Biomedical subjects

N A Gómez

Publications and source records attributed to N A Gómez.

12 recordsLinked to original sources

PubMed2003

Use of a polytetrafluoroethylene tube and patch in the repair of a difficult duodenal stump.

In the cases where a primary anastomosis is unable after a duodenal resection, special care must be taken to avoid any complication in the duodenal stump such as suture dehiscence. Wall inflammation is an important factor in the development of this complication. We report a case of a 35-year-old woman who had previously undergone to pyloric exclusion due to a wall defect occurred after a bilio-digestive anastomosis, which complicated with a posterior duodenal stump dehiscence. The acute edema of the stump walls that resulted after it because exposure to bile conducted to heroic measures for its closure: first, the use of a polytetrafluoroethylene tube as duodenostomy and posteriorly a patch of the same material for its final closure. Both gave successful results in the repair of a refractory duodenal stump dehiscence.

Acute Disease↗

PubMed2002

Rectum leiomyoma in a 10-month-old female.

An unexpected case of leiomyoma (LM) of the rectum in a 10-month-old female patient. The patient presented with a palpable mass and symptoms of intestinal obstruction, constipation and rectal discomfort. Rectal examination revealed a clearly visible mass. The treatment consisted of a surgical resection with wide margins. Pathology reported a leiomyoma. The patient was submitted to a careful clinical evaluation and a continuous follow up.

Female↗

PubMed2000

[Percutaneous endoscopic gastrotomy (GEP): designed reusable (NAGEP) for one time endoscopic technique. Experimental study in dogs].

INTRODUCTION: This aim of our experimental study was to demonstrate the versatility of our designed reusable device for PEG and its future application in humans. MATERIALS AND METHODS: 20 mongrel dogs received enteral nutrition by a Foley tube placed by a single endoscopic technique using a reusable stainless steel designed device, three reusable stainless steel designed device, three reusable stainless steel dilators, an Olympus XQ20 video gastrointestinal endoscope, basic surgical equipment and surgical material. RESULTS: The procedure was successfully performed in all dogs under general anaesthesia. The duration of the whole procedure ranged from 10 to 18 min. The complications regardless by the PEG procedure were minimal. The Foley tube was retained by 15 days. CONCLUSIONS: The application of the stainless steel reusable designed device for the PEG is safe, and presents several advantages. This technique for PEG placement could be used in the future due the characteristics of the designed device: durable and reusable for unlimited number of procedures.

Animals↗

PubMed1999

[Amebic liver abscess in newborn. Report of a case].

The amebic liver abscess in newborns is an uncommon disease. There are few cases reported in the literature. This is a case of a 20 day-old female newborn who presented an abdominal mass, yellowish diarrheic depositions and jaundice. An abdominal CT scan showed a cystic mass located in the right hepatic lobe. The laboratory exams confirmed the amebic etiology. The clinical treatment failed and the surgery was decided. The pathologic results confirmed the diagnosis of an amebic liver abscess. Eight days after the resection the patient died because of a necrotizing enterocolitis.

Female↗

PubMed1998

Biliary sludge: a well defined sonographic entity.

OBJECTIVES: Identify the present of biliary sludge (BS) in our patients, since different authors have concluded that this entity may be an etiologic agent of biliary colic, gallbladder stones and some complications such as acute pancreatitis and acalculous cholecystitis. METHODS: We reviewed retrospectively the abdominal sonographic reports of 2802 patients of our gastroenterologic unit, with an average age of 40.5 years. The variables of the protocol were: gallbladder stones, BS and acute and chronic gallbladder inflammation. RESULTS: Considering the mentioned criteria, we entered to the study 2682 patients, 17.8% (n = 479) had lithiasis, 13.2% (n = 356) had BS, 2% (n = 54) had acute gallbladder inflammation and 2.3% (n = 64) had chronic gallbladder inflammation. Of the group of patients with BS 42.7% (n = 152) were female and 57.3% (n = 204) were males. 52% of the patients with BS were between the ages of 26 to 45 years. CONCLUSIONS: In our study we found an important prevalence of BS that was over 13% which is higher than the results reported by additional series. Its early sonographic detection, follow-up, removal of precipitating factors and treatment are all adequate measures in order to achieve its elimination.

Adolescent↗

PubMed1997

Syphilitic rectal ulcer associated with perforation of the hard palate: case report.

We report a case of a patient that presented with a perforated hard palate as a late complication due to an unsuspected syphilis. This disease first presented as a rectal ulcer which was misdiagnosed as an amebic proctitis. The patient received antiamebic treatment with a satisfactory outcome. He did not return for late control of the latter treatment and returned seeking medical advice six years later with the former complication. He tested positive for syphilis and appropriate treatment was performed. In addition, the ORL department recommended a palate prosthesis.

Humans↗

PubMed1997

[Use of spasmolytic agent otilonium bromide (spasmomen) in digestive endoscopy: a prospective study in 63 patients].

Otilonium bromide is a calcium antagonist with a direct myolytic effect, that is indicated in spastic conditions and functional dyskinesias of the gastroenteric apparatus (irritable bowel syndrome) and as a premedication for gastrointestinal endoscopic procedures. The present study assessed otilonium bromide 40 mg PO the night before and 40 mg PO the morning in 49 upper and 14 lower flexible endoscopies in 63 patients, to determine the presence or absence of peristalsis and relaxation of the pylorus. No side effects were observed due to the medication. In 46 (93.8%) upper endoscopies marked relaxation of the gastrointestinal tract and also pylorus relaxation were observed. In 13 (92.8%) lower endoscopies, marked relaxation of the colonic tract was also seen. All patients tolerated well the endoscopies. Otilonium bromide was useful as premedication in order to enable upper and lower endoscopic explorations, because of its spasmolytic effect.

Adolescent↗

PubMed1997

[Esophageal squamous papilloma: a case report and review of the literature].

We report a case of an esophagic squamous papilloma (SP) in a 90 year old patient. This pathology is benign and its diagnosis is generally a finding during an upper digestive endoscopy. Only 150 cases have been reported in the world's medical literature. Treatment consists in an endoscopic resection with diathermic snare or a conservative approach with periodical endoscopic control and observation depending of the type of patient.

Aged↗

PubMed1995

[Helicobacter pylori in patients with gastritis and gastric ulcer].

Seventy patients symptoms and signs compatible with gastritis and/or peptic ulcer were included in the study; they were 41 women and 29 men, with an age range of 9-84 years, and they underwent upper endoscopy. Brushing of the antrum was performed and 4 biopsies were taken from it. With the gastric mucus, a smear was prepared for Gram staining; one sample of tissue was placed directly in urea medium and another tissue sample in Skirrow medium; and two samples of tissue were stained with Hematoxylin-eosin and examined under the light microscope. Those patients who were taking antibiotics capable of inhibiting growth of Helicobacter pylori (Hp), the last four weeks prior endoscopy, were excluded from the study. Twenty-six patients (37.1%) were positive (+) for Hp the culture in urea medium. Of these 26 patients, 15 (21.4%) were also positive by the Skirrow method, and 11 (15.7%) by Gram stain. Epigastric pain was the most predominant symptom in (+) patients (80.7%) and (-) patients (68.1%) for Hp. Superficial acute gastritis within the antrum was the most frequent endoscopic finding in (+) (84.6%) and (-) (68.1%) patients. Chronic superficial gastritis was the predominant microscopic finding in (+) (42.3%) and (-) (38.6%) patients as well. Microscopic examination was positive for Hp in 6 (23%) patients by H-E stain. According to these results, there was no statistically significant difference in symptoms, endoscopic and microscopic findings between positive and negative patients for Hp.

Adolescent↗

PubMed1993

[Asymptomatic cholecystoduodenal fistula in a patient with diabetes mellitus and primary hypothyroidism: report of a case].

The case of a 60-year-old woman with diabetes mellitus type II and primary hypothyroidism, who presented a clinical picture compatible with intestinal obstruction is reported. An abdominal sonogram revealed acute calculous cholecystitis and ileus. A plain film of the abdomen showed dilatation of small bowel loops. She underwent celiotomy, once stabilized, and gallstone ileus+cholecystoduodenal fistula were diagnosed intraoperatively. Resection of the ischemic segment of distal jejunum and the stone, cholecystectomy and primary repair of the fistula were performed. In spite of the systemic complications (metabolic, cardiovascular and pulmonary), that appeared postoperatively, the patient had a favorable outcome. This patient had an acute calculous cholecystitis and a spontaneous biliary-enteric fistula with intestinal obstruction, without previous symptoms of biliary tract disease preceding the episode of bowel obstruction.

Biliary Fistula↗

PubMed1992

[Ascariasis of the gallbladder. Report of 2 cases and review of the literature].

Two patients who complained of a clinical picture compatible with cholelithiasis; and in whom the diagnosis of ascariasis of the gallbladder was made sonographically, are reported. In the first patient, cholecystectomy was curative and corroborated the presence of the roundworm. In the second patient, piperazine citrate was given. A second sonogram performed after therapy showed no roundworm within the gallbladder; and the patient remains asymptomatic until now. The usefulness of ultrasonography in the diagnosis of gallbladder ascariasis, and during surveillance in those patients who are managed with medical therapy only, is emphasized.

Adult↗

PubMed1985

[Surgical aspect in the management of pancreatic pseudocyst].

During the years from 1969 to 1979, 35 patients were operated 36 occasioned by pancreatic pseudocysts in the Department of Surgery of the University Hospital of Göettingen, West Germany. They were utilized as diagnostic methods laboratory exams, especially serial seric and urinary amylase as creatinine and at the same time abdominal echography, upper gastrointestinal tract X-rays, thorax X-rays, Barium Enema and Biliary tract X-rays. Although the great number of transit accidents, the traumatic pancreatic pseudocysts were seldom found and most of them were operated as a result of a chronic pancreatitis. Contrarily the pancreatic pseudocysts as result of an acute pancreatitis and recurrent acute pancreatitis were in a limited number. We observed only 2 cases of acute pancreatitis with biliary etiology. We realized one operation in 31 cases and in one resection, four of the series, was the only occasion that we recurred for a second and a third operation. The external drainage was realized exclusively in 3 cases while internal drainage was performed 28 times. The surgical technic frequently used as internal drainage was the Roux en-Y Cystojejunostomy and was perfomed in 21 patients. This method demonstrated to be the most fit by morphologic as functional reasons. We observed that our mortality was null and our post-operative morbility was minimal, so, we have only 3 patients with complicated post-operative course. The mean hospitalization time was 25 days. We surgical treatment of choice for the drainage of the pancreatic pseudocysts.

Acute Disease↗