Biomedical subjects
Publications and source records attributed to A Andrade.
We present a case of gastrocolic fistula secondary to a benign gastric ulcer. In our Knowledge, this is the first reported case with an endoscopic diagnosis using the video-system; we did a complementary upper radiological series with oral contrast. This patient was treated with a subtotal gastrectomy and primary closure of the colonic defect.
AIM: To determine the incidence of recent coronary thrombus in a population died of acute myocardial infarction (AMI) and to evaluate the relation between its presence and some clinical parameters (age, gender, time interval between the onset of symptoms and death and cause of death). POPULATION AND METHODS: 167 hearts of consecutive patients died of AMI and without thrombolytic therapy. Hearts were fixed in formaldehyde 10% for two weeks and then the epicardial coronary arteries were divided in 5 mm segments, which were examined by visual inspection to identify recent thrombi. Cuts for microscopical observation were obtained in cause of doubt. In each patients a clinical protocol with 64 parameters is performed. In statistical treatment Pearson's dispersion test and Student's t test were used. RESULTS: We found coronary thrombus in the infarction related artery in 74%. The thrombus distribution in the epicardiac coronary arteries was the following: 47% in the anterior descendent artery, 27% in the right coronary artery, 21% in the left circumflex and 5% in the left main. The comparison between the groups with and without coronary thrombus showed no differences in age and gender, but the time interval between AMI and death was shorter in the group with thrombus. Concerning the different causes of death (cardiac failure, cardiac rupture and others) the coronary thrombus prevailed in the group with left ventricule free wall rupture. There was no influence of the time interval between AMI and death on the larger prevalence of coronary thrombus found in cardiac rupture. CONCLUSIONS: The frequency of recent coronary thrombus in the infarction related artery was of 74% in this group of patients died of AMI without thrombolytic therapy. The presence of coronary thrombus was not related with patients age or gender. The frequency of coronary thrombus was inversely proportional to the time interval between AMI and death, and larger in the group with left ventricule free wall rupture.
Biliary Cystadenoma are rare benign neoplasms that occurs mainly in young women. Clinical features includes abdominal pain and biliary obstruction. The diagnosis is for clinical features and radiologic method, but require the pathological report. The treatment is surgical. We report a 30 years old woman, with biliary obstruction and radiological findings of a neoplasm located in the left hepatic duct, that was surgically removed. The pathological report was a biliary cystadenoma. We discuss the clinical radiological and pathological tindings.
Enterocutaneous fistulas are not a minor problem in gastrointestinal tract surgery. Significant reduction of mortality and morbidity has been attained but they still remain high. The authors report three clinical cases in which they sealed and treated enterocutaneous, chronic, iatrogenic fistulas by injecting biological glue (N-Butil 2-Cyanoacrylate-Histoacryl) into the internal opening and fistulous tract. We believe that the technic we propose here, in the proper setting, may be an important contribution to the management of iatrogenic (postoperative) enterocutaneous fistulas.