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Biomedical subjects

I Juvara

Publications and source records attributed to I Juvara.

78 records · Page 5Linked to original sources
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

[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.

Aged↗
PubMedDate not supplied

[Multiple colonic cancers: simultaneous and successive].

The authors attempt an approach of a controversial problem of contemporary surgery and stress the following significant aspects:--the frequency of multiple colon cancers is of 3%, approximately 25% of the cases being associated with benign proliferative lesions:--the intra-operatory diagnosis of multiple colon cancers is difficult (3 out of 12 cases); intrasurgical exploration may give rise to problems in connection with the insufficiency of the exploration, or the inaccessibility of unique tumors, thus existing the risk of leaving in place a developing tumor, that can be discovered at a new intervention (one case); the operability of multiple colon cancers is similar to that of the unique malignant lesions, depending on the extension, the variety and the focal distribution of the neoplastic lesions.

Colonic Neoplasms↗