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Biomedical subjects

V Szendrényi

Publications and source records attributed to V Szendrényi.

16 recordsLinked to original sources
PubMed2004

[Surgical treatment of acquired, benign esophago-respiratory fistulas].

BACKGROUND: Acquired, benign esophago-respiratory fistula occurs as a rare complication of different disorders. STUDY DESIGN: Over a period of 30 years, 37 patients with acquired, benign esophago-respiratory fistulas were treated at the authors' institutions. 35 of the 37 patients were operated upon. Acute operation involved primary repair of the trachea and esophagus, or intubation of the gullet and/or gastrostomy. Elective operations were performed on 13 patients. RESULTS: Complications were observed in 14 patients. There were 4 cases with anastomotic leakage (all of them on the neck). Direct closure was carried out in 2 patients; the remaining 2 cases healed spontaneously. None of the 4 patients died. Seven of the 37 patients died (18.9%). This seems acceptable in view of the severity of the cases and the extension of the operations. CONCLUSIONS: 1. The causes of a majority of the esophago-respiratory fistulas in this material are connected with the complications of corrosive injury and peptic stricture of the esophagus. 2. The well-known fact that most of these fistulas occur in the right chest is confirmed. 3. Gastrostomy and/or intubation of the gullet seems to be the best solution for this lesion in the acute cases and in severely ill patients. 4. In elective cases, reconstruction is suggested, if possible in one step.

Adult↗
PubMed2000

[Surgical treatment of Boerhaave's syndrome].

The authors treated four patients with spontaneous oesophageal rupture between 1995 and 1999. The interval from injury to surgical treatment was less than 24 h in two cases, and longer than 24 h in the other two cases. The surgical treatment was primary closure of the rupture and mediastinal drainage with gastrostomy within 24 h after the onset. Septic complications occurred in lately presented patients. In these cases, the surgical treatment consisted of oesophagectomy, mediastinal drainage and feeding gastrostomy. The alimentary tract was reconstructed with interposed ileocolon eight weeks later. Each patients was fully recovered. The authors underline the importance of early diagnosis which obviously determine the prognosis and the choice of surgical treatment. Primary repair is proposed after early diagnosis, however oesophageal resection is recommended 24 h after the injury.

Adult↗
PubMed2000

Lipoma of the liver: a differential-diagnostic problem.

BACKGROUND AND AIMS: Lipomatous tumors of the liver are extremely rare; most of them are found incidentally at autopsy. Appropriate methods of the diagnosis of these lesions are ultrasonography (US), computed tomography (CT) and biopsy. CASE REPORT: The case of a 65-year-old man who had undergone an upper-rectum resection because of exulcerated adenocarcinoma of the rectum is described. Six months later, routine control examination revealed a solid tumor in the left lobe of the liver. The tumor was not demonstrated by either sonography or CT before the operation. Repeated US, CT scan and fine-needle biopsy could not exclude the possibility of a metastatic tumor secondary to previous malignancy. The lesion was removed by wedge resection and was proven to be a lipoma. CONCLUSION: Despite adequate preoperative examination (CT, biopsy and US), an anamnestic adenocarcinoma of the rectum can lead to inappropriate therapy. The inadequate result of our therapeutic policy can be explained by the extremely rare incidence of lipoma of the liver.

Adenocarcinoma↗
PubMed1999

[Esophago-pericardial fistula caused by recurrent esophageal tumor].

The esophago-pericardial fistula is a rare disease that causes a rather high mortality. Up to now less than 70 cases were published in the literature. The authors report an esophago-pericardial fistula caused by recurrent esophageal tumor one year after resection in the lower third esophagus for esophageal cancer. With conservative treatment the patient was kept alive for a month. No case report can be found in the literature of an esophago-pericardial fistula of the same etiology.

Esophageal Fistula↗
PubMed1998

[Drug therapy of gastroesophageal reflux (a prospective controlled clinical trial)].

One year follow up(1.5, 3, 6, 12 months) study was established to examine the role of several classes of drugs in the treatment of reflux disease in 40 patients on the basis of objective control parameters (pH-metry, endoscopy, histology). The therapy was initiated, respectively, the different stage of severity (Savary-Miller): in stage 0 sucralfate + domperidone, in stage I and II: ranitidine + domperidone and in stage III-IV omeprazole was introduced. Our results proved that sucralfate + domperidone is curative on reflux oesophagitis in stage 0 cases. In stage I sucralfate and domperidone were effective in 3 of 9 cases, ranitidine + domperidone was optimal in 5 of 9, and omeprazole was required in 1 of 9 patients. In stage II, ranitidine + domperidone was effective only in 4 of 11 patients, and the initial therapy was modified to omeprazole in 7 of 11 patients to find the optimal drug in this stage. In stage III and IV only omeprazole showed curative effect and the doses required were 20 mg in 8 of 13 and 40 mg in 5 of 13 patients. The complaints improved in 34 of 40 patients after 6 weeks treatment, while histological healing of reflux oesophagitis was observed in 12 of 40 cases. After 3 months the endoscopic healing rate was 28/40, but histological healing could be reached after 6 months of optimal treatment in 30 of 40 cases. We can conclude, that the optimal drug selection may result a rapid improvement of complaints, but endoscopic and histological regeneration of the oesophageal mucosa is more graduated with time. The healing process of the reflux oesophagitis requires 3 months. Proton pump inhibitor drugs have an enhanced role in the treatment of gastrooesophageal reflux disease, and our results proved that the efficient and safety treatment of mild form (stage II) of disease requires the administration of proton pump inhibitors.

Adult↗
PubMed1997

[Treatment of achalasia of the cardia using thoracoscopic esophago-myotomy].

We performed left thoracoscopic esophagomyotomy in four patients suffering from achalasia cardiac. In one patients the esophageal mucosa was opened during the myotomy. This was sutured through thoracoscopy and the per os feeding of the patient started on the 8th postoperative day, while in the other three patients this was done on the 2nd postoperative day. The mean emission of the patients was on the 6th postoperative day. Comparison of the status before and 6 weeks following the operation was done on the basis of results of different examinations i. e. x-ray, esophago-gastroscopy, manometry, pH-metry, isotope test. The favourable results of the operations were declared as all examinations revealed marked improvement and all patients have better swallow function and 6-9 kg increase in body weight.

Adult↗
PubMed1996

[Hepatitis C virus antibody in the serum of blood donors].

Authors investigated the presence of antibody to hepatitis C virus (anti-HCV) at 67,534 blood donations, and alanin-amino-transferase (ALT) levels were analysed at the same time. The prevalence of anti-HCV antibody was 0.73% at 15,864 blood donors. Frequency of positive reactions of anti-HCV antibody increased paralelly with advance of age. Increased or high serum ALT level was found at more than 50% of samples with positive HCV reactivity. At the base of follow-up the blood donors were screened out from blood donation temporarily or definitively. Anti-HCV donors were taken to hepatic care. The treatment with interferon of HCV seropositive donors proved by PCR (polimerase chain reaction) was started. Transfusion and tattou are underlined as risk factors of HCV infection. The data were analysed according to sex and ages.

Adolescent↗
PubMed1996

[Evaluation of complaints and diagnostic methods, considered to be objective, in gastroesophageal reflux].

Authors analyse complaints of 166 patients suffering in gastroesophageal reflux disease, and results of different objective diagnostic methods (X-ray swallowing, endoscopy, 24 hour pH-monitoring, esophageal manometry). The degree of severity of typical complaints and changes found by diagnostic procedures were scored. Individual diagnostic proceduresindicated the characteristic changes of gastroesophageal reflux with great deviations. Hiatal hernia identified by x-ray, esophagitis observed by endoscopy, abnormal reflux revealed by pH-metry together occurred only at 36% of patients. Significant correlation could be revealed only between the degree of changes found by x-ray or pH-metry--applying them one by one--and the complaints of the patients, but with the combination of four diagnostic methods a tight, positive correlation could be demonstrated with the severity of the complaints of the patients in every case. Applying of diagnostic methods as much as possible completing each others, with consideration to the complaints of the patients is suggested for having the diagnosis been precise of the gastroesophageal reflux disease, and for measuring of efficacy of treatment. The importance of tight collaboration of internist, radiologist and surgeon and the significance of complex examination is underlined.

Esophagoscopy↗
PubMed1994

[Radioisotope study of esophageal transit].

Diagnostics relating to esophageal motility disorders has come into the focus of attention in recent years. A review is made of the possibilities of application of radioisotope esophageal transit measurement. The methods employed and the models of data recording and processing in this field are listed. The value of this procedure in different esophageal disorders is discussed in detail. Two characteristic cases are reported to illustrate the method. It is concluded that measurement of the radionuclide esophageal transit is a noninvasive, simple and safe technique for the screening of esophageal motility dysfunction.

Esophageal Motility Disorders↗
PubMed1993

[Endoscopic and surgical removal of foreign bodies from the upper gastrointestinal tract].

Results of management of 67 patients who swallowed foreign bodies are discussed. Types of foreign bodies, the importance of previous esophageal strictures, the rare diagnostic difficulties and the different clinical signs are analyzed. Authors stress that the most frequent causes of the artificial esophageal perforation are the endoscopic removal of swallowed foreign bodies. A surgical intervention in 14 cases was necessary. Three patients were lost after the surgical intervention.

Adolescent↗
PubMed1992

[Esophageal dilatation using the Savary-Gilliard sound set].

Authors present a method of esophageal dilatation and report their experiences. The place of esophageal dilatation among other therapeutic approaches of esophageal stricture is discussed. The advantage of Savary-Gilliard bougies and guide wire and its applications are presented. During one and a half year 218 esophageal dilatations were performed at 82 patients. 11 patients were intubated endoscopically. Esophageal perforation occurred in 2 cases (0.93%). Dilatation of the esophagus with Savary-Gilliard bougies and using of the guide wire are considered a safe and many-sided method in the diagnosis and treatment of esophageal strictures.

Dilatation↗
PubMed1992

[Barrett esophagus].

There are a lot of contradiction and uncertainty related to Barrett's esophagus. Authors review the literature about the incidence, the aetiology, the pathology of the ailment, the possibility of diagnosis and treatment. 25 Barrett's esophagus were observed in the course of controlling of patients after antireflux operations and investigations of patients suffering from gastroesophageal reflux disease. X-ray examination, endoscopy, biopsy, 24-hour pH monitoring of the distal esophagus and esophageal manometry were performed. Because of the possibility of malignant transformation Barrett's esophagus requires yearly endoscopic surveillance and biopsy at least. Antireflux procedure does not protect against the development of adenocarcinoma.

Barrett Esophagus↗
PubMed1992

[Reconstruction of the mandible using a vascularized graft from the iliac bone].

Twelve vascularized iliac crest free-tissue transfers were used for oromandibular reconstruction, 2 as osteocutaneous and 10 as osseous flaps. Two patients had preoperative radiotherapy. Nine of the 12 reconstruction were carried out primarily, following radical surgery for oral cancer. One graft was lost by venous thrombosis. Evidence of bone union was noted in 11 patients, and no pseudoarthrosis was observed. The main advantage of this method is the availability of a large bloc of living composite tissue and both the functional and cosmetic results should be improved in patients undergoing resection of the anterior part of the mandible.

Bone Transplantation↗
PubMed1991

[Incidence of fungal infection in surgical diseases of the pancreas].

Recently the number of mycotic infections has increased significantly. Authors have observed 13 mycotic infections on operated patients suffering pancreatic diseases between 1984 and 1990. 9 of 13 patients had pancreatic abscesses as well. The risk factors of fungal infections are analysed. It is important to take differentiation between fungal colonisation and septicaemia caused by yeasts. Repeated microbiological examinations can promote recognising of the fungal invasion. The base of the therapy is to avoid risk factors of infections and to use antifungal medication in time.

Abscess↗