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Search Results: 1 - 10 of 977 matches for " Gh. Ghidirim "
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LEIOMYOMA OF THE TRANSVERSE COLON – UNCOMMON SOURCE OF PERITONITIS
Gh. Ghidirim,I. Mi?in,Gh. Zastavni?chi
Jurnalul de Chirurgie , 2009,
Abstract: Leiomyoma of the transverse colon is uncommon. The majorities of these lesions are clinically insignificant, being diagnosed incidentally. Symptomatic leiomyomas of the colon are less common; sporadic case reports have been described in the relevant literature. We describe an additional case of extraluminal transverse colon leiomyoma with necrosis and perforation. A 22-year old female patient complaining abdominal pain was admitted with the diagnosis of peritonitis. The intraoperative findings were: a transverse colon mass on the mesenteric wall, purulent fluid on the left flank and Douglas pouch. A transverse colon resection with primary anastomosis has been performed. The histological findings were consistent with extraluminal leiomyoma with necrosis. The postoperative period was uneventful and the patient discharged on the 9th postoperative day. During a 9 month follow-up the patient is free of disease recurrence. Although benign, colon leiomyoma may cause life-threatening complications, requiring emergency surgery.
SCROTAL FAECAL FISTULA: A RARE COMPLICATION OF INCARCERATED INGUINAL HERNIA
Gh. Ghidirim,I. Mi?in,S. Ignatenco,Elina ?or
Jurnalul de Chirurgie , 2010,
Abstract: Scrotal faecal fistula is a rare complication of incarcerated inguinal hernia. We report a case of a 54-year-old male, who presented fistula following prolonged incarceration of a left inguinal hernia (the presence of a caecum and vermiform appendix in a hernia sac). The patient presented himself to the emergency department with the diagnosis of a Fournier's gangrene. On second postoperative day after debridement of the scrotal fasciitis a enterocutaneous fistula in the scrotum was diagnosed as result of a strangulated inguinal hernia. The patient was treated by right hemicolectomy with an anastomosis and routine hernia repair was performed. Postoperative period was uneventful. The aetiology and management of this rare complication is discussed.
EMERGENCY SURGICAL ABDOMINAL PATHOLOGY IN REPUBLIC OF MOLDOVA
E. Maloman, ,,Gh.Ghidirim,V. Cazacov
Jurnalul de Chirurgie , 2007,
Abstract: The aim of this paper is to study the abdominal surgical emergencies. Methods: We made a retrospective study during 1982 – 2004. We encountered 586 patients. From these, 98 patients had acute surgical pathology with peritonitis and were admitted into the hospital in the first 24 hours from the debut. We studied the type of diagnosis and the surgical procedure. Results: The incidence of some of the acute abdominal pathology is encreasing: intestinal obstruction with 49.3%, the haemorrhagic complication of the ulcer with 66%, the complicated hernias with 107%, the acute cholecistitis with 41.4%, the acute pancreatitis with 240%. The rate of the perforated peptic ulcer is on the same level in all these years. Acute apendicitis had a decreasing incidence with 27%. We also discuss the rate of postroperative mortality and morbidity. Conclusions: The overall abdominal acute pathology had an encreasing rate. The postoperative results depends from the moment of the diagnosis (late diagnosis is associated with worse prognosis), type of surgical procedure, surgeons experience, hospital endowment
Consideration on the nonoperative treatment of blunt splenic injury
R. Gurghi?,Gh. Rojnoveanu,Gh. Ghidirim,,V. Gafton
Jurnalul de Chirurgie , 2012,
Abstract: A prospective study (2008-2009) 30 patients with Blunt Splenic Injuries or NOM. The hemoperitoneum was established by USG (100%). The extent of parenchimatous organ injury was quantified at CT 27(90%) cases. Laparoscopy was performed in 6(20%) cases for assessing USG sensitivity. The following parameters were recorded: age, sex,trauma mechanism, Glasgow scale, trauma score (RTS), trauma severity score (ISS), diagnostic procedures, value of hemoperitoneum as a predictive factor, volume of blood transfusions,morbidity and mortality. The criteria for NOM selection included hemodinamyc stability,radiologic confirmation of splenic injury and absence of other abdominal trauma which would need surgical treatment. Based on our tomographic findings, we tried, according to different tomographic grading systems of blunt injuries of the spleen to predict the need for surgery. The Schweizer tomographic scale and the Resciniti score do not have predictive value neither in thereported nor in our results. The new MDTC system that incorporates LVL seems to have predictive value and the possibility to decrease the failure rates of NMO by embolization opportunities for grade 4a and 4b lesions. The decision to perform laparotomy should not bebased solely on the results of tomographic grading, surgical tactics being decided only in complex with clinical parameters.
POSTTRAUMATIC CHOLECYSTOCUTANEOUS FISTULA
Gh. Ghidirim,Gh. Rojnoveanu,I. Mi?in,R. Gurghi?
Jurnalul de Chirurgie , 2007,
Abstract: Spontaneous cholecystocutaneous fistulas are rare complications of untreated gallbladder empiema in patients with biliary stone disease. Posttraumatic cholecystocutaneous fistulas due to blunt abdominal trauma are exceptional, and only three such cases being described in the medical literature. Cholecystocutaneous fistulas are rarely observed today because of the early diagnosis and progress in surgical treatment of biliary stone disease. We present the case of a 73 years old patient admitted two months after blunt abdominal trauma with cutaneous fistula in the right-upper abdominal quadrant with biliary discharge. The diagnosis was established by means of fistulography. The patient underwent laparotomy, cholecystectomy and fistula excision. Postoperative period was uneventful.
SPONTANEOUS MESENTERIC HEMATOMA
Gh. Ghidirim,I.Mi?in,Gh.Zastavni?chi,E.Condra?chi
Jurnalul de Chirurgie , 2009,
Abstract: Spontaneous small bowel mesentery or retroperitoneal hematomas are rare pathology occurring in absence of any trauma, anticoagulant therapy, vessel’s anomaly or systemic inflammatory disease. We present a case of a 23-year old male patient diagnosed with small bowel mesentery hematoma that corresponds to the spontaneous” definition, who was admitted three days after onset accusing pain and a tumorous mass in the mesogastric region. Abdominal US and CT revealed a high density tumorous mass with well defined borders and nonhomogenous content, localized anterior to the left kidney, being in intimate contact with the small bowel loops and the transverse colon. Surgery was performed and the mesenteric hematoma was completely removed. Histological examination revealed characteristic changes for encapsulated hematoma. Postoperative period was uneventful, the patient being disease free during 24 months follow-up.
MESOCOLONIC LYMPHANGIOMA IN ADULT
Gh. Ghidirim,I. G?g?uz,I. Mi?in,,E. Condra?chi
Jurnalul de Chirurgie , 2007,
Abstract: Lymphangioma is a benign tumor of the lymphatic system, histogenetic it is characterized by a congenital mesenchimal malformation affecting the wall of the lymphatic vessels. Intraabdominal lymphangioma is a rare disease, mesocolon localization being exceptional. Mesocolonic lymphangioma occurs extremely rare in adults. We report a case of lymphangioma of mesocolon in an adult patient. A 23-year old male was admitted with 1 month history of moderate progressive abdominal pain and palpable mesogastric mass. Abdominal ultrasonography (US) and computed tomography (CT) scanning demonstrated a cystic mass located in mesogastric area adherent with the transverse colon and the anterior abdominal wall. Complete excision of the cystic mass was performed. The histological findings were confident with lymphangioma. The postoperative period was uneventful. During a 6 month follow-up period the patient is free of disease recurrence.
Non-Operative Treatment for Gall-Stone Ileus - A Case Report
Igor Mishin, Gheorghe Ghidirim, Gheorghe Zastavnitsky
Polish Journal of Surgery , 2011, DOI: 10.2478/v10035-011-0034-4
Abstract: Gall-stone intestinal obstruction (GSO) is an unusual form of mechanical obstruction and a rare complication of cholelithiasis. The treatment options are controversial, usually the management is surgical but associated with significant morbidity and mortality. A spontaneous evacuation of the gall-stone that had induced GSO is even more exceptional, only few reports being published up to date. We report the case of an 81-year-old female patient presenting GSO admitted to our department due to abdominal pain and vomiting. Computed tomography revealed pneumobilia, distention of the ileum and a calcified mass in the small bowel lumen. The diagnosis of GSO was established, but since the gall-stone was <25 mm and severe cardiorespiratory co-morbidities conservative treatment was initiated and spontaneous evacuation of the gall-stone was obtained. Diagnostic and management modalities of GSO as well as literature reviews are reported.
Study on Radon and Radium Concentrations in Drinking Water in West Region of Iran
Gh. Forozani,Gh. Soori
Agricultural Journal , 2013, DOI: 10.3923/aj.2011.310.312
Abstract: One of the most important characterizations of social health is existence the availability of safe drinking water. Since, one of the sources of water contamination is nuclear contamination from radon gas so in this research radon 222 concentration levels in water supplies in the Toyserkan (a region located in the West of Iran) is investigated. For measuring radon gas in water wells and springs Lucas chamber method is used. Review the results of these measurements that taken from 15th place show that only five sites have radon concentrations above the limit dose. To reduce radon concentration, it is better to keep water in open pools in contact with air before the water is delivered to users.
SEVERE ACUTE PANCREATITIS WITH ABDOMINAL COMPARTMENT SYNDROME – CASE REPORT
Ghidirim G,Gagauz I,Misin I,Zastavnitchi G
Jurnalul de Chirurgie , 2006,
Abstract: The current management guidelines in severe acute pancreatitis call for non-operative treatment as long as there is no evidence of infection. Recently a few reports describing abdominal compartment syndrome in patients with severe acute pancreatitis necessitating decompressive laparotomy were published in the English literature. We describe an additional case of abdominal compartment syndrome in a patient with severe acute pancreatitis successfully treated by decompressive burso-omentostomy. A 42 years old male patient was admitted to our surgical unit, within 48 hours after onset, complaining diffuse abdominal pain, nausea and multiple vomiting. The diagnosis of acute pancreatitis was established based on USG (free fluid in the abdominal cavity and lesser sack, pancreatic edema) and urine amylase level - 1200 g/h/L. Due to his poor condition the patient was admitted to the intensive care unit. During next 48 hours after admission the patient developed intra-abdominal hypertension (35 cm H2O measured transvesically) and abdominal compartment syndrome with multiple organ dysfunction. CT revealed gross pancreatic and retroperitoneal edema accompanied by abdominal distension with massive gas in the gastrointestinal tract. The patient necessitated abdominal decompression and burso-omentostomy was performed, followed by three sessions of lesser sack debridement. Intra-abdominal pressure normalized after surgical decompression and multiple organ dysfunction disappeared. The patient was discharged on 54 postoperative day. His ventral hernia was repaired 6 months later. This case report highlights that severe acute pancreatitis may be associated with intra-abdominal hypertension with clinically significant abdominal compartment syndrome in the early stages of the disease and decompression by burso-omentostomy in absence of infection is one possible solution of this critical situation. Further evaluation on a large patients series is necessary before final conclusion will be reached, regarding the efficacy of laparostomy (burso-omentostomy) in the management of severe acute pancreatitis with abdominal compartment syndrome.
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