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P Milosević

Publications and source records attributed to P Milosević.

16 recordsLinked to original sources
PubMed1992

[10 years' experience with the use of endoscopy in the intraoperative diagnosis of extrahepatic biliary tract diseases].

In the last ten years 375 patients were operated on biliary tract examined with intraoperative choledochoscopy. Sensitivity of choledochoscopy in our investigation was 72% and negative predictive value was 85% while specificity and positive predictive value for flexible choledochoscopy was 100%. There were no false positive results. After the instrumental exploration of the common bile duct, unsuspected stones were found in 9.19% of patients recorded with choledochoscopy and 3.44% of retained stones confirmed by postoperative cholangiography. Choledochoscopy was successful in determination of the level of obstruction by tumors in all patients (100%), but of limited value in determination of tumor extension through the bile duct wall in 66.66% of patients. Interventional procedures through the work channel of the instrument showed little success. Extraction of impacted stones was recorded in one patient (3.70%) while the biopsies were completely unsuccessful. We recommend choledochoscopy for each patient with open common bile duct, especially with proved multiple common bile duct stones.

Bile Duct Diseases↗
PubMed1969

[Not Available].

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Equipment and Supplies↗
PubMed1969

[Not Available].

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History, Modern 1601-↗
PubMedDate not supplied

[Total abdominal colectomy in treatment of acute malignant obstruction of the left colon].

This paper deals with an experience of a total abdominal colectomy in acute malignant obstruction of the left sided colon. Ten patients were treated with total abdominal colectomy during 1991 with a high frequency of synchronous carcinoma (in two patients) and precancerous lesions (a big polyp in one patient) in total 30%. One patient died after the treatment (10%) and a complete dehiscence of the ileo-rectal anastomosis and reoperation on the ninth postoperative day. One patient had had an infection of the wound. Total abdominal colectomy is an operation which can have an important role in decreasing malignant reoccurrence, avoiding stoma in the postoperative period of one month in most patients. Absolute indication for total abdominal colectomy in patients with acute malignant obstruction of the left sided colon is the "closed loop" obstruction with a decompensated colon, as well as the factor of heredity in close relatives and the absence of locally spread tumors and metasthases disregarding the age of the patient and the competence of the ileocecal valvula.

Acute Disease↗
PubMedDate not supplied

[Fournier's gangrene associated with carcinoma of the colon].

BACKGROUND: A case of Fournier's gangrene associated with colon carcinoma was reported. Fournier's gangrene is a progressive soft tissue infection of the perineal and scrotal region. CASE REPORT: A 50-year-old man was transferred to our hospital with clinical signs of septic shock and necrotizing soft tissue infection, of the scrotal and perianal regions. Local examination revealed a communication between rectum and left ishioanal fossa, many openings in the skin with purulent discharge and crepitus. After resuscitation the patient underwent emergent operation. Surgical debridements were performed. The wounds healed well with good granulation tissue. DISCUSSION: The majority of patients with Fournier's gangrene are immunocompromised. Malignant disease, obesity, diabetes mellitus and peripheral vascular disease have been cited as the main predisposing factors. The origin of this synergic infection is in alimentary and urinary tract. As a rule, penis, testes, bladder and rectum are spared. Conventional treatment includes repeated surgical debridement, special antibiotic regimen to cover both, aerobes and anaerobes, and intensive care treatment. Despite optimal medical and surgical management the mortality rate in Fournier's gangrene still remains high.

Carcinoma↗