Biomedical subjects

I Popescu

Publications and source records attributed to I Popescu.

131 records · Page 8Linked to original sources

PubMedDate not supplied

[Couinard's technics of liver resection].

Six cases of major liver resections (five right lobectomies and one left lobectomy) are reported. In all these cases the technique described by Couinaud (of suprahilar intrahepatic ligation of the portal pedicle) was used. Although the technique could be simple and rapid, it may produce severe accidents, especially in patients with biliary anomalies. Five of the six cases had an uneventful postoperative course, while in the sixth case, obstructive jaundice developed postoperatively. The case was solved through reoperation and a Roux-en-Y anastomosis. The main conclusion is that the Couinaud technique could be used, because of its advantages (speed, less blood loss) but special precautions are necessary when biliovascular anomalies of the liver are present.

Adenoma↗

PubMedDate not supplied

Fatal intestinal hemorrhage complicating ileal lymphoma after cyclosporine for unresponsive celiac disease.

BACKGROUND/AIMS: Unresponsive celiac disease may benefit from immunosuppressive therapy. Malignant small intestinal lymphoma is the most serious complication of celiac disease, also being noted as a complication of immunosuppressive therapy. The diagnosis of small intestinal lymphoma complicating celiac disease is notoriously difficult. Perforation is the most common complication of small intestinal lymphoma, frank hemorrhage being unusual. We report a case of massive, fatal hemorrhage from small intestinal lymphoma complicating unresponsive celiac disease treated with cyclosporine. The patient was presented with severe diarrhea and nutritional deterioration. Unresponsive celiac disease was diagnosed on the basis of clinical and histologic criteria with no response while on a gluten-free diet, corticotherapy and octreotide acetate injections. Cyclosporine therapy was advised. The patient had a remarkable clinical response. After 3 months from the start of the cyclosporine therapy, the patient returned with massive intestinal bleeding. The patient underwent emergency surgery diagnosing an enteropathy-associated lymphoma. We conclude that cyclosporine therapy for unresponsive celiac disease should be considered in select, severely ill patients only after a full-thickness biopsy of the small intestinal wall to disclose a latent super-imposed lymphoma, which course may be accelerated by immunosuppressive therapy.

Adult↗

PubMedDate not supplied

[2 cases of total duodenopancreatectomy with resection of the portal vein in cancer of the pancreas].

Two cases of pancreatic cancer with portal vein invasion are presented. In both cases a total duodenopancreatectomy was performed due to the extension of tumour. The portal vein invasion was diagnosed intraoperatively; it was a circular invasion in one case and a lateral invasion in the second case. A segmental resection of the portal vein (2 cm in length) with end-to-end anastomosis was performed in the first case, while a lateral excision with venorrhaphy was sufficient in the second case. The first patient died after six months while the second patient is still alive, without recurrence, at seven months postoperatively.

Adenocarcinoma↗

PubMedDate not supplied

[Repeat hepatic resections].

Five cases of iterative liver resections are presented, out of a total of 150 hepatectomies performed between 1.01.1995-1.01.1998. The resections were carried out for recurrent adenoma (one case), cholangiocarcinoma (two cases), hepatocellular carcinoma (one case), colo-rectal cancer metastasis (one case). Only cases with at least one major hepatic resection were included. Re-resections were more difficult than the primary resection due, first of all, to the modified vascular anatomy. Intraoperative ultrasound permitted localization of intrahepatic recurrences. Iterative liver resection appears to be the best therapeutical choice for patients with recurrent liver tumors.

Adenoma↗

PubMedDate not supplied

Long esophageal stricture in Crohn's disease: a case report.

Crohn's disease of the esophagus is rare, and it is very unusual for it to be located only in the esophagus. We report a case of Crohn's disease confined to the esophagus in a 26-year-old female. The patient was admitted because of progressive dysphagia, odynophagia and weight loss. A barium-swallow examination showed an irregular narrowing of the esophagus below the level of the aortic arch which was 15 cm long, with marginal ulcers and a pseudopolypoid appearance of the mucosa; a computed tomographic scan of the thorax revealed a thickened esophageal wall. Esophagoscopy revealed an esophageal stricture 25 cm distal to the incisor teeth, 2 mm in diameter, with "punched out" ulcers and pseudopolypoid mucosa. Endobiopsy specimens showed chronic lymphocytic infiltration into the corion in the absence of neutrophils, basal-cell hyperplasia and elongation of the stromal papillae. The patient underwent an esophagectomy through a combined cervico-abdominal approach followed by a cervical esogastrostomy. The specimen was 18 cm long, the thickness of the wall was 1.7 cm with fibrosis involving all layers of the esophageal wall and a cobblestone appearance of the mucosa. A heavy lymphoplasmocytic infiltrate extended from the mucosa deep into the muscularis, fibrosis and granulomas were found transmurally. Crohn's disease of the esophagus is a rare and specific entity which can present in various ways; strictures resembling those from reflux esophagitis or a tumor are common. Diagnosis may be suggested by the presence of a chronic lymphocytic infiltrate with or without non-caseating granulomas, and no histologic evidence of chronic reflux esophagitis.

Adult↗