Laparoscopic dual mesh repair of a diaphragmatic hernia of Bochdalek in a symptomatic elderly patient.

Bochdalek hernia is a congenital posterolateral diaphragmatic defect. It is usually diagnosed in newborns and children; the mortality rate is high due to further congenital anomalies such as pulmonary hypoplasia and pulmonary hypertension. In adulthood, the diagnosis is often incidental, while sometimes it is related to gastrointestinal or respiratory symptoms, or to herniated viscera complications.

[Intestinal perforation due to accidental ingestion of foreign bodies].

Usually the ingested foreign bodies (IFB) pass the gastrointestinal tract making no lesions. Sometimes IFB could lead to a gastrointestinal perforation. The most frequently perforating IFB are chicken or fish bones and toothpicks, while risks factors are mental retardation, alcohol or drug abuse, denture usage, quick eating or habitual chewing of toothpicks.

[Cholelithiasis and renal cysts: simultaneous laparoscopic treatment].

Laparoscopic surgery has been increasingly used in different fields of surgery. This report concerns the authors' experience with combined laparoscopic cholecystectomy and symptomatic renal cyst decortication. The mean diameter of the cysts was 11.

[Cavernous hemangioma of the adrenal glands: a clinical case].

Cavernous haemangiomas of the adrenal gland are rare and the preoperative diagnosis is very difficult. We report the case of a patient admitted for aspecific abdominal pain. Instrumental diagnostic investigations (ultrasonography and CT scan) revealed an adrenal mass of uncertain interpretation which was surgically removed and histologically diagnosed as a cavernous haemangioma.

[The transesophageal echocardiographic evaluation of the hemodynamic effects of the pneumoperitoneum in laparoscopic hemicolectomy].

Materials And Methods: Ten patients undergoing laparoscopic left hemicolectomy were monitored by transesophageal echocardiography in order to assess the effects of pneumoperitoneum and head-down tilt on the following parameters: end-diastolic left ventricular volume, stroke volume, cardiac output, left ventricular ejection fraction, mean blood pressure and cardiac frequency. Pneumoperitoneum, by a mean CO2 pressure of 13 mmHg, was performed in five of them; for the other patients, mechanical abdominal wall suspension was used, without any increase in abdominal pressure.

Results: The group treated by abdominal wall suspension underwent an increase in end-diastolic left ventricular dimension, stroke volume, cardiac output and blood pressure, while the group treated by pneumoperitoneum had no significant changes in hemodynamic parameters.

Sigmoid volvulus in west Africa: a prospective study on surgical treatments.

To evaluate the efficacy of different types of surgery, we performed a prospective, randomized trial in 31 consecutively hospitalized patients with sigmoid volvulus. These patients represented 8 percent of 377 cases of emergency surgery. At the time of surgery, the patients were divided into two groups according to the absence (Group A) or presence (Group B) of bowel gangrene.

[Effects of somatostatin peridurally administered in the treatment of postoperative pain].

Somatostatin (SMS), a hormone extensively found within the CNS, has shown to have a powerful analgesic effects administered either via the epidural or subdural route. The aim of the present study was to evaluate the efficacy of SMS administered epidurally compared with placebo, for the treatment of post-operative pain in patients receiving epidural anaesthesia for surgery. Of the 86 patients observed, 58 entered the study and were randomized to receive either SMS or placebo in a double blind fashion.

Role of thyrotropin-releasing hormone in stress ulcer formation in the rat.

The role of the hypothalamic peptide thyrotropin-releasing hormone in stress ulcer formation was investigated. In experiment 1, TRH was peripherally administered (10 micrograms/kg) to rats subjected to cold-restraint stress and compared to an inactive peptide; in experiment 2, TRH was administered intracerebroventricularly (0.02, 0.

Effect of somatostatin in controlling bleeding from esophageal varices.

A multicenter double-blind clinical trial was undertaken to evaluate the efficacy of a short-term somatostatin treatment versus a short-term vasopressin treatment on acute hemorrhage from esophageal varices in patients with liver cirrhosis and portal hypertension. Forty-nine patients with massive hemorrhage and endoscopic diagnosis of bleeding esophageal varices completed the study. Patients were randomly assigned to somatostatin treatment (24 patients: 250 micrograms/hr i.

Ranitidine and somatostatin. Their effects on bleeding from the upper gastrointestinal tract.

In a randomized, double-blind placebo-controlled clinical trial, the effect of ranitidine was compared with the effect of somatostatin in the control of massive gastrointestinal tract bleeding. Ninety-six patients completed the study. Rates of continuing bleeding and death, incidence of surgery, and blood transfusion requirements were not significantly different in the three treatment groups.

Effect of caerulein in patients with biliary colic pain.

A randomized placebo-controlled double-blind trial was carried out in 24 patients with biliary colic pain in order to evaluate the analgesic effect of caerulein (CRL). Caerulein (1 ng/kg . min infused intravenously over 15 min) showed an analgesic effect that was significantly higher than placebo (p less than 0.

Effect of ceruletide on rest pain in patients with arterial insufficiency of the lower extremity.

The effect of ceruletide (CRL), a synthetic decapeptide analogue of cholecystokinin, on rest pain and arterial blood flow was evaluated in 8 patients with advanced, occlusive atherosclerosis of the lower extremities. CRL 1, 2, or 4 ng kg-1 or placebo were infused intravenously in random order, and in a double-blind fashion. Pain relief, assessed by a scoring system, was significantly better (p less than 0.

Cimetidine and antacid prophylaxis of acute upper gastrointestinal bleeding in high risk patients. Controlled, randomized trial.

A randomized, controlled clinical trial was performed to compare the efficacy of prophylactic cimetidine treatment, antacid treatment and no treatment in high risk patients. Sixty patients received cimetidine (200 mg every 6 hours), 52 patients received antacids (Maalox, 10 ml/hour), and 56 patients received no treatment. One hundred thirty-five patients completed the study.

Management and long-term results in patients with two-thirds gastrectomy and stomal ulcer.

In 67 patients with two-thirds gastrectomy and endoscopically proven stomal ulcer, serum gastrin levels were measured under basal conditions and after intravenous infusion of bombesin (15 ng/kg/min), calcium (4 mg/kg/hour) and secretion (2 units/kg). All patients underwent medical or surgical therapy. The long-term results were evaluated according to the Visick grading system (average follow-up, 3.