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        תוצאת חיפוש

        ינואר 1999
        מיגל יוכטמן, עמוס שטרנברג, ריקרדו אלפיסי, אהוד שטרנברג וצבי פיירמן

        Iatrogenic Gallstone Ileus: A New Complication of Bouveret's Syndrome

         

        Miguel Iuchtman, Amos Sternberg, Ricardo Alfici, Ehud Sternberg, Tzvi Fireman

         

        Depts. of Surgery and Gastroenterology, Hillel Yaffe Medical Center, Hadera, and Rappaport Medical School, Haifa

         

        Bouveret's syndrome involves gastric outlet obstruction caused by a gallstone in the duodenum. This type of gallstone ileus can be diagnosed and treated endoscopically. Endoscopic stone removal is especially indicated in poor risk patients. A dislodged impacted stone can migrate distally and cause small bowel mechanical obstruction. We report a 51-year-old woman who underwent endoscopic duodenal stone manipulation which resulted in small bowel obstruction.

        מנשה ברזילי, אריה ביטרמן, דורית שלג-אייזנברג ונתן פלד

        The Fate of Gallstones "Dropped" during Laparoscopy

         

        Menashe Barzilai, Arie Bitterman, Dorit Schlag-Eisenberg, Nathan Peled

         

        Depts. of Radiology and Surgery B, Carmel Medical Center, Haifa

         

        Laparoscopic cholecystectomy is considered the procedure of choice for removing symptomatic, stone-containing gallbladders. It is estimated that in 30-40% of these operations stone(s) spill into the peritoneal cavity. It was assumed that these "dropped stones" are harmless and are dissolved and absorbed spontaneously. We present a 70-year-old woman in whom such a stone, dropped during laparoscopy, led to formation of an intraperitoneal abscess.

        דצמבר 1998
        אליעזר אלקלעי, דניאל יפה וצבי שפינדל

        Radiologic Appearance of "Falling Gallstones" during Laparoscopic Cholecystectomy

         

        E. Alkalay, D. Yaffe, Z. Spindel

         

        Eyn Vered Clinic and Depts. of Radiology and Surgery, Sapir Medical Center, Kfar Saba and Sackler Faculty of Medicine, Tel Aviv University

         

        Laparoscopic cholecystectomy is the "gold standard" in treating cholelithiasis. Stones are frequently lost in the peritoneal cavity during the procedure, but "missing stones" have been regarded as insignificant. However, there is accumulating evidence that untreated "lost" stones may cause complications even years after operation.

         

        We present a 65-year-old woman who presented with vague complaints, anemia and an elevated ESR. CT scan showed an infiltrating process in extra-abdominal muscles compatible with sarcoma. At operation, 2.5 years after previous laparoscopic cholecystectomy, an abscess was found which contained biliary stones. Because of their small size they were not visible on CT scan. We discuss the possible ways of handling "falling stones."

        שמואל כץ, אילן ארז, איטה ליטמנוביץ, לודוויג לזר, אריה רז וציפורה דולפין

        Bowel-Lengthening in a Newborn with Short Bowel Syndrome

         

        Schmuel Katz, Ilan Erez, Ita Litmanovitz, Ludwig Lazar, Arie Raz, Zipora Dolfin

         

        Depts. of Pediatric Surgery, Neonatology and Pediatrics; Meir Hospital, Kfar Saba

         

        Advances in parenteral nutrition and supportive therapy have led to improvement in survival of babies with short-bowel syndrome. Those whose intestinal mass is very unlikely to be adequate should have surgical therapy as soon as possible, before they develop the complications of long-term parenteral nutrition or significant enteritis.

         

        We present a newborn with short-bowel syndrome due to prenatal midgut volvulus. At operation the remaining viable jejunum, 15 cm long, was anastomosed to the cecum. All feeding attempts failed, and the infant suffered from malabsorption. Calories and proteins had to be supplied by intravenous total parenteral nutrition.

         

        At 3 months of age there was significant widening of the remaining bowel and Bianchi's bowel-lengthening procedure was performed. The postoperative course was uneventful and there was gradual improvement in intestinal absorptive capacity. The patient was weaned from parenteral nutrition at 3 years of age. Now, 2 years later, she eats a normal diet.

        אפריל 1998
        חיים ביבי, ג'מאל מחמיד, דויד שוסיוב, מיכאל ארמוני, צביקה ליס, שלמה פולק ומנחם שלזינגר

        Fatal Asthma in Children: Preventable?

         

        Haim Bibi, Jamal Mahamid, David Shoseyov, Michael Armoni, Zvika Liss, Menachem Schlesinger

         

        Pediatrics Dept., Barzilai Medical Center, Ashkelon (Affiliated with the Faculty of Health Sciences, Ben-Gurion University of the Negev); Pediatric Intensive Care Unit, Bikur Holim Hospital, Jerusalem, and Kupat Holim Klalit, Darom District

         

        Sudden death from asthma is rare but occurs in the young age group. We recently faced this rare situation, when 3 asthmatic children were dead on arrival at the local emergency room. All 3 had been treated with beta-2 agonist inhalation on a regular basis, without anti-inflammatory treatment. 2 of the children died while inhaling the beta-2 agonist. It is important that there be clear guidelines and full education about the management of asthma, during and between exacerbations, to prevent such deaths.

        ינואר 1998
        מירית הרשמן-סרפוב, אורורה טובי, יצחק סרוגו ודוד בדר

        Fungus-Ball in a Preterm Infant Successfully Treated with Fluconazole

         

        Mirit Hershman-Sarafov, Orora Tubi, Isaac Srugo, David Bader

         

        Neonatal and Radiology Depts., and Microbiology Laboratory, Bnai-Zion Medical Center and Bruce Rappaport Faculty of Medicine, The Technion, Haifa

         

        Very-low-birth-weight premature infants are at high risk for invasive candidiasis. The most commonly involved organ is the kidney. Renal candidiasis may present as fungus-ball obstructive uropathy. We describe unilateral renal obstruction secondary to fungus-ball in a premature infant. Noninvasive, systemic antibiotic treatment, including amphotericin B and fluconazole, resulted in disappearance of the finding.

        מאי 1997
        איתן מור, דן שמואלי, זיו בן-ארי, נתן בר-נתן, עזרא שהרבני, אלכסנדר יוסים, בוריס דורפמן, רן טור-כספא וזכי שפירא

        Liver Allografts from Donors older than 60: Benefits and Risks

         

        Eytan Mor, Dan Shmueli, Ziv Ben-Ari, Nathan Bar-Nathan, Ezra Sharabani, Alexander Yussim, Boris Dorfman, Ran Tur-Kaspa, Zaki Shapira

         

        Transplantation Dept. and Institute of Liver Diseases, Rabin Medical Center, Beilinson Campus; and Sackler School of Medicine, Tel Aviv University

         

        With limited organ resources and an increasing number of candidates for liver transplantation, the world-wide trend is towards using liver allografts from donors older than 60 years. This strategy, however, may be hazardous because of the known correlation between advanced donor age and graft dysfunction. Since January 1996, each of 5 patients received a liver allograft from a donor older than 60 years. Preservation time in these cases was shortened as much as possible and liver allografts were used only if there were no other potential risk factors for primary nonfunction. Mean cold ischemic time was significantly shorter in this donor group (7.8 hrs) than for livers from 28 younger donors (10.2 hour; p<0.01). 3 of the 5 grafts from older donors had normal function immediately. The other 2 initially had biochemical features of preservation injury, but graft function returned to normal within the first week after transplantation. All 5 patients currently have normal graft function, with follow-up ranging from 3-8 months. There was no difference between the 5 recipients of grafts from older donors and 28 adult recipients of grafts from younger donors in extent of preservation injury and in immediate graft function. We conclude that in countries with limited organ resources, such as Israel, liver allografts from older donors can be used within defined limits and minimal preservation time.

        הבהרה משפטית: כל נושא המופיע באתר זה נועד להשכלה בלבד ואין לראות בו ייעוץ רפואי או משפטי. אין הר"י אחראית לתוכן המתפרסם באתר זה ולכל נזק שעלול להיגרם. כל הזכויות על המידע באתר שייכות להסתדרות הרפואית בישראל. מדיניות פרטיות
        כתובתנו: ז'בוטינסקי 35 רמת גן, בניין התאומים 2 קומות 10-11, ת.ד. 3566, מיקוד 5213604. טלפון: 03-6100444, פקס: 03-5753303