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Biomedical subjects

I Vereanu

Publications and source records attributed to I Vereanu.

At least 19 recordsLinked to original sources
PubMed1994

[The clinical and therapeutic characteristics of a neoplasm of the left superior colon].

As "CSS" the authors name the left segment (1/3) of the transverse colon with the splenic angle and fixed segment of the left colon. The author's conclusion of a retrospective analysis upon 34 neoplasms situated in this colonic area is the fact that there are enough arguments to treat them as a unitary group. From the anatomic point of view these arguments are the common vessels and lymphatics reports, and from the clinical point of view these neoplasms have in common the symptomatology (generally the diagnostic is established later on) and a great tendency of a loco-regional invasion which generate severe complications. The surgical treatment with oncologic radical intervention is the same for any primary neoplasm localization (within the there segments of "CSS"). Multi-visceral resections are frequently necessary too.

Adult↗
PubMed1992

[The timely diagnosis of postoperative clostridial infection].

Authors report a case of clostridial myonecrosis postcholecystectomy. The causes of the occurrence of this severe, frequently lethal complication are reviewed, as well as the difficulties of an early diagnosis, the only factor able to save the patient. The curative treatment of the detected infection requires the initiation of a series of local and general measures and a permanent cooperation between the surgeon, the specialist in resuscitation and the infectionist.

Acute Disease↗
PubMedDate not supplied

[The use of 10-percent mannitol solution in colonic surgery].

Based on the experience acquired in 20 cases the authors discuss the use of the mannitol solution in the surgery of the colon. The colic voiding was evaluated in 19 cases as very good, a fact that stresses the efficiency of this method of mechanical preparation of the colon. The method is very well tolerated by the patients, and the secondary biological modifications are not significant. Contraindications are limited to the very aged (above 75 years), in patients with cardiac disease, or in those with hepatic and renal diseases, as well as in those with occluding forms of neoplasies.

Adult↗
PubMedDate not supplied

[Diabetic gangrene].

The large variety of the lesions in diabetic gangrene which require different therapeutical decisions explains our attempt to determine an useful way for the approach of the surgical treatment. Our aim was to avoid both an underestimation of the lesion, which may lead to an insufficient procedure, followed by reinterventions, as well as an overestimation--generating avoidable amputations. We have elaborated a scale of indices of therapeutical prognosis (ITP), using a computer programme, with the main risk factors. The result was a scale between 1 and 10; the value is proportional to the severity of each lesion. We have also analyzed the fiability of ITP on a prospective study including 72 patients with diabetic gangrene. The result was 93%, which has encouraged us to consider ITP useful in establishing a therapeutical attitude.

Adult↗
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

[Abscesses of psoas in diabetic patients: anatomo-clinical and therapeutical peculiarities].

Difficulties of diagnosis and of an adequate treatment of psoas muscle abscesses are increased by the evolution of the suppurative process in diabetic patients. We review 3 cases of poses muscle abscesses, characterized by a long-term evolution until revealing the initial source of the abscess and by particular clinical features, due to the exteriorization of suppuration far away from its source (retrosacral, hip, thigh). Computerized tomography is essential for diagnosis and for an accurate therapeutical approach, consisting in incision and drainage of primary abscess in psoas muscle and of its expansions as well in the same time, with an adequate antibiotherapy.

Adult↗
PubMedDate not supplied

[Organic hypoglycemia of pancreatic cause].

Insulinomas represent the most common cause of organic hypoglycemia. They are rare tumors: a review of the world literature reported a total number of 2000-3000 cases. The clinical diagnosis is based on the Whipple triad, which consists of: a) symptoms of hypoglycemia, b) blood glucose level: 40-50 mg/dl during the crisis, c) relief of symptoms after oral or intravenous administration of glucose. The most ticklish problem is the settlement of the accurate location of the tumor. Nowadays, there are many diagnostic methods; one of the best appears to be intra-operative ultrasonography. The authors analyse a series of 16 patients, operated between 1985 and 2002 in "I. Juvara" Surgical Clinic and present their opinions concerning tactic and technical aspects of different surgical procedures, with their advantages and limits. The results of the surgical treatment are detailed. There are also mentioned new imagery techniques and laparoscopic procedures, from recent medical issues.

Adult↗
PubMedDate not supplied

[Late intestinal perforations after alloplastic repair of postoperative eventrations].

Late intestinal perforation is the most rare and the most serious complication following the repair of abdominal parietal defects with alloplastic material. The authors have gathered in 7 years 6 cases of perforations which occurred between 1 and 10 years after using nonabsorbable synthetic mesh prostheses made of polyester (4 cases) and polypropylene (2 cases) as parietal substitution materials. The perforations were discovered either by the appearance of complete enteric fistulas after exploration of circumscribed parietal suppurations (3 cases) or during surgery of suppurations without external fistulas. All cases involved perforations of the small intestine and in only one case there was also a perforation of the transverse colon. In 4 cases, where eventration relapse co-existed, the polyester prostheses were found partially or totally detached from the abdominal wall. The treatment of enteric perforation consisted of 5 segmental enterectomies (one of those a double one) followed by anastomoses and one enteroraphy. The colic perforation was excised and sutured. The mesh was totally removed in 5 cases and partially removed in 1 case (around the perforation). The postoperative evolution was simple in only 3 cases. In the other 3 cases anastomotic fistulas occurred and one of them (with reduced leakage) was treated by nonoperative management. It did not close spontaneously even after 12 months. The other 2 cases required multiple reinterventions (enterectomies, ileostomies, ileocoloanastomosis). One of these patients has been lost away after 200 days of hospitalization and multiple reinterventions. In all cases, the closure of the abdominal wall was simplificad by cutaneous suture only whereas consecutive relapsed eventrations remain to be treated by subsequent reinterventions.

Hernia, Ventral↗
PubMedDate not supplied

[Sacrococcygeal teratoma in an adult female operated with abdominoperineal approach].

The authors present the case of a 28 years old female with a mature, three-layers sacrococcygeal teratoma, which has been operated using an abdominoperineal approach. Teratomas are quite frequent in pediatric surgery; their incidence gradually decreases in adult population. Lately, significant progresses in the diagnosis and treatment of fetus and new born teratomas have been achieved; a review of the literature (2000-2004) is added. In adults, the diagnosis of teratomas is rather difficult. The symptoms are due to their size, to the compression of pelvic viscera or to their complications (infections, bowel obstruction, fistulas, malignancy). The treatment of teratomas is mainly surgical. The approach depends on the peculiarities of each case (size, invasion of the nearby viscera).

Abdomen↗
PubMedDate not supplied

[Extensive necrotizing perineal infections in diabetic patients].

We present the pathogenic and the therapeutic features of the extensive necrotizing perineal infections in diabetic patients, based on the clinical experience of our surgical department (45 cases in 10 years) and on the data in the medical literature. We analyzed the case of a 45 years male with an unbalanced type I diabetes mellitus, which has been admitted for an extensive necrotizing infection of the lower abdominal wall (hypogastrium and both right and left lower quadrant), with crepitation on this area. The origin of this necrotizing infection was an upward extension of an insufficiently drained right ischiorectal abscess. The therapeutic management consisted in 6 consecutive surgical procedures (drainage, necrectomy, large fasciectomy), which permitted a favourable evolution and the healing of the patient. We used this demonstrative case for emphasizing the clinical, paraclinical and therapeutical peculiarities of the extensive perineal infections in diabetic patients.

Debridement↗