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C Dragomirescu

Publications and source records attributed to C Dragomirescu.

At least 55 records · Page 3Linked to original sources
PubMedDate not supplied

[Pancreatic fistulas].

Based on 17 observations the authors review the major etiopathogenic, evolutive, clinical and therapeutic aspects of pancreatic fistulae. In 14 cases the cure was achieved by medical treatment while surgery was resorted to in only three cases. The medical measures are discussed, as well as the indications for surgical treatment.

Adult↗
PubMedDate not supplied

[Sacrococcygeal teratoma in the adult].

Problems of diagnosis, classification, and histologic definition, as well as possibilities of evolution are discussed, of teratomas or of tumours resulting from the disturbed development of the sacro-coccygeal area, in connection with a case of recidivating sacro-coccygeal teratoma in a woman aged 40 years. The therapeutic principles are also discussed The risk of malignant degeneration of these lesions, in parallel with their evolution in time, make necessary surgical exeresis immediately after making the diagnosis. Surgery should be performed with a maximum amount of comfort, under general anesthesia, preferably in the Kraske position, in view of the complete extirpation of pathological tissues. Resection of the coccyx and of the last sacral vertebrae allows to widen the approach, facilitating the complete exeresis, and avoiding the two risks which are characteristic for this intervention: lesion of the rectum, and haemorrhage which is difficult to control. The postoperative aspiratory draining is useful for the favourable evolution of the wound.

Adult↗
PubMedDate not supplied

[Duodenal ulcer and a short common bile duct. Significance of duodenocholedochal reflux].

In connection with 8 cases of congenital short choledochus, associated with duodenal ulcers, of which 5 were diagnosed before surgery on the basis of duodeno-choledociab barium reflux, the authors review the data in the literature, confronted to their own experience. The frequency and the functional consequences are discussed, of the congenital short choledochus, the relationships of the papilla with the ulcerative lesion depending on the variants of the papilla, and the topography of the ulcers, the problems of diagnosis raised by the duodeno-biliary barium reflex, the preoperative complementary investigations, the intra-operative exploration, as well as the elements of operative tactics and techniques. The importance of intravenous cholangiography is stressed, on a routine basis in ulcerous patients, as well as the usefulness of intraoperative cholangiography in difficult cases of duodenal ulcers, that have a close relationship with them main biliary pathway. From the viewpoint of their surgical attitude and preferences the authors apparently prefer the exclusion resection of the ulcer, in association with troncular vagotomy.

Adult↗
PubMedDate not supplied

[Intrahepatic lithiasis (considerations on 20 cases)].

The authors present an analysis of 20 cases with intrahepatic lithiasis, stressing the possibility of the development of lithiasis inside the liver as a result of either metabolic disturbances (one case), or secondary to congenital obstacles (2 cases), or following surgery (3 cases). In the remaining 12 cases intrahepatic lithiasis was secondary to lithiasis in the hepato-choledocus canal through a mechanism of ascending obstruction - identified in 5 cases -,or it was due to ascending migration of calculi (in 7 cases). The diagnosis is made with the aid of good quality intra-surgery cholangiographia. There are various possibilities for surgical solution, but the authors have preferred the bilio-digestive anastomosis that was performed in 15 of the patients. The hepatic duct-jejunal anastomosis on a "Y" loop is considered to be the method that responds most satisfactorily to operatory objectives. Various conditions are discussed, that may render the solution of the condition more difficult from the surgical viewpoint, such as the presence of congenital intrahepatic septa, or the development of intrahepatic lithiasis in a patient with a narrow hepato-choledocus duct. The mortality rate was of 20% (4 patients). Death occurred through acute hepator-renal failure.

Adult↗
PubMedDate not supplied

[Digestive lipomas: clinical and therapeutic aspects].

The authors present 6 cases of lipomas of the digestive pathways, five in females and one in a male. The patients were aged between 31 and 75 years and an average age of 51 years. The benign lipomatous tumor was unique in all the cases. It was located in the antrum in 3 of the patients and in the ileum, the right segment of the colon and on the sigmoid in each of the three other patients respectively. In all the cases the radiological examination confirmed the clinical diagnosis of digestive tumour. The radiological aspects were typical for benignity in four of the cases and suggested malignancies in the other two. Gastric lipomas were characterized from the clinical viewpoint by dyspeptic disturbances that were not systematized, as well as by bleeding while the ileal and the colic tumours were accompanied by repeated invagination. The sigmoid tumour was accompanied by colic and disturbances of the transit. The surgical solution consisted in 3 of the cases in a simple exeresis of the lipoma (two gastric lipomas and the sigmoid tumour). In one of the gastric lipomas a limited resection was performed, and for the colic and ileal tumours, complicated by invagination a right hemicolectomy was carried out.

Adult↗
PubMedDate not supplied

[Complications of colonic diverticulitis [apropos of 22 cases)].

After establishing the nosologic frame of the notions of diverticulosis, diverticulitis and the complications of the latter the authors make an analysis of 22 cases with complications of colic diverticulitis, and stress the frequency of this complication in the aged. Ten of the complication consisted in haemorrhagia, 8 were perforations and 4 were obstructive. The authors establish the attitude which should be adopted when confronted with confirmed diverticulitis, and make an analysis of each type of complication from the viewpoint of the diagnosis and of the therapeutic attitude. In haemorrhagic complications surgical intervention is rarely necessary (one out of the 10 cases recorded), surgery is however mandatory in the obstructive and perforating complications. The authors prefer the Hartmann type of intervention considering the risks of anastomosis in conditions which are generally doubtful at the best, due to advanced age of patients and associated deficiencies. Beside the analysis this paper also updates the major elements of the problem, as shown by the references.

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