Search PubMed⌕ Search

Biomedical subjects

L Bolondi

Publications and source records attributed to L Bolondi.

At least 145 records · Page 8Linked to original sources
PubMed1982

Ultrasonography in the diagnosis of portal hypertension: diminished response of portal vessels to respiration.

This study assesses the usefulness of ultrasound in the diagnosis of portal hypertension due to hepatic cirrhosis. Seventy-nine patients with portal hypertension and 45 control subjects underwent ultrasonography. Two factors were measured: (a) the caliber of the portal vein and (b) the caliber variation of the splenic and superior mesenteric veins during respiration. A lack of normal caliber variation (an increase during inspiration and a decrease during expiration) in these vessels is put forward as an ultrasonographic sign of portal hypertension, and the pathophysiological and clinical significance of this finding are discussed. The sensitivity of ultrasound in detecting portal hypertension, based on the measurement of caliber variation, was 79.7%, and the specificity was 100%. In contrast, the sensitivity of the method, assessed on the basis of portal dilatation, was only 41.8%.

Humans↗
PubMed1981

[Control of the patency of porto-systemic anastomoses].

After having discussed the direct and indirect methods to control the patency of porto-systemic anastomoses, the Authors report on their series of 42 cases (28 side-to-side porto-cava shunts, 6 end-to-side porto-cava shunts, 6 spleno-renal shunts, 2 mesenterico-cava shunts) where the postop. control was carried out with portography, hepatic superselective arteriography in 29 cases, transcaval catheterism of the anastomosis in 6 patients, and pre-op., and post-op. echotomography in 15 cases. Portography revealed 39 cases of patent anastomosis and thrombotic occlusion in 3 cases. The typical sign of shunt patency is the visualisation of the inferior V.C. and the less frequent disappearance of right gastric reflux. Furthermore the investigations consented the evaluation of altered post-shunt hepato-portal flow: side-to-side porto-cava shunt (25 patent anastomoses) revealed a complete deviation of portal glow towards the I.V.C. and in 15 cases there was inverted portal flow; portography after splenorenal shunt (5 cases of patent anastomosis) showed a preserved hepatopetal portal flow only in early controls (7 days) while in all long term controls it was hepatofugal. In 13 cases the morphology of the hepatic arterial system was compared before and after surgery; in 12 cases the hepatic artery was larger and its intrahepatic branches more tortuous after surgery Ultrasonography revealed only 8 patent shunts out of 15 examined since the amount of gas in the bowel rendered the exam technically insufficient.

Adult↗
PubMed1980

[Endoscopic treatment of obstructive cholangitis].

A long catheter can be positioned in the bile ducts by means of a fibre glass gastroduodenoscope, thus making it possible to drain bile and inject medicaments locally. This technique gives excellent results and is particularly indicated in cases of choledocic lithiasis complicated by cholangitis in order to clear up the infection and send the patient in for surgery in ideal condition.

Aged↗
PubMed1980

Diathermy ERCP: an alternative method for endoscopic retrograde cholangiopancreatography (ERCP) in jaundiced patients.

Standard ERCP was unsuccessful in 5 jaundiced patients. This problem was surmounted in 4 of these patients by endoscopically inducing a small choledochoduodenal fistula through which a catheter could be inserted and diagnostic cholangiograms were obtained. In the fifth patient, the attempt to create a fistula was insufficient, and the contrast material infiltrated the duodenal wall with transient ensuing fever. In subsequent observations, the induced fistulas promptly healed. The method is offered as an alternative procedure when standard ERCP fails.

Adult↗
PubMed1979

Ultrasound in the diagnosis of cholestatic jaundice.

A total of 70 cases of cholestatic jaundice have been studied by gray scale ultrasonography in order to evaluate how this technic may be used to differentiate between intra- and extrahepatic cholestasis. In 37 out of 42 patients (88.1%) with jaundice of extrahepatic origin, dilatation of the biliary tree was demonstrated, whereas in all the 28 patients with intrahepatic cholestasis biliary dilatation was clearly excluded. In addition, gallstones in the biliary ducts were detected in 12 out of 20 cases and enlargement of the head of the pancreas (due to carcinoma or chronic pancreatitis) was often correctly diagnosed (nine out of 13 cases). These results suggest that ultrasonography should represent the first step in the diagnostic approach to cholestasis. Information gained from this noninvasive technic should make it possible to correctly plan the more complex investigations (endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography).

Adult↗
PubMed1978

Endoscopic retrograde cholangiography (ERC) through artificial endoscopic choledocho-duodenal fistula.

A new endoscopic method for retrograde cholangiography in cases of unsuccessful cannulation of the papilla is described. In 1 patient with obstructive jaundice, severe diabetes and a previous history of biliary pain traditional ERC failed. An endoscopic artificial choledocho-duodenal fistula by means of a diathermic cutter (needle type) was performed at the lower end of the intramural portion of the common bile duct for retrograde cholangiography. X-ray showed an obstruction of the common bile duct due to a carcinoma of the head of the pancreas. Complications did not occur during the procedure and in the post-operative period. It is concluded that the described method may be helpful when traditional selective ERC fails, moreover it may permit an endoscopic choledocho-duodenostomy for choledocholithiasis in cases of unsuccessful endoscopic papillo-sphincterotomy.

Aged↗
PubMed1977

[Ascites in chronic pancreatitides. Report of 2 cases].

2 cases of alcoholic chronic pancreatitis complicated by ascites are described. Both presented a cystic formation in the pancreas. In the first, a direct communication existed between the cystic and peritoneal cavities with passage of pancreatic secretion and serous membrane inflammatory reaction. The literature shows that this mechanism is the one most frequently responsible for ascites in chronic pancreatitis. For diagnosis, demonstration of high amylase and proteins in the ascitic fluid was decisive. Internal drainage of the cyst carried out in one of the two cases resolved the picture.

Adult↗
PubMed1976

An evaluation of echography in the diagnosis of pancreatic disease.

In the present study an attempt to evaluate the efficacy of echography as a diagnostic tool has been made. A total of 52 patients (chronic pancreatitis (42); pancreatic cysts (three); and carcinoma of the pancreas (seven)) were studied and the results compared with those from other diagnostic techniques. In 65.7% of chronic pancreatitis patients, and in all cases of carcinoma of the pancreas, echography provided evidence of pancreatic abnormality but in no case could an unambiguous diagnosis of the disease be made. However, in all cases of pancreatic cyst, echography gave precise and unequivocal diagnostic information. There was good agreement between the echographic picture and surgical findings. Cholangiography and duodenography indicated duodenal and choledochal compression in a high proportion of cases in which echography revealed enlargement of the head of the pancreas. It is concluded that echography is a simple, safe, and valuable addition to the techniques available for studying the pancreas.

Adolescent↗
PubMed1975

[Therapeutic effect of a pharmacologic combination of choleretics and digestive enzymes in exocrine pancreatic insufficiency].

Phosphorylcholine and homocysteine have an important choleretic action and also potentiate exocrine pancreatic secretion by way of stimulation and a more effective preparation of the substrate against attack by lipolytic enzymes. The protection offered by pancreatic enzymes in the correction of the digestive insufficiency in the endoluminal stage is also known. An analysis was therefore made of the action of an association of phosphorylcholine homocysteine and digestive enzymes in cases of exocrine pancreatic insufficiency and primary or secondary malabsorption. This action was evaluated on the basis of the reduction of elimination of steatorrhoea. For this purpose, faecal lipids were determined with the method proposed by van de Kramer et al. The most significant results were obtained in cases where digestive insufficiency was most marked, where correction of the pancreatic enzyme deficiency and improved biliary function were particularly required.

Adolescent↗