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Biomedical subjects

A Petri

Publications and source records attributed to A Petri.

At least 55 records · Page 3Linked to original sources
PubMed1997

Laparoscopic deroofing of nonparasitic liver cysts. Comparison different methods.

Between 1982 and 1995 116 patients underwent operations because of NC of the liver, 18 of them were operated on by laparoscopic way. There were 94 male (mean age: 51.9 years) and 66 female (mean age: 54.6 years) patients. The mean size of the cysts were 57.4 mm in diameter (20-140 mm), In 94 cases they were solitary and in 11 they were multiple. In 31 cases we performed an enucleation, in 60 cases a fenestration and in one case a punction of the cysts. A liver resection had to be carried out in two cases. In 18 cases the fenestration of the cysts was performed by laparoscopy and in 10 cases cholecystectomy was simultaneously carried out. The most common complications were fever and wound suppuration. There was no mortality. Another 26 patients with NC have been treated with ultrasound guided puntion of the liver cysts. The cysts were solitary in twenty-three cases and multiple in three other cases. The number of the cysts were thirty-two. One case had to be operated on because of recurrence of the cyst. Mortality could not be observed. In the laparotomized group the average time of the hospitalisation was 14.3 days, and among the patients who were operated on by laparoscopic way 7.0 days. An intervention is indicated only in case of severe complaints or the growing of the lesion. Recently we prefer the ultrasound guided punction or the fenestration of the liver cysts by means of the laparoscopic way.

Adult↗
PubMed1996

[Postoperative lumbar discitis. Types, diagnosis and treatment].

Medical reports of 17 patients with discitis after lumbar disc operation (PD) were analyzed retrospectively. None of the patients had had previous lumbar disc operations. The diagnosis was confirmed by laminar tomography. The prevalence of PD was 2.75%. We found indications of bacterial infection in 82% of the cases. For all patients the infection was long lasting, with hospital contact for a mean period of eight months. PD was classified into three categories according to symptoms and laboratory investigations (ESR, CRP, WBC and alkaline phosphatase): type I = acute septic PD (53%), type II = subacute septic PD (29%), and type III = aseptic PD (18%). For PD type I and type II we recommend that antibiotics be administered intravenously until a fall in ESR and CRP are seen, followed by peroral antibiotics until normalisation. For all three types immobilisation of the back and analgetics are necessary.

Anti-Bacterial Agents↗
PubMed1996

The diagnoses of patients admitted with acute chest pain but without myocardial infarction.

OBJECTIVE: The purpose of this study was to describe the frequencies of various diagnoses in patients admitted with acute chest pain, but without acute myocardial infarction, and to evaluate a non-invasive screening programme for these patients. PATIENTS: A total of 204 consecutive non-acute myocardial infarction patients were included. Fifty-six had a definite diagnosis within 48 h, whereas 148 patients underwent an examination programme including pulmonary scintigraphy, echocardiography, exercise electrocardiography, myocardial scintigraphy, Holter monitoring, hyperventilation test, oesophago-gastro-duodenoscopy, 3 h monitoring of oesophageal pH, oesophageal manometry, Bernstein test, physical examination of the chest wall and thoracic spine, bronchial histamine provocation test and ultrasonic examination of the abdomen. RESULTS: According to predefined criteria, 186 patients (91%) had at least one diagnosis, 144 had one, whereas 39 had two, and three patients had three diagnoses. In 18 patients no diagnosis was obtained. The diagnoses belonged mainly to three groups: (1) ischaemic heart disease (n = 64); (2) gastro-oesophageal diseases (n = 85); (3) chest-wall syndromes (n = 58). Less frequent diagnoses included pulmonary embolism, pleuritis/pneumonia, lung cancer, aortic stenosis, aortic aneurysm and herpes zoster. CONCLUSIONS: The high risk subset of a non-acute myocardial infarction population can be identified by means of a clinical evaluation and non-invasive cardiac examinations. Among the remainder, pulmonary embolism, gastro-oesophageal diseases and chest-wall syndromes should be paid special attention. A careful physical examination of the chest wall and upper endoscopy seems to be the most cost-beneficial examination to employ in this subset.

Acute Disease↗
PubMed1994

[Therapeutic possibilities in the management of gastrointestinal bleeding in thrombocytopenic patients].

Gastrointestinal bleeding is often fatal in elderly. The danger could be multiplied by thrombocytopenia or by other disorder of the coagulation system. In a thrombocytopenic patient with myelodysplastic syndrome life threatening gastrointestinal bleeding occurred which could not be controlled by conventional methods (cimetidine, antacids, aminocaproic acid, platelet transfusions, blood transfusion 400-1200 ml/day). Continuous i.v. infusion of somatostatin [250 micrograms/hour Stilamin (Serono)] and per os omeprazole [2 x 1 capsule Losec (Astra)] resulted in the cessation of bleeding in 24 hours. Adverse effect was not observed.

Aged↗
PubMed1994

[Value and results of esophageal transsection in treatment of bleeding esophageal varices].

A report on 40 patients is given, who had to undergo esophageal transection due to bleeding varices. 17 patients were operated as an emergency, 23 patients had a prophylactic treatment. Mortality was high with 58.82% and 21.7% respectively. The need of blood replacement was higher in the emergencies. The main cause of death was liver failure, the average time of survival 40 months. We conclude that esophageal transection is of some value in cases of acute bleeding, after failure of non-interventional treatment.

Adult↗
PubMed1993

[Surgical management of liver echinococcosis].

In the last ten years 62 patients were operated on by the authors because of liver echinococcosis. Each of the infections caused by echinococcus granulosus. In the course of the examination ultrasonography, abdominal X-ray, Casoni test and ELISA were used. Angiography and ERCP were applied only to answer special questions. The echinococcus cysts were removed in 15 cases by atypical liver resection, in 42 cases by pericystectomy and in 5 cases by partial cystectomy using the Pringle's manoeuvre in all of them. Operative mortality was 3.22%. Jaundice was observed in three cases, fever in five cases, wound infection in two cases. Reoperations had to be performed in two cases. All of the patients were treated postoperatively with mebendasol (Vermox). Recurrence of the infection could not be observed.

Adult↗
PubMed1993

Surgical treatment of cavernous haemangiomas of the liver.

Cavernous haemangiomas of the liver were surgically treated in 36 women and 14 men over a 10-year period. The tumours were solitary in 42 cases and multiple in 8. Locations were the right lobe in 39 cases, the left one in 5 and both lobes in 6. The size of the tumours ranged from 0.4 to 14 cm in diameter. Enucleation of tumours was carried out in 29 cases, an atypical liver resection in 19 cases, anatomical lobectomy in 2 cases and a right trisegmentectomy in 1 case. There was no mortality. Morbidity rate seems to be lower in patients who underwent enucleation. The authors indicate the importance of enucleation for removal of liver haemangiomas of various sizes.

Adult↗
PubMed1993

[Acute venous liver circulatory disorder caused by blunt abdominal trauma: is it a compartment syndrome?].

Authors describe the case of a 37-year-old female patient who had been operated on for a subcapsular haematoma of the liver that had developed following a blunt abdominal trauma. This manifested as a Budd-Chiari syndrome-like phenomenon that was not recognized until an exploratory operation was performed, when we found that the liver was hard and dark purple in colour and there was considerable ascites in the abdominal cavity. After aspiration of the haematoma, which contained about 1 l of a mixture of fluid and clotted blood, the circulation of the liver rapidly improved. On the basis of the findings, a posttraumatic Budd-Chiari syndrome seems unlikely, since the symptoms caused by the rise in intracapsular pressure are similar to those of a compartment syndrome. No literature data can be found to define such a posttraumatic failure of the liver circulation. Subcapsular and intrahepatic haematomata can be successfully monitored by ultrasonography and managed conservatively if they are asymptomatic. Operation is restricted to lesions with worsening symptoms or increasing danger of haemorrhage.

Adult↗
PubMed1992

[Differential diagnosis in acute chest pain and suspected myocardial infarction. A pilot study].

In half of the patients admitted with chest pain on suspicion of an acute myocardial infarction (AMI), this diagnosis is not confirmed (non-AMI). Both AMI and non-AMI patients have a mortality which exceeds the mortality of the background population in the years following discharge based on a high incidence of cardiac death. As a pilot investigation, a comprehensive investigation programme was tested in 32 consecutive non-AMI patients. The possible organic causes of acute chest pain were thus illustrated systematically in each individual patient. In ten of the patients, a definitive diagnosis was established within the first 24 hours of admission and no further investigation was thus performed. The remaining 22 patients participated in the planned investigation programme. In 30 of the patients (94%) a probable organic cause for the chest pain was found. This investigation demonstrates that the investigation programme is employable and it suggests that the cause of chest pain in non-AMI patients usually can be placed in one of the three main groups: 1) IHS, 2) oesophageal disease and 3) physiurgic conditions.

Adult↗