Rev Esp Enferm Dig
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Review Case Reports
[An aneurysm of the inferior mesenteric artery associated with obstruction of the superior mesenteric artery and the celiac trunk].
The exact prevalence of visceral arteries aneurysms is not well documented and its is mainly known from necropsies. Inferior mesenteric artery aneurysms are the rarest of visceral aneurysms. ⋯ The aneurysm was resected with superior and inferior mesenteric arteries revascularization. Surgical approach is needed in these aneurysms and when they are associated with obstructive disease of other intestinal artery, revascularization is mandatory.
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Review Case Reports
[Hypersplenism secondary to splenic tuberculosis].
We report a case of abdominal tuberculosis with predominant splenic involvement and hypersplenism in a patient without any risk factor for tuberculosis. We review the literature and emphasize the unusual splenic involvement, the difficulties in the specific diagnosis and the therapeutic strategy. We conclude that this disease should be included in the differential diagnosis of hypersplenism.
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Review Case Reports
[The treatment of a simple pancreatic pseudoaneurysm or one associated with hemosuccus pancreaticus].
When a permanent communication occurs between an artery and a pancreatic pseudocyst, the pseudocyst becomes a pseudoaneurysm. Pancreatic pseudoaneurysms are primarily found in patients with alcoholic chronic pancreatitis. Fistulization of a pseudoaneurysm into the main pancreatic duct results in ductal hemorrhage. ⋯ We herein describe two patients with alcoholic chronic pancreatitis and pancreatic pseudoaneurysm; one patient presented with ductal hemorrhage. The inferior pancreatico-duodenal artery was the affected vessel. Both patients were treated with suture-ligation; an internal drainage was added to the patient presenting with ductal hemorrhage.
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The literature of infections after colo-rectal surgery is reviewed, including the influence of mechanical preparation and the prophylactic use of various antibiotic combinations, orally or parenterally. Is is concluded that appropriate prophylaxis is mandatory. Third generation cephalosporins singly or in combination seem to give the best results in the majority of reports. They are economically justified as prophylaxis with antibiotics decreases hospital costs.
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The only non-general sensation that can be elicited from the gastrointestinal (GI) tract is that of pain, which can go from slight discomfort to severe pain. However, in certain parts of the intestine, such as the rectum and gastroesophagus, the sensation of pain can be preceded by a non-painful sensation of distension at low levels of stimulation. GI pain is often dull, poorly defined and difficult to pinpoint. ⋯ In any case, the number of afferent nociceptive fibers in the intestine is minimal, and this accounts for the fact that large areas of the GI tract appear to be insensitive or to require considerable stimulation before pain can be elicited. The few afferent nociceptive fibers contained in the sympathetic nerves can excite quite a few second order neurons in the medulla spinalis, which in turn generate an extensive divergence within the medulla spinalis and brain stem, including at times long supraspinal branches. This divergent input can activate different motor, autonomous and sensory systems, thus triggering the general reactions which characterize visceral nociception: diffuse pain which is difficult to pinpoint, referred at times to somatic areas, and autonomous and somatic reflexes resulting in prolonged motor activity.