Minerva chirurgica
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Comparative Study
[Inguinal hernia prosthetic repair through the anterior approach].
Aim of this study is to compare the Lichtenstein's, Rutkow's and PHS techniques of inguinal hernia repair in terms of therapeutical efficacy and grade of acceptability, expressed in function of the complications, compliance and performance status of the patients. ⋯ The conclusion is drawn that the PHS, Rutkow's and Lichtenstein's procedures for inguinal hernia repair are safe (no complications), effective and well accepted by the patients (85% of the patients expressed a very good judgement) although the Rutkow's repair seems more invasive. The appearance of a better trend, in patient's compliance and performance status when operated with the PHS technique, need to be confirmed in the future but, if it will be, this could became our first choice technique of repair for the medium and large hernia defect.
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The aim of the study was to examine the different therapeutic options for traumatic hemopneumothorax and in particular the latest concepts (videothoracoscopy). ⋯ In the past few years videothoracoscopy has allowed a different approach to be used in patients affected by hemo-pneumothorax since it allows a more accurate diagnosis (extent and origin of bleeding, identification of associated diaphragmatic lesion) and the possibility of treating pleuro-pulmonary injuries without performing extensive thoracotomies.
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The case of a 59 year-old patient, who sustained a post-traumatic fracture of the silastic catheter of his totally implantable venous access device that migrated in the right pulmonary artery, is reported. The venous device was placed six months earlier for the treatment of metastatic spread of a primary unknown adenocarcinoma. The venous device was placed on the left side in consideration of a recent right supraclavicular node biopsy. ⋯ The accidental fracture of the catheter was attributed to a closed trauma occurred during the transport of a refrigerator on the homolateral shoulder. Treatment involved extraction of the migrated fragment through a percutaneous transfemoral angioradiological procedure. A few days later the chamber was removed and a new totally implantable venous access device was placed on the other side.
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Pneumomediastinum may be due to various diseases. In young adults without thoracic trauma or pulmonary or mediastinal diseases pneumomediastium is secondary to mild strain or cough. This disease is defined as spontaneous pneumomediastinum or Hamman's syndrome, with a good prognosis, and doesn't need any treatment. X-ray and CT of the chest can provide correct diagnosis and adequate treatment.
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A review of the literature on pancreatic trauma and its treatment in the light of recent experience is presented. The incidence, mechanism, classification, diagnosis, treatment and complications of pancreatic trauma are discussed. A case of pancreatic transection after blunt abdominal trauma is described.