Cirurgia
Permanent URI for this community
Browse
Browsing Cirurgia by Title
Now showing 1 - 10 of 72
Results Per Page
Sort Options
- Adenoma seroso oligoquístico do pâncreas: a propósito de um caso clínicoPublication . Almeida, N; Alves, S; Borges, I; Gregório, C; Gomes, D; Portela, F; Sérgio, M; Rui, M; Urbano, M; Gouveia, H; Martinho, F; Freitas, D
- Adult right-sided Bochdalek hernia with ileo-cecal appendix: Almeida-Reis herniaPublication . Costa-Almeida, CE; Reis, LS; Almeida, CMINTRODUCTION: Bochdalek hernia is one of the most common congenital abnormalities manifested in infants. In the adult is a rarity, with a prevalence of 0.17-6% of all diaphragmatic hernias. Right-sided Bochdalek hernias containing colon are even more rare, with no case described in the literature with ileo-cecal appendix. PRESENTATION OF CASE: The authors present a case of a right-sided Bochdalek hernia in an adult female of 49 years old, presented with severe respiratory failure. During laparotomy for hernia correction, were found in an intrathoracic position the cecum and ileo-cecal appendix, the right colon and the transverse colon. DISCUSSION: Although useful in patient evaluation, clinical history and physical examination are not helpful in making diagnosis because of their nonspecific character. CT scan is the most accurate exam for making diagnosis. Most of the times there is no hernial sac. Surgery is the treatment of choice, and it is always indicated even if asymptomatic. In general suture of the defect is possible. Due to patient's weak respiratory function we chose laparotomy by Kocher incision. CONCLUSION: Being the first case of a right-sided Bochdalek hernia in the adult with a herniated ileo-cecal appendix, we name it Almeida-Reis hernia.
- Alterações precoces dos enzimas hepáticos após colecistectomia: estudo prospectivo incluindo cintigrafia hepatobiliar quantificadaPublication . Milheiro, A; Diogo, C; Lapa, P; Cunha, MJ; Manso, E; Martins, L; Mártires, E; Pedroso de Lima, J; Castro e Sousa, F
- Anatomie abdominale et inguino-femoralePublication . Patrício, J; Bernardes, A
- Arteriovenous fistula with a saphenous long loopPublication . Patrício, J; Silveira, JAAfter radiation, chronic infection or previous operations recipient vessels for free tissue transfer become difficult to find. It may be necessary to locate vessels remote from the area of reconstruction and to construct long venous grafts. Long venous grafts can be compressed in the tissue tunnels that may be required. In this series of patients, an arteriovenous fistula was created with a long saphenous loop 10 to 21 days prior to tissue transfer. The saphenous loops were placed close to the area for reconstruction and when divided at the time of transplantation, provided one artery and one vein. In this series of 12 cases, adequate vascularization was achieved in 10 cases. In the other 2 cases, we believe that maturation of the fistula may have been necessary before proper function. The other advantages of the technique are: the procedure can be carried out under local anaesthesia, ease of positioning of the patient on the operating table, and a reduction in the time taken to perform the tissue transfer
- O balão intragástrico nas formas graves de obesidadePublication . Almeida, N; Gomes, D; Gonçalves, C; Gregório, C; Brito, D; Campos, JC; Gouveia, H; Freitas, DIntroduction: In patients with morbid obesity the intragastric balloon (IGB) can be a “bridge” to surgery or a temporary treatment in patients who are not candidates for surgery. Objective: Evaluate IGB efficacy in morbidly obese patients. Patients and Methods: In 2003/2004 seventeen IGB Bioenterics ® filled with normal saline and methylene blue were placed in 17 patients [11 women, median age was 49.2 (27-69 years); median body mass index was 55.6 (40.2-74.2 Kg/m2)], followed by nutritionists and/or endocrinologists. They had previously tried dietetic and/or pharmacological measures with limited results. Co-morbidities were present in 13 (76.5%). Results: Eight (47%) patients presented nausea/vomiting in the first 24-72h that persisted in 4 (23.5%) leading to dehydration and pre-renal insufficiency and forcing premature removal of the balloon (0.5 to 4 months). In the other patients, the device was removed at 6 months treatment (in 1 patient at 10 months). All patients suffered weight loss (5-70 Kg); median loss-19.6 Kg (p<0.001). No cases of spontaneous deflation/displacement occurred. Six (35.3%) underwent bariatric surgery. Conclusions: The IGB is a useful method for weight loss in morbidly obese patients. Nausea and vomiting are the most common complications. Although desirable, subsequent surgery is not always performed.
- Bártholo Thumannn do Valle PereiraPublication . Xavier da Cunha, E
- Bezoar gástrico e intestinal: caso clínico e revisão da literaturaPublication . Andrade, CS; Lopes, S; Pinheiro, C; Figueiredo, P; Tomé, L; Pinho, A; Martinho, F; Sofia, C; Leitão, MOs bezoars gastrointestinais são achados relativamente raros, apresentando uma variação regional na sua distribuição relacionada com diferenças na ingestão de alimentos ricos em fibras. A sua verdadeira incidência é desconhecida. A sua ocorrência apresenta uma tendência crescente, em provável relação com a maior taxa de cirurgias gastroduodenais realizadas no último século, consideradas factores de risco para a sua formação. Os autores apresentam o caso de um doente com antecedentes de cirurgia gastroduodenal, com quadro clínico caracterizado por vómitos alimentares, dor e distensão abdominal, paragem de emissão de fezes, anorexia e perda ponderal. O estudo complementar levantou a suspeita da existência de dois bezoars, um gástrico e um intestinal, a qual foi confirmada por laparotomia.Gastrointestinal bezoars are relatively uncommon findings and its distribution has a regional variation that correlates with differences in fibre enriched alimentary products ingestion. Its true incidence is unknown but its occurrence shows a growing tendency, which is probably related with the higher number of gastroduodenal surgeries performed in the past century, considered to be risk factors for bezoar formation. The authors present the case of a patient with a past history of gastric and duodenal surgery, admitted with vomiting, abdominal pain and distension, anorexia and weight loss. The diagnostic workup brought about the possibility of the existence of two bezoars, one gastric and one intestinal, which were confirmed by surgery.
- Uma causa rara de hipertensão portal: Caso clínicoPublication . Moreira, J; Antunes, L; Baptista, A; Pereira, R; Gonçalves, A; Anacleto, G; Alegrio, J; Fonseca, M; Gonçalves, O; Furtado, E; A, MatosApresenta-se caso clínico de doente com quadro de hipertensão portal pela presença de fístula artério-venosa entre a artéria gastroduodenal e a veia porta. Indivíduo do sexo masculino, de 77 anos, previamente saudável, com ascite volumosa de instalação recente. Hemorragia digestiva alta por rotura de varizes esofágicas. TAC abdominal revelando acentuada dilatação da veia porta (30 mm), envolvida em fístula artério-venosa com origem na artéria gastroduodenal; fígado sem estigmas de hepatopatia crónica e sem nódulos; ascite volumosa. Procedeu-se à laparotomia com drenagem de ascite, isolamento e laqueação do trajecto fístuloso entre a artéria gastroduodenal e a veia porta. Sem complicações intra-operatórias. Ao 18º dia, após regressão da ascite, teve alta medicado com diuréticos
- Chemoprevention of DMBA-Induced Mammary Tumors in Rats by a Combined Regimen of Alpha-Tocopherol, Selenium, and Ascorbic AcidPublication . Dias, MF; Sousa, E; Cabrita, S; Patrício, J; Oliveira, CFThis experimental study was designed to evaluate the efficacy of associated naturally occuring antioxidants in the prevention of chemically induced breast cancer using DMBA in virgin female Wistar rats. Rats were randomly allocated to three groups: control group (CG; n = 20), induction group (IG; n = 100), and prevention group (PG; n = 70). A single dose (65 mg/kg) of DMBA was administered in the IG and PG animals at 50 days of age. PG animals also received a single dose of alpha-tocopherol (200 mg/rat) 1 hour after DMBA administration and an association of selenium (p-XSC, 40 ppm/day/rat) and ascorbic acid (540 mg/day/rat) in drinking water, daily, from carcinogenic induction until necropsy. Macroscopic study and pathology revealed a significantly lower development of neoplasms in the PG animals (p < 0.05); the number of rats with mammary tumors, breast cancer incidence, and the number of malignant breast tumors per rat as well as per tumor-bearing rat were significantly decreased in the PG animals. Other types of primary neoplasms existing in the IG animals totally disappeared in the PG animals. Immunostaining to hormone steroid receptors (ER and PR) and cathepsin D was similar in both groups. Overexpression of p53 and metallothioneine was significantly increased in the PG animals (p < 0.05) and immunostaining to bromodeoxiuridin and Ki-67 was also stronger in the remaining tumors in the PG animals. These data thus add to the accumulating evidence that those micronutrients in combination seem to be effective in reducing the incidence of malignant tumors. Nevertheless, remaining tumors seem to present more aggressive behavior and characteristics of drug resistance