Biomedical subjects

I Juvara

Publications and source records attributed to I Juvara.

At least 55 records · Page 3Linked to original sources

PubMedDate not supplied

[Atypical postoperative peritonitis].

In the present conditions of development of the medical sciences the wide and varied use of pre- and postoperative antibiotherapy, to which is added the complex therapy carried out in the intensive-care unit, have changed the course of the dramatic postoperative peritonitis that at present do not develop any more according to the classical symptomatology. The key to success in these cases is the discovery as rapidly as possible of the moment when peritoneal infection has started to develop in view of applying the only correct treatment--reintervention. The present study makes an analysis of 32 cases and stresses the atypical evolution of postoperative peritonitis: contracture, pain, high fever and hyperleukocytosis cannot be considered any more as constant and certain signs. Meteorism and gastric stasis that is prolonged or that developes after 4-8 days following surgery are the most frequently encountered of the signs and are considered to be the most important. Exploratory laparotomy is the most correct attitude in dubious cases.

Humans↗

PubMedDate not supplied

[Complications of splenectomy].

The present study is an analysis of complications developing after a total of 200 splenectomies carried out for various indications: primary hypersplenism (83), secondary hypersplenism following portal hypertension (72), diseases of the hemopoietic system (24), parasitic and infectious splenomegalies (13), rupture of the spleen or of splenic artery aneurisma (8). A number of 68 patients (34%) had a total of 73 complications following surgery. Of these 60 have recovered (30%) while 8 (representing 4% of the total), died. A total of 22 local or general septic complications were noted, as well as 20 complications generated by disturbances of the balance of fluids and/or of the coagulation system, 19 pleuro-pulmonary complications, 6 complications that were not specific for splenectomy, 5 pancreatic complications and 5 cases of hepatic failure.

Hemorrhage↗

PubMedDate not supplied

[An autochthonous case of amebic hepatic abscess with pleural dissemination].

The present paper reports on the first autochtonous case of amoebic hepatic abscess in Romania in a patient in which the epidemiologic survey showed that there had been no possible import infection. The amoebic abscess was located in the superoexternal area of the right hepatic lobe. Subsequently a major complication developed: a tendency to pleuropulmonary invasion with the formation of fluid in the right pleural cavity. The diagnosis, suggested by the aspect of the abscess cavity, was established by the presence of the parasite in the flaky pleural exudate obtained by puncture, by cultures in Loeffler medium and by serum immunofluorescence. The abscess was evacuated surgically and a specific treatment with Chloroquine and Metronidazol combined with antibiotics and a symptomatic medication was prescribed. The patient recovered and was discharged 51 days after surgery.

Humans↗

PubMedDate not supplied

[Surgical rehabilitation of nonfunctioning bilio-digestive shunts].

The authors consider the internal biliary derivations as a choice procedure for the resolution of various pathological conditions of the biliary pathways and of the pancreas. They are based on the experience accumulated in the course of a total of 416 derivations performed in the last 10 years. The confrontation with particular problems raised by 40 re-interventions for failure of internal biliary derivations has determined an analysis of causes, clinical manifestations and possibilities to solve the disturbances. Categories are discussed, in which these patients can be classified and clinical observations are presented, in connection with the etiopathogeny of the non-functioning of the derivations. Possibilities are also presented for the resolution of the problems in each particular case. Two technical possibilities are presented for the correction of non-functioning biliary-digestive anastomoses, by performing bilio-biliary anastomoses.

Adult↗

PubMedDate not supplied

[Surgical reoperation after vagotomy].

In 39 cases of re-interventions carried out after vagotomy (of which 31 were patients hospitalized in the Clinic and represent 8,6% of the total 358 vagotomies performed), the experience, the viewpoints and the recommendations of the authors are presented. Early re-interventions were necessayr because of complications which are common to abdominal surgery and only in a much lower degree to accidents that can be attributed to vagotomy or the associated intervention. Late re-interventions (26 cases) were necessary in 20 cases for ulcer recidives (13 for vagotomies performed in the Clinic and 7 for vagotomies performed in other units) while late-re-interventions for dumping syndrome, cholelythiasis, etc. represented only isolated cases in these statistics.

Cholelithiasis↗

PubMedDate not supplied

[Postbular duodenal ulcer. Problems of diagnosis and treatment. Role of vagotomy in surgical treatment].

A number of 43 cases is presented, of post-bulbar duodenal ulcers in which surgery has been performed between 1965 and 1974, of which 30 were located in the first portion of the duodenum, in the postbulbar area, and 15 in the second portion, above the ampula of Vater. Problems of terminology and pathological anatomy are discussed, especially in connection with the symptomatology, complications, methodology of investigations and treatment of post-bulbar ulcers. The particular frequency is stressed, of complicated clinical forms, with stenosis and hemorrhagies, and a detailed description is made of atypical forms, with misleading, predominantly biliary or pancreatic symptomatology. Conditions are stressed, of the radiologic gastroduodenal exploration, of major importance in the diagnosis preceding surgery, as well as of pre- and intra-surgery cholangiography. The risk must be carefully evaluated, in the choice of the surgical method, and exeresis of the ulcer must be balanced with the risk of its continued presence. Priority should be given to th risks entailed by surgery. The choice solution in many cases is vagotomy associated to exclusion resection or to gastric derivation.

Adult↗

PubMedDate not supplied