reconstructive techniques were required. Hyperbaric oxygenation administrated in one patient induced surprisingly the healing of the lesion. CONCLUSIONS: The Authors confirm that Fournier's gangrene is a rare and potentially fatal disease. Early suspicion, accurate diagnosis and multimodality treatment including aggressive surgical intervention are essential for successful outcome.

Adult↗

PubMedDate not supplied

Malignant proliferating trichilemmal tumour of the scalp. Report of a case and a short review of the literature.

BACKGROUND: Malignant proliferating trichilemmal tumour is a rare skin tumour that originates from the root sheath of the hair and usually arises in the sun-exposed areas of elderly women. It mimicks poorly differential squamous cell carcinoma ant its biological behaviour is unpredictable, because rarely can produce distant metastases. CASE REPORT: The Authors report on a case of a 54-year-old female patients who proceeded with a cystic lesion in the scalp. The lesion was removed with wide excision. The histological examination of the lesion revealed a malignant proliferating trichilemmal tumour. Two years after the excison the patients is free of disease. DISCUSSION: Only few cases (about seventy) of malignant proliferating trichilemmal tumours have been reported in the Bibliography, in some of the patients with malignancy, the tumour produces distant metastases. In the reported case, although the high risk of distant metastasis, two years after the tumour resection the patient is free of disease, It is also reported a short review of the literature. CONCLUSIONS: Malignant proliferating trichilemmal tumours are rare malignant lesions that affect mainly older women. The appropriate treatment includes wide resection and dose postoperative follow-up of the patient to facilitate the early diagnosis of distant metastases.

Female↗