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Biomedical subjects

P Gentileschi

Publications and source records attributed to P Gentileschi.

30 records · Page 2Linked to original sources

[Primary sarcoidosis of the breast: a clinical case].

Sarcoidosis of the breast is rare and only few cases are reported in the literature. A case of sarcoidosis presenting as a breast mass with no other evidence of disease is herein reported. Ultrasound and fine needle aspiration biopsy were performed, but only excisional biopsy with microscopic examination confirmed the diagnosis. Differential diagnosis with other granulomatous lesions is important to select the proper treatment.

Biopsy, Needle↗

[The pilonidal sinus: its surgical treatment, our experience and a review of the literature].

The authors report their experience in the surgical management of pilonidal sinus. During a 3-year period (1989-1991) 106 patients underwent primary closure. Average postoperative stay was 5.5 days, while mean healing time was 14.6 days. During the follow up, 3 patients developed a true recurrence (3.26%). After a critical review of the literature, the authors emphasize the importance of primary closure in the surgical treatment of pilonidal disease.

Adolescent↗

[Alkaline esophagitis following total gastrectomy].

Two cases of severe alkaline esophagitis following total gastrectomy, respectively for a gastric sarcoma and a gastric carcinoma, are reported. In the first case digestive continuity was assured through an Omega loop esophagojejunostomy, while in the second one an esophagojejunostomy according to the Moricca technique was performed. Both patients underwent reoperation and a conversion in Roux-en-Y esophagojejunostomy resolved the reflux related problems. The Authors, therefore, confirm Roux-en-Y esophagojejunostomy as the procedure of choice in preventing and curing esophagitis, which can seriously affect the quality of life and nutritional status of gastrectomized patients.

Adult↗

[Leiomyosarcomas of the stomach: a report of 3 clinical cases and a review of the literature].

Three consecutive malignant smooth-muscle gastric tumor cases are reported. Digestive endoscopy allowed a correct diagnosis in 2 out of 3 cases, when neoplasias were ulcerated, enabling a deep endoscopic biopsy. On the contrary, in the third case the endoscopic diagnosis was a benign leiomyoma and the endoscopic biopsies were completely negative. Even CT scan was not able to reveal the malignant nature of the disease in this patient. Surgical procedures performed were: polar superior gastric resection, Billroth I partial gastric resection and extended total gastrectomy. In one patient, regional lymph nodes were positive for metastases. The patient who died at 6 months from surgery had a large (approximately 12 cm) neoplasia of the gastric fundus.

Adult↗

[Retrospective analysis of the use of prophylactic drainage of the pelvis after anterior resection of the rectum].

Although the use of drains is common in clinical practice, its real role in the prophylaxis and therapy of postoperative complications is still not clear. In the literature we can find both supporters of drains, and many opponents who consider their use unnecessary and sometimes even dangerous. In fact, during new experimental and clinical studies, it was impossible to determine the usefulness of prophylactic abdominal drain, at least in the case of colo-rectal anastomosis, it has been demonstrated that use of drains limits the risks of an anastomotic leakage but, in some cases, the same drains could be the cause of some of the complications that should be avoided. Although there is a considerable theoretical and practical evidences in favour of drainage, the dispute about "to drain or not to drain" the peritoneal cavity after elective colo-rectal surgery remains open. This retrospective study made on 150 patients operated on elective surgery for rectal cancer demonstrates that prophylactic drain does not significantly influence the general rate of leakage (3.15% for group A and 5.45% for group B, p > 0.1); in two of the three fistulas in patients with drains, the drains have permitted the diagnosis, but have not permitted the reduction of the number of operations for fistulas.

Adult↗

Laparoscopic pancreatic resection.

The extent of reported laparoscopic resections vary from enucleation to pancreaticoduodenectomy. Although initial series have been reported with encouraging results, most patients with pancreatic disease requiring resection are still treated with an open approach. We present a review of our experience and of the world literature on laparoscopic pancreatic resection. Laparoscopic pancreaticoduodenectomy has been attempted in 12 patients with a conversion rate of 33%. Complications occurred in the laparoscopic group. The laparoscopic patients have experienced no benefit in the postoperative recovery and convalescence. Early experience with the hand-assisted approach is promising. Sixty-eight laparoscopic distal pancreatectomies and enucleations have been reported to date. They were 42 distal pancreatectomies and 26 enucleations. Thirteen procedures have been converted to open surgery (19.1%). There was no mortality and the main postoperative complication was pancreatic leak (5 patients, 7.3%). Average hospital stay was 9 days. These results compare favorably with the outcomes after open pancreatic resection. While laparoscopic pancreaticoduodenectomy is not associated with patient benefit and may be accompanied by increased morbidity, laparoscopic distal pancreatectomy and enucleation are safe, carry low morbidity and have encouraging results in terms of postoperative recovery.

Humans↗

[Emergency endoscopic sphincterotomy in acute lithiasic cholangitis].

Emergency endoscopic sphincterotomy in acute cholangitis for bile duct stones should be the first choice treatment in patients with and without gallbladder. In fact, emergency surgery carries higher mortality and morbidity rates. Urgent biliary drainage, easily and quickly obtainable by endoscopy is the major goal. Bile duct stone clearance can be attempted subsequently, when the patient general conditions are stable. Elective open surgery can be performed thereafter, if indicated, with less risk. This experience is clearly shown by many surgical and endoscopic, mainly retrospective, studies.

Acute Disease↗

[Solitary ulcer of the rectum: a report of a clinical case associated with rectal prolapse].

Solitary ulcer of the rectum is an unusual condition occurring more often in young adults. Unfortunately the term is rather confusing, since the lesion may not necessarily be solitary, nor be confined to the rectum; moreover, it may be polypoid rather than ulcerating. The etiology is uncertain, but chronic constipation and fecal impaction could play a role. Today most authors believe solitary ulcer syndrome is a distinct clinical inflammatory manifestation associated with rectal prolapse. Surgical treatment of the prolapse is usually followed by a recovery of the solitary rectal ulcer.

Adult↗

[Carotid chemodectoma: a clinical case report and review of the literature].

Carotid chemodectoma (CC) is a very rare neoplasia. It originates from Type 1 main cells of the carotid body and affects both sexes almost in the same proportion (mostly in the fourth and fifth decades). It can be on a familiar basis (5-10%) and in these cases it is more frequently multicentric, being sporadically found in association with other paragangliomas. CC is a slow-growing neoplasia, locally aggressive and it can give metastases to regional lymph nodes and surrounding anatomical structures. Once surgically removed, it can reoccur in a small percentage of patients. Early diagnosis is of the utmost importance and surgeon's skill is fundamental as well as awareness of the real nature of the disease. Surgical treatment of CC is difficult and demanding, for the close relation of CC to the neighbouring neurovascular structures. The authors report a case of CC radically operated on. Clinical parameters are analysed as well, and Literature is reviewed.

Carotid Body↗

[Clinico-pathological study of microcarcinoma of the thyroid].

We have analysed the results of surgical treatment for microcarcinoma of the thyroid (MCT). In sixteen patient clinical and follow-up data were retrospectively evaluated during a 35.1-month follow-up. Thyroid hyperfunctional state us was present in two subjects. A single nodule was detected by echotomography in 11 patients, while multinodular diffuse goitre was revealed in 3 patients. In the last two subjects, thyroid gland appeared completely normal at ultrasonography, despite laterocervical lymph node metastases. Fine-needle aspiration biopsy was performed in 6 patients and its diagnostic accuracy was high (83,3%). MCT was classified as "incidental" in 12 patients and "occult" in the remaining 4 patients. Eight subjects underwent total thyroidectomy and 8 hemithyroidectomy plus isthmectomy. No postoperative complications were recorded. In 10 patients MCT histotype was papillar adenocarcinoma, in 5 was follicular adenocarcinoma and in the remaining case it was medullary carcinoma. Goitre was associated in 75% of the cases. Only in a patient disease progressed to death because of hematogenous metastases. In conclusion, we believe that incidental MCT is a low-grade malignancy with a benign biological behaviour. Occult MCT is a potentially lethal disease. We did not observe differences in the long-term results between different surgical treatments of MCT.

Adenocarcinoma, Follicular↗

[Role of p53 gene in colorectal neoplasms].

A prospective study on the role of the p53 gene in sporadic colorectal neoplasms is presented and the level of mutant p53 protein was measured in the tissue removed during colonoscopy from: patients previously operated for colorectal malignant neoplasms, patients with active neoplasms, first degree relatives and during regular checks. 72% of patients with an active tumour showed a positive p53 and 38% in follow-up checks. Longer follow-up periods and a major number of patients are necessary to assess the prognostic importance of the p53 protein.

Colorectal Neoplasms↗