Biomedical subjects

A Hubens

Publications and source records attributed to A Hubens.

86 records · Page 5Linked to original sources

PubMedDate not supplied

Peritoneal lavage in acute pancreatitis. An experimental and clinical study.

Experiments were performed to evaluate the use of peritoneal lavage in dogs, in which an acute non fatal necrotic-hemorrhagic pancreatitis was obtained by means of intraductal sodium-taurocholate injection. A single lavage of 2 liters of a balanced solution 6 hours after the pancreatitis onset produced a temporary biochemical improvement, as evidenced by the amylase, lipase and alcaline phosphatase values. Triple lavage with or without heparin, performed after 6, 18 and 24 hours, produced on the other hand clearcut reduction in mortality rates and long lasting improvement of the biochemical parameters. Two patients with operatively confirmed necrotic hemorrhagic pancreatitis were treated by the lavage method during three days. The treatment resulted in a significant improvement of the clinical condition and the biochemical parameters of both patients.

Acute Disease↗

PubMedDate not supplied

[Conservative treatment of a traumatic biliopleural fistula].

Conservative management of a traumatic biliopleural fistula. A female patient, 13 years of age, developed a right-sided haemothorax after a stab wound in the right para-vertebral region. Pleural effusion reoccurred after thoracic drainage was stopped. Ten days after the injury, thoracic puncture enabled a diagnosis of biliopleural fistula to be made, confirmed by ERCP and CT-scan. The fistula closed after repeat thoracic drainage combined with prophylactic antibiotic therapy.

Adolescent↗

PubMedDate not supplied

[Aneurysms of the splanchnic region].

Splanchnic artery aneurysms. The management of 16 patients, presenting with splanchnic artery aneurysms is reviewed in a retrospective study. 5 patients presented with aneurysms of the hepatic arteries, 6 patients had an aneurysm of the splenic artery and 5 patients developed aneurysms of the remaining branches of the splanchnic arteries (1 gastroduodenal, 3 pancreaticoduodenal and 1 superior mesenteric), 8 patients were treated conservatively. 8 patients had a surgical procedure performed. Two patients died from a complication of their aneurysm. Ligation of the hepatic artery, was insufficient to avoid a recurrent and fatal hemobilia in a man presenting, with a centrally located intrahepatic ruptured aneurysm. Another patient developed a fatal necrohemorrhagic pancreatitis after ligation of the splenic artery for an aneurysm that ruptured in the stomach.

Adult↗

PubMedDate not supplied

[Indications for total parenteral nutrition in surgery (author's transl)].

The indications for total parenteral nutrition are compared with those for enteral alimentation. The indications for parenteral nutrition (nutrition support and hyperalimentation) in gastro-intestinal surgery, traumatology and burn care are discussed. Prophylactic TPN, supplemental TPN and therapeutic TPN are covered as well as their merit in the treatment of surgical complications.

Acute Kidney Injury↗

PubMedDate not supplied

[Duplication of the colon in the adult (author's transl)].

The authors describe 2 cases of duplication of the colon. One was discovered by accident and not treated. The other occurred in a patient with a long story of abdominal pain and had been operated twice with signs of intestinal obstruction. A partial resection of the duplication with the adjoining bowel segment was performed and the digestive tract was reconstructed bij and end-to-end anastomosis. The different forms of duplication are described with their specific features and the current theories about their mode of formation. Finally a brief description of the symptoms and of the available surgical techniques is given.

Adolescent↗

PubMedDate not supplied

[General surgery].

Explore the source record for details and available documents.

General Surgery↗

PubMedDate not supplied

Single-dose parenteral antibiotic prophylaxis in gastrointestinal surgery.

In the course of two consecutive, double-blind and prospective studies, the authors evaluated the prophylactic effect of a single peroperative intravenous dose of gentamicin (this study included 166 patients) or the combination gentamicin and clindamycin (this study included 127 patients), on the wound infection rate following interventions involving the incision of an abdominal hollow viscus. Antibiotic prophylaxis lowered the post-operative wound sepsis rate, especially following clinically contaminated interventions, but this reduction did not reach statistical significance. It is concluded that a single peroperative parenteral dose of antibiotics does not constitute an entirely satisfactory means of wound infection prophylaxis in digestive surgery.

Adolescent↗

PubMedDate not supplied

Extra-adrenal malignant phaeochromocytoma.

This paper describes a 35-year-old hypertensive woman presenting with two para-aortic catecholamine-secreting tumors. This bilateral lesion was successfully resected, but one year later proved to be malignant by spreading of the tumor to involve non-chromaffin tissues (liver and bones). A competitive inhibitor of alpha and beta receptors kept the blood pressure within reasonable limits.

Adult↗

PubMedDate not supplied

Is there a place for research in the training of surgeons?

The incorporation of research facilities into the surgical curriculum is a major asset in supporting the scientific aspect of surgery. The dearly won place of surgery in medical science should be preserved and consolidated by encouraging motivated young surgeons to carry out research. It is the task of the universities to set up laboratories and research units, where the necessary know-how and infrastructure are present and accountable research activities can be developed.

Belgium↗

PubMedDate not supplied

The unexpected thyroid cancer: surgical attitude.

A series of 18 patients with unexpected well-differentiated cancers of the thyroid is presented. This proved to be a high percentage of all patients operated for "benign" thyroid disease (6.5%), and a substantial percentage of all patients operated for thyroid cancer (44%). Preoperative investigations consisting mainly of thyroid function tests, ultrasound, scintigraphy, and fine needle aspiration biopsy, were not contributive for cancer. Intraoperative suspicion of malignancy induced extended surgery in one patient and frozen section biopsies in another 5 patients, with 3 positive answers resulting in immediate more radical operations. In 12 patients unsuspected cancer was diagnosed at paraffin section. This resulted in reoperation in 8 patients. Considering a number of arguments, we advocate a therapeutical guideline which makes a distinction between tumours which should be reoperated and tumours which are adequately treated by the initial resection.

Adenocarcinoma, Follicular↗

PubMedDate not supplied

Implantation of colon cancer cells on intact and damaged colon mucosa and serosa: an experimental study in the rat.

The ability of malignant colon cancer cells to implant on intact and damaged colonic mucosa and serosa was tested in a series of experiments using male WAG rats. The mucosa was damaged in an "acute" way by multiple biopsies and in a "chronic" way by means of a chemically induced colitis. The creation of an anastomosis provoked both mucosal and serosal damages. CC531 colon cancer cells injected intraluminally as an enema implanted at the serosal side of an anastomosis without invading the mucosa in 66% of the rats. An intact colon mucosa is 100% resistant to the implantation of viable CC531 cells. In contrast, tumour growth was noticed in 100% of the rats when the malignant cells were sprayed over the intact colon serosa at laparotomy. Mucosal damage by biopsies in the presence of viable colon cancer cells resulted in mucosal implantation and intraluminal tumour growth in one out of thirty rats. No tumour growth was observed when the CC531 cells were instilled on one week old mucosal ulcerations resulting from a chemical induced colitis.

Anastomosis, Surgical↗

PubMedDate not supplied

Thoracoscopic pericardial fenestration, a first experience of a new approach.

Surgical treatment of pericardial effusions are, in general, treated by methods using a subxiphoid or a transthoracic route. The former is criticized for the high recurrence rate, the latter for the high incidence of respiratory complications. To minimize these problems and in view of the growing enthusiasm for using minimal invasive techniques, we treated one patient with pericardial effusion by using video-assisted thoracoscopy for the creation of a pericardial window. We achieved an adequate drainage, and the postoperative pain and pulmonary dysfunction were minimal. The operative technique and pitfalls are discussed in this report. Thoracoscopic pericardial fenestration might facilitate a much less aggressive transthoracic approach to the pericardium which is of great importance, as many of these patients are already in a poor clinical condition.

Drainage↗

PubMedDate not supplied

The Hartmann procedure revisited.

The results of 37 consecutive cases of Hartmann's procedure over a 5-year period (1985-1990) were reviewed. The series consisted of 27 emergency procedures (11 diverticular disease, 13 carcinoma, two trauma and one sigmoid volvulus) and ten elective procedures (nine carcinoma and one peridiverticular abscess). The indications for emergency procedures were obstruction and perforation. All patients presented with faecal peritonitis owing to colonic perforation. The mean (range) age was 79.4 (34-90) years. The postoperative mortality rate was 30 per cent overall (11 of 37), 33 per cent (four of 12) in the diverticulitis group, 23 per cent (five of 22) in the carcinoma group, and 100 per cent in the iatrogenic trauma group. Death was mainly due to sepsis (82 per cent). Postoperative complications were mainly wound infections, which occurred in 43 per cent (16 of 37) cases. In 25 per cent of the surviving patients, re-establishment of continuity was performed in three of 17 (18 per cent) of the carcinoma group and three of seven (43 per cent) of the diverticulitis group. No attempt at restoration of intestinal continuity was made in six cases due to medical risk in two, extensive carcinoma in two and local recurrence with metastatic disease in two. Three patients refused all further intervention. There were no postoperative deaths after the restoration of continuity. This series reflects the severity of the pathology in this high risk group of patients. However, the operation can be life-saving for a selected group of patients and offers good palliation for advanced colorectal tumours.

Adult↗

PubMedDate not supplied

Selective rupture of the Wirsung duct: a rare form of pancreatic trauma.

A patient with a traumatic pancreatic lesion, confined to the Wirsung duct, is presented. At first laparotomy, the diagnosis was missed. Posttraumatic acute pancreatitis led to endoscopic pancreatography, disclosing the exact localization of the lesion. Left pancreatectomy led to rapid recovery. A late postoperative pancreatic fistula healed without problems.

Abdominal Injuries↗