Hepato Gastroenterol
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Hepato Gastroenterol · Nov 2002
Gastrectomy circumstances that influence early postoperative outcome.
Despite decreasing mortality, gastric resection is still a procedure of significant morbidity. ⋯ Gastrectomies for cancer, especially when done electively with curative intent, can lead to excellent postoperative recovery. Palliative gastrectomies or emergency procedures for "benign" conditions have significantly more complicated outcomes.
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Hepato Gastroenterol · Nov 2002
Case ReportsEarly diagnosis and radical surgical treatment of Budd-Chiari syndrome.
We report a 26-year-old woman who was diagnosed with Budd-Chiari syndrome following consultation for a skin nodule in the lower extremity. Histopathological examination of a biopsy specimen showed features of erythema induratum. As part of the diagnostic work-up, chest roentgenography performed to rule out possible tuberculosis showed enlarged right lower mediastinum. ⋯ One-stage surgical reconstruction of the vascular abnormalities affecting inferior vena cava and hepatic vein using autologous pericardial patch was performed 11 months after angioplasty, which resulted in normalization of blood flow. Examination of a liver biopsy obtained intraoperatively revealed hepatic fibrosis compatible with early-stage Budd-Chiari syndrome. No complications were noted postoperatively and the nodular lesion in the lower extremity disappeared after surgery.
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Stricture of the upper digestive tract is the most feared sequelae of caustic ingestion. Determinant risk factors for its development are not entirely known. The aim of this study was to investigate the risk factors associated with the development of fibrotic strictures induced by caustic ingestion. ⋯ Severe endoscopic lesions, involvement of the entire length of the esophagus, hematemesis and increased serum lactic dehydrogenase represent risk factors for the development of fibrotic strictures induced by caustic ingestion. Assessment of these parameters may contribute to prevent this complication.
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Hepato Gastroenterol · Sep 2002
Review Case ReportsTreatment of superior mesenteric artery embolism with a fibrinolytic agent: case report and literature review.
Successful treatment of superior mesenteric artery embolism depends on an aggressive approach in patients at risk for mesenteric ischemia. This approach favors an early diagnosis and permits the reestablishment of arterial flow within an appropriate time, with prevention of vasospasm and control of organic insufficiencies. We report here a case of superior mesenteric artery embolism in which arterial flow was reestablished by selective intra-arterial infusion of streptokinase. ⋯ This procedure could be an alternative to embolectomy in selected patients, i.e., patients with an early diagnosis, no evidence of intestinal necrosis and with partial occlusion and/or occlusion of secondary branches of the superior mesenteric artery. Frequent arteriographies and intensive care are necessary in this approach. The patient should be continuously monitored because of the possibility of treatment failure and the need for embolectomy.
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Hepato Gastroenterol · Sep 2002
Respiratory function after esophagectomy for patients with esophageal cancer.
Postoperative respiratory hypofunction sometime ruins quality of life of patients with esophageal cancer. From 1993, we introduced transhiatal esophagectomy without thoracotomy as a less invasive surgery to prevent postoperative respiratory complications for patients who have relatively early stage of esophageal cancer and have preoperative respiratory complication, or who are older in age. In this study, postoperative long-term evaluation of respiratory functions of patients with esophageal cancer who underwent esophagectomy was performed. ⋯ In patients treated with transthoracic esophagectomy, postoperative respiratory hypofunctions continued over 6 months after surgery. However, postoperative respiratory complications may not be related with the long-term postoperative respiratory hypofunction in patients with esophageal cancer.