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Biomedical subjects

F Ibba

Publications and source records attributed to F Ibba.

At least 37 records · Page 2Linked to original sources

[Problems in emergency surgery: ligation of the hepatic artery].

Reference is made to the literature data and a personal series for the proposal of ligation of hepatic artery as a useful means of controlling: 1) massive haemorrhage following certain forms of liver trauma; 2) haemorrhage following lobectomy or atypical subtotal resection; 3) post-traumatic haemobilia. It is a valuable alternative to lobar resection which, in spite of its over 50% mortality, is still the treatment of choice in serious lesions, especially if these are associated with lesions of the suprahepatic veins or cava, or massive crushing of the parenchima. Haemorrhagic shock following liver damage is usually met by reduced portal and increased hepatic artery flow. It is obvious that ligation of the hepatic artery leads to considerable ischaemia and hypoxia. This disadvantage can only be offset by massive replacement transfusions, protracted parenteral feeding (fasting leads to maximum oxygenation of the portal blood), and intravenous glucagone, to improve the overall liver blood flow and the oxygen saturation of the portal blood.

Adult↗

[Use of transhepatic drainage in neoplastic stenosis of the upper biliary tract].

Rodney-Smith's technique (transtumoral transhepatic drainage) was used palliatively in 6 patients with cancer of the upper biliary tracts. Diagnosis from the symptomatology (essentially obstructive icterus) was not easy, though the picture can almost always be clarified by endovenous and endoscopic retrograde cholangiography and, more particularly, by preoperative and intrahepatic intraoperative cholangiography and choledochoscopy in connection with laparatomy. Two patients survived for 9 months and 2 yr respectively, whereas the remainder died within 30 days of surgery. Despite this high mortality, primarily due to very poor general condition, this type of palliative operation is still the best form of management.

Bile Duct Neoplasms↗

[Intestinal occlusion caused by endometriosis].

Three cases of intestinal occlusion due to endometriosis, presenting as surgical emergencies, are reported. After a review of the literature on the incidence of endometriosis, the mechanisms underlying the occlusive process and the various anatomopathological pictures are presented. The reasons why no correct preoperative diagnosis was possible and the problems encountered in differential diagnosis, particularly with respect to carcinoma of the colon and the sigma-rectum, are discussed. It is considered that correct preoperative diagnosis is very important to avoid subjecting the non-cancer patient to destructive surgery. The therapy recommended for intestinal occlusion due to suspected endometriosis is presented.

Adult↗

[Emergency surgery problems: selective decompression of esophagogastric varices].

The physiopathological premisses of portosystemic anastomosis and the modern approach to this question are explained. Stress is laid on the general and haemodynamic advantages offered by selective shunts and 6 cases (4 distal splenorenal and 2 coronarocava shunts) are presented. As yet the postoperative period is not long enough to enable a final judgement to be formed. However, it can be stated that the success of this form of management is primarily determined by the proper choice of candidates, i.e. patients with non-decompensated initial cirrhosis and unimpaired portal hepatic flow.

Adult↗

[Villose polyps of the duodenum].

A case of villous polyps of the duodenum is reported, world-wide series also being considered. The various symptomatologies and percentages of malignant transformation and localization are described and stress laid on the superiority of endoscopy to radiography owing to the fact that it gave: 1) exact site and nature diagnosis of the lesion during the haemorrhagic phase; 2) exact histological and topographical diagnosis, following the haemorrhage, paving the way to the subsequent surgery.

Aged↗

[Intraoperative choledochoscopy].

Intraoperative choledochoscopy is examined and the instruments mostly employed for this purpose are described, with particular reference to the Olympus CHF B2, and personal modifications to the same, as used in the present study. The indications for the examination and the technique required are explained. It is especially useful in diseases of the bile ducts, and superior to cholangiography, which often fails to diagnose intrahepatic calculosis and small, multicentered tumours. A series of images relating to calculosis of the bile ducts, biliary neoplasia, the choledochus in lesions of the head of the pancreas, and the normal appearance of the bile ducts is presented.

Bile Duct Neoplasms↗