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Biomedical subjects

M Bronda

Publications and source records attributed to M Bronda.

10 recordsLinked to original sources

Giant sigmoid diverticulum.

The case of a giant diverticulum of the sigmoid colon in a 74 year-old woman is reported. The diverticulum had perforated into the urinary bladder and required a 3-phase operation with resection of the sigmoid colon and urinary bladder. Giant diverticulum is considered a rare complication of diverticulosis. Generally, it is a pseudo-diverticulum that grows due to a valve mechanism working in the neck of the diverticulum. The differential diagnosis lies mainly between intestinal duplication and pneumatosis cystoides. Surgical therapy yields favorable results.

Aged↗

[Post-traumatic right diaphragmatic hernia. Description of a clinical case].

The paper reports a case of chronic right posttraumatic diaphragmatic hernia which was brought to the authors' attention due to onset of intestinal subocclusion. Surgery was performed using thoracotomy with reduction of the ilial loops in the abdomen and suture of the diaphragmatic breech; a laparotomic route was used to resect a tract of ischemic small intestine using a termino-terminal anastomosis. The authors discuss the etiopathogenetic, diagnostic and therapeutic problems in the light of data reported in the literature.

Chronic Disease↗

[Post-traumatic hernia of the diaphragm].

The paper reports the series of post-traumatic hernias of the diaphragm observed during the period between 1954 and June 1992. This group of 77 patients (59 males and 18 females) were aged between 6 and 75 years old. Both acute and chronic hernias were reported; in 60 cases the diaphragmatic lesion was on the left, in 9 cases on the right, and there were 8 cases of laceration to both hemidiaphragms. The most frequently herniated organ was the stomach, followed by the transverse colon and spleen. With regard to the access route used, the authors draw attention to the fact that during the first twenty years of the series thoracotomies were prevalently used, whereas during the last decade laparotomy has been used in cases of early post-traumatic hernia, thoracotomy in cases of chronic post-traumatic hernia or if there is suspected damage to organs and intrathoracic structures.

Adolescent↗

[Functional study of intestinal transplants after esophagectomy].

The Authors contribute their experience covering 228 cases of esophagoplasty after esophagectomy for cancer of the esophagus and of the esophagogastric junction, from 1980 to 1989. Thirty four of these patients (24 EGP, 8 EDP, 2 ECP) underwent accurate functional investigation by X-ray, manometry, pH-metry and scintigraphy. The investigation into esophagogastroplasty in particular revealed that the transposed organ is devoid of motor activity and that emptying is therefore achieved by gravity. It was also shown that the entity of the alkaline, acid and mixed-type reflux is linked to the site of the anastomosis: greater proximity of the anastomosis translates into lower involvement. An investigation into esophagojejunoplasty, instead, highlighted normal motor function: no cases presented reflux of the alkaline type. The two cases of colon plasty investigated presented efficient emptying even though manometry could not detect the presence of motor waves of the propulsive type. The authors conclude that, although the jejunum constitutes the best prosthetic element to transpose from the functional point of view, highly inconsistent and precarious vascularization limits the use of this organ to the higher anastomoses only. Therefore the Authors claim that the stomach, despite its tendency to behave as an inert tube, is still the best choice for transpositions following esophagectomy.

Colon↗

Observations on surgical anatomy for rectal cancer surgery.

BACKGROUND/AIMS: The investigators studied the surgical anatomy of the main structures involved in the mobilization of the rectum (Denonvilliers' fascia, mesorectum, middle rectal artery, superior and inferior hypogastric plexuses). METHODOLOGY: The study was carried out on 20 cadavers (17 unembalmed and 3 embalmed). To study Denonvilliers' fascia, ten embryos and fetuses (11 mm to 80 mm CRL) were also examined. RESULTS: Denonvilliers' fascia originates from the fusion of the primary pouch of Douglas. The two leaves making up this structure are easily separated. The mesorectum surrounds the rectum on three sides; it is easily separated from the presacral fascia and its connective tissue is bordered by a thin membrane. The middle rectal artery varies in appearance rate, origin, size, distribution and anastomosis. It runs under the lateral ligament and also sends branches to the genital apparatus. Of the two hypogastric plexuses, the inferior is the most difficult one to identify. Its superior branches extend to the rectum, and the inferior ones to the genital apparatus. Because the anterior part contains the parasympathetic nerves and the middle rectal artery, this region is at major risk during surgical dissection. CONCLUSIONS: A sound understanding of the surgical anatomy of the rectum enables the surgeon to perform a more correct and reasonable procedure in terms of both the extent of surgical treatment and the preservation of important anatomical structures.

Adolescent↗