Pathology of the Digestive system (2) | Pathologies and health.

• Colitis
• Intestinal obstruction
• Tumors of the small intestine and colon
• Hemorrhoids
• Anal fissures
• Anorectal abscesses
• Anal itching
• Anal fistula
• Rectal prolapse
• Rectal polyps
• Rectal cancer
• Salivary Gland Tumors
• Steatosis
• Viral hepatitis
• Toxic hepatitis
• Cirrhosis
• Liver tumors
• Gallbladder and biliary tract
• Cholecystectomy
• Pancreatitis
• Pancreatic abscess
• Pancreatic cyst
• Benign tumors of the pancreas
• Carcinoma of the pancreas

COLITIS

What is ulcerative colitis?

The term "colitis" means an inflammation of the colon, which may be linked to several factors such as:
infectious agents); may be due to viruses, bacteria (salmonella, Shigellas, staphylococci), parasites (Amoeba). These forms are also referred to as dysenteric illness colitis;
b) situations of decreased blood supply to the intestine; We speak in this case of ischemic colitis;
c) radiation exposure, such as when you submit a radiotherapy;
d) drugs, generally antibiotics that alter the normal intestinal flora, enabling the development of a bacterium, Clostridium difficile toxin, which can cause Necrobiosis phenomena; less frequently, other toxin-producing bacteria may underlie colitis; in all these cases we speak of pseudomembranous enterocolitis;
and a last group) is finally made up of so-called idiopathic forms, i.e. Forms of which you do not know the cause. Fall within this group the irritable bowel syndrome and ulcerative colitis.

What is dysenteric illness colitis?

Is an inflammation of the colon that occurs in that particular infectious disease called dysentery.

Which pathogens cause the dysenteric illness colitis?

Dysenteric illness colitis germs, bacillary or protozoa (Amoeba) that determines the amebic colitis.

As it contracts the dysenteric illness colitis?

Through food or water that contain specific pathogens.

You can prevent it?

Avoiding the foods of questionable and suspect water preparation; This is especially true when traveling in tropical countries.

There is an effective treatment against dysentery?

Yes; There are medicines to specific action that can lead to healing, as long as the therapy is applied when the disease is still in its early stages.

Dysenteric illness colitis is common?

Due to the increased tourist traffic in tropical countries, today there is much more frequently than in the past, when in practice affected only the armies stationed in those countries.

You can recover completely from an amoebic or bacillary dysenteric illness colitis?

Yes, if you care for time and with radical measures; otherwise, the disease tends to become chronic and give rise to complications of considerable gravity, including (in the case of amebic colitis) the formation of abscesses in the liver or other organs.

Dysentery is susceptible to relapses?

If not treated radically, is subject to recurrent attacks.

What is ulcerative colitis?

Is a chronic inflammatory disease involving the mucosa and submucosa of the descending colon, sigmoid colon and rectum.

What is due?

We do not know with precision the cause; were made though several hypotheses that involve very different factors, such as:
alterations) function of the immune system;
b) bacterial factors, because inflammation observed in the areas affected by the disease is very similar to that given by certain microorganisms; in the case of ulcerative colitis, though, has never been possible to isolate any specific bacterium;
c) psychological factors (stress, emotional lability).

What are your symptoms?

The most frequent symptoms are: rectal bleeding, diarrhea, abdominal pain crampy type, weight loss, malaise, fever. Can also appear extraintestinal involvement marks that are extremely various and variable. In particular, you may be asking:
skin appearance) of Erythema Nodosum;
b) articulate that manifests itself with a sacroilite (inflammation of the sacrum) and arthritis of the joints:
c) eye (conjunctivitis);
d) (formation);
and cholangitis and liver) hepatitis, cirrhosis of the liver up to full-blown.

What course can have?

The disease can take three main types of trends:
in mild form with) symptoms and accentuated a good prognosis; This form affects approximately 50% of patients;
b) moderate: symptoms are more severe, you can have 4-5 discharge of bloody diarrhea per day, accompanied by severe abdominal cramps, fever, asthenia, malaise, signs of extraintestinal involvement; This form occurs in approximately 30% of patients;
c) severe or fulminant form: affects observant manner with profuse diarrhea, rectal bleeding, fever up to 39° C, abdominal cramps, asthenia, nausea, anorexia; generally occurs
as the episode superimposed on a form of colitis with milder.
Mild and moderate forms can last for a few weeks and then regress, then rise again in subsequent months or years.

What complications can give ulcerative colitis?

The moderate (and much less frequently the milder form), when last for at least 8-10 years, sometimes degenerates into colon cancer. So who is affected by the disease should undergo a regular medical visits, and if necessary also to tests, in order to capture the cancer when it is still at an early stage and therefore inoperable. A complication rather than severe form is the so called toxic megacolon is characterized by an abnormal bowel distension, accompanied by severe abdominal pain, and malaise marked hypotension; If nothing is done quickly, toxic megacolon is fatal in 20-30% of cases. In ulcerative colitis can also verify massive bleeding, perforation and cicatricial stenosis of colon.

How do you diagnose ulcerative colitis?

Based on:
characteristic symptoms);
b) sigmoid colon endoscopy, which detects the characteristic inflammatory changes and ulcerative lesions;
c) radiologic examination;
d) biopsy, which allows you to exclude other diseases of the colon, especially tumors;
and) the culture of stool (stool test) to exclude stock-based infectious colitis.

How is ulcerative colitis treated?

in the forms) are not serious, medical therapy, which involves a diet adjustment (reduction of food leaving fibres, to decrease peristalsis and the stimuli to the evacuation) and the use of drugs such as salazopirina and corticosteroids; with these measures you can control symptoms in most cases;
b) in cases of severe acute colitis, or in cases of colitis that do not respond to medical therapy or complications occurred (tumour degeneration, massive bleeding, intestinal perforation) you must resort to surgery that may consist of the entire colon, excision followed by Ileostomy;
c) a special therapy is necessary then for toxic megacolon, which represents a very serious situation, not only because of the danger involved in the intestine but also for systemic symptoms with which manifests (hypotension until cardiovascular shock).

In the most severe forms of ulcerative colitis exist possibility of healing?

Yes, as long as those patients who have not responded to medical therapy are subjected to due to surgery.

When the colon is removed completely and practice an Ileostomy, the Ileostomy remains permanently?

Yes, however most patients learn how to behave with ease.

When he suffered an Ileostomy, you can lead a normal life?

Yes, there are thousands of people who have a permanent Ileostomy and nevertheless dedicate themselves to their activities as perfectly healthy individuals.

The operation of ulcerative colitis sometimes allows to save the rectum?

In a small number of cases, not having been involved in the disease process, the rectum can be stored; in some other cases, unfortunately not many, it is also possible during the first operation, connecting the ileum with the rectum directly using sutures. In other cases, an Ileostomy is practiced, leaving the patient time to recover from the operation. a few months or years later, when you are sure that the rectum is absolutely not affected by disease process, you can close the Ileostomy and connecting the ileum with the rectum.

How does the irritable bowel syndrome?

Vague) abdominal discomfort, mild pain, flatulence;
b) irregular defecation with alternating constipation and diarrhea;
c) copious amounts of mucus in the stool.

How is it diagnosed?

With a detailed analysis of symptoms, with radiological examination with colonoscopy (examination of the colon); It is important to differentiate this form from ulcerative colitis and cancers.

There are factors that favour the irritable bowel syndrome?

The syndrome is characteristic of individuals who have an insecure, emotionally unstable personality.

How to cure the irritable bowel syndrome?

in) With psychological therapy, which is sometimes necessary to resort to a psychiatrist;
b) with good hygiene habits: regular evacuations; avoid laxatives and enemas, which alter the pace of intestinal functions;
c) with diet: regular meals and moderate, avoid alcohol and strongly spiced foods;
d) with medication: judicious use of antispasmodic medications and tranquilizers.

You can heal?

Yes, but when stress persist, no diet, taking laxatives and enemas, can grow again.

It is a dangerous disease?

No, it does not affect even a normal and active life.
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INTESTINAL OBSTRUCTION

What is acute intestinal occlusion?

Intestinal occlusion, also called the ileum, is a syndrome caused by the arrest of liquid, solid content, gas in the intestine.

What are the causes that can cause an intestinal obstruction?

We can distinguish two types of causes:
mechanical) (ilei);
b) Dynamics (dynamic ilei).
The ilei mechanics are due to the presence of an anatomical barrier: vegetanti tumors, gallstones, clusters of hairs (bezoars), inflammatory stenosis or neoplastic, malformation or compression by extrinsic, formation of tumors "angles" due to inflammatory adhesions that attach the handles together or other abdominal viscera or wall, being strangled by anse, as volvoli (gut twisting on its axis) , intussusception, irreducible hernia.
The dynamic ilei are due to functional impairment conditions, whereby the intestine becomes incapable of peristalsis and its walls, having lost muscle tone, you release. Among the conditions that most frequently cause paralytic ileus are: peritonitis, abdominal trauma (even in the absence of visceral perforations or tears), laparotomici, Biliary colic or pieloureterali, twists of ovarian cysts or testicle, spinal cord trauma, diaphragmatic Pleurisy or lower lung lobe pleuropneumonia, drugs (opium alkaloids, muscle relaxants, neuroplegici).

What are the symptoms of intestinal obstruction?

Swelling of the abdomen);
b) no evacuations;
c) repeated attacks of vomiting;
d) type pains colico, i.e. violent fits, localized to the abdominal region.
Typically, the presence of bowel obstruction is highlighted by the radiological examination.

Is always total occlusion?

Depends on the cause: volvulus, the occlusion is total and immediate. In other cases, initially is partial and is manifested by constipation, which over several days is accentuated and is accompanied by swelling of abdomen and appearance of abdominal pain.

What happens if the occlusion is not deleted?

The abdomen becomes swollen and strongly progressive vomiting attacks arise; mineral balance is altered by the loss of gastric juices and water retention in the intestine; in the composition of blood will produce severe changes. In other cases the intestines, swollen so abnormal, can rupture, leading to peritonitis.

Intestinal occlusion can regress without surgery?

In some cases, Yes, if it has been caused by volvulus, intussusception or colitis; These pathological States, in fact, sometimes regress spontaneously, and occlusion.

How to cure intestinal partial occlusion?

A probe into the small intestine (through the nose, the pharynx, the esophagus and the stomach); the probe, connected to a vacuum cleaner removes most of stagnant liquids and gases. To improve the General State, the patient are practiced
a drip, with which it provides the necessary fluid intake, sugars and minerals.
Finally, we proceed, where they exist, to remove the causes.

How do you diagnose intestinal obstruction?

Based on the symptoms and radiological findings. The presence of a scar left by a previous laparotomy leads to suspect that the occlusion have a mechanical origin and was probably caused by an intestinal loop throttle following the formation of a grip.

What kind of causes this disease?

If the intestinal obstruction has developed as a result of a narrowing or adhesion formation, you will cut the throttled fabric; If it is instead the result of a tumor, it is necessary to remove the diseased bowel portion.

Acute intestinal occlusion results in the need for repeated surgeries?

In some cases, Yes. Since the fundamental aim is to eliminate occlusion as quickly as possible, it is often necessary to practice a colostomy to allow evacuation of feces.

In such cases, you need a permanent colostomy?

As a rule, no. If after deleting the occlusion of patient general condition improves, the surgeon may undertake a careful examination in order to ascertain exactly the cause and location of occlusion; This eliminates the root cause and then close the Ileostomy restoring the intestinal passage.

In case of complete bowel obstruction, what are the chances of recovery?

If the operation is carried out within 24-48 hours after the onset of disease, healing is achieved in most cases, later than 48 hours, the chances of recovery decrease appreciably.
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TUMORS OF THE SMALL INTESTINE AND COLON

Where are usually localized intestinal tumors?

Mainly in the colon; those of the small intestine are, in comparison, quite rare.

What factors determine whether you suffer from bowel cancer?

The two "warning signals" are the most reliable passing blood from the rectum and change of habitual rhythm of the evacuation. It should also investigate an unexplained weight loss.

You can prevent the onset of an intestinal tumor?

No, but if you experience any troubles you should undergo periodic medical check-ups, with rectal and colon endoscopy. It is now believed that a proper diet can help reduce the likelihood of developing cancer; in particular we recommend a diet low in animal fats (saturated), so even red meat and rich instead of vegetable fiber. It also seems that goes also fought obesity, in order to reduce the risk of colorectal cancer, as it would be in any way related to this disease.

Benign tumors which grow with greater frequency in the gut?

Fibroids and polyps; These are the most common benign form of intestinal tumors.

These benign tumors can degenerate into cancer?

Polyps can escalate and this is one of the main reasons why the appearance of abdominal or intestinal disorders makes appropriate medical examination.

What items can I tell if a person is suffering from a polyp?

The most characteristic symptom of this tumor formation is painless bleeding from the rectum. Large polyps and located in the upper portion of the colon may also cause recurrent colonic type pains, or temporary episodes of intestinal obstruction. The diagnosis, however, can be done only with colonoscopy (survey conducted by using a fiberoptic probe, which is inserted through the anus) and possibly with x-ray.

How are polyps treated?

If you are located in a place not far from the anus can be removed simply with a sigmoidoscope (a 30 cm long, usually used for endoscopic examination of the sigmoid colon); If more are moved to the upper portion, is still possible during the colonoscopy, capture them and Excise them with tiny surgical tools, get "pass" through the endoscope. Only in individual cases is practiced one opening can laparotomy play and colon polyp excision.

You can prevent intestinal polyps?

You can identify them early through regular inspections. These include several tests, including the occult blood in feces and in the case of previous removal of polyps or a family history of familial adenomatous polyposis, colonoscopy or barium enema (x-ray of the colon and rectum after introduction of a means of
by contrast anal). It is also recommended that a diet rich in fiber and low in fat.

What is the incidence of bowel cancer?

A major impact. Bowel cancer is one of the most common neoplasms and frequent.

Bowel cancer affects men more often?

No, its incidence is roughly equal in both sexes.

At what age it is more inclined to this tumor formation?

Between 60 and 80 years.

Susceptibility to intestinal cancer is hereditary or applicant under familiar?

No, but can appear in family circle the tendency to the formation of polyps and other cytological alterations which are considered to be the forerunner of cancer.
It has been established that specific mutations in particular genes load are related to familial adenomatous polyposis, a condition that can develop into colon cancer.
Therefore, a family history of this disease, as well as the presence of polyps or inflammatory bowel disease risk factors to be considered.

Radiological examination (barium enema) allow you to confidently diagnose bowel cancer?

Yes, because it highlights the strain in which continuity of the intestinal wall at the point where the tumor is located.
Today, however, the best test is a colonoscopy.

There are useful markers for the diagnosis of colorectal cancer?

Yes; searching for carcinoembrionale and Antigen levels of the Antigen CA 19-9.

How to take care of intestinal tumors?

Surgically, as soon as it was made definitive diagnosis. Can sometimes be associated with radiotherapy or chemotherapy.

What types of surgeries are practiced in these cases?

in) If this is a benign tumor, we merely remove the tumor itself;
b) if it is malignant, instead you shall, if possible, to remove both the portion of diseased bowel is a large tract of healthy portions, which are then sutured to one another; If it is not possible to restore the intestinal passage, a colostomy is practiced. The main purpose of the surgeon is indeed radical excision of malignant formation, although in some cases this involves creating an Ileostomy.

Excision of bowel cancer is a very complex surgery?

Yes, certainly, but is passed well in over 90% of cases.

The extent to which such an operation gets positive and permanent results?

According to the most recent data, more than 50% of the people you work with successful bowel cancer are still alive after 5 or more years. We must not forget, however, that several factors may influence more or less survival; among these the most important is early diagnosis.

Bowel cancer can be reformed?

Once removed, usually not, but in a number of cases varies from 5 to 10% develop a new tumor somewhere else in the intestine.

After the operation, how often you should undergo examinations and tests of control?

At least once a year, and when new symptoms arise.

According to what the surgeon decides whether or not to create an Ileostomy?

Whenever you encounter a chance, the surgeon restores intestinal continuity; its purpose is however never leave on site diseased tissues.

The Ileostomy is not necessarily permanent?

No. In some cases, is created for the sole purpose of eliminating a bowel obstruction caused by the presence of a tumor; the normal gut Raceway reverts subsequently. In individual cases, also, you can rebuild the anus through plastic surgery.

In which cases the surgeon decides to close the Ileostomy?

When has the confidence to restore normal intestinal passage, which may occur several weeks or months after the first operation.

You can lead a normal life with a permanent colostomy?

Yes; most patients learn to take under control the Ileostomy so that the regularity of the evacuation does not undergo almost no alteration than in the past.

People with Ileostomy give off an unpleasant odor?

No; not only because they learn to keep it as clean as possible, but also because there is an opening, a special type of bag and manufactured
specifically, that prevents the spread of odours when an evacuation occurs while you are away from home or work.

Other people may notice that you have an Ileostomy?

No: there are thousands of people in similar conditions, which however perform several tasks with complete freedom of movement, no hassles for yourself and those who approach.

The removal of a large part of the intestine impairs the ability to lead a normal life?

No. Feeding and digestion can be done normally even when excised the entire colon; even excision of about half of the small intestine does not affect at all the possibility of having a normal power supply. This of course involves excision decreased absorption surface.

As the Surgeon a malignant tumor from benign one?

Primarily based on the appearance of tumor formation, secondly by biopsy, which enables the tissue taken at microscopic examination and to ascertain the true nature of the disease.

Examination of the abdomen allows the surgeon to see if the patient is suffering from intestinal cancer?

No; for this reason it is extremely important to undergo endoscopic examination of the gastrointestinal tract when experiencing bowel disorders.
Intestinal tumors can develop in young people? Yes; in individual cases there is also found in individuals of 20 or 30 years.

In the case of colon surgery, how long do I have to stay in hospital?

These interventions are complex and may result in a hospital stay of several weeks; measures also require pre-and postoperative treatment of all details, including
bowel preparation with frequent cleansing enemas and administering antibiotics and chemotherapeutics; This measure is intended to prevent the occurrence of postoperative peritonitis.

Peritonitis is a frequent complication of these surgeries?

At one time Yes, but currently you can almost completely sterilize the intestinal lumen with sulfa drugs and antibiotics. This eliminates the risk of peritonitis.
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HEMORRHOIDS

What are hemorrhoids?

Varicose veins, i.e. permanent expansion of veins that supply the anorectal area.

What are caused?

It is believed that the stresses produced by irregular habits lead to a weakening of these veins and a functional impairment of their valves.
The formation of hemorrhoids is probably favored by chronic constipation, irregular defecation, excessive and prolonged pressure at the time of evacuation, as well as for pregnant women, from the pressure of the fetus on the large blood vessels that supply the basin. Another possible cause is hypertension Portal circle level in which it meets part of hemorrhoidal veins.

What is their impact?

Hemorrhoids are the most common pathologic disease of the anal region and about 25% of people affected at least once in their lifetime.

Depending on which items you can determine if you are suffering from hemorrhoids?

The presence of one or more nodules around the anus, which at the time of defecation are detected; in the anal region is also testing a feeling of firmness, which also intensifies during the evacuation. Hemorrhoids are often painful and may rupture, bleeding more or less strong.

You can prevent the training?

To some extent, Yes; accustomed to make regular bowel movements, to observe a high fiber diet and do not exert excessive pressure during bowel movements, you reduce the possibility of their development.

How are hemorrhoids diagnosed?

Find a local inspector, if you are outside; by proctoscopy, if they instead.

What is rettoscopia?

Endoscopic examination of the rectum, performed with a special tool, the proctoscope/30 cm long, and allows direct observation of the entire intestinal tract concerned.

How to treat hemorrhoids?

in) with medical therapy, which involves the regularization of intestinal functions, maintaining a diet (avoid alcohol, spicy foods and in any case over-eating), a scrupulous local hygiene (cold water sitz baths), the application of creams and suppositories to decongest and relieve pain during attacks. This therapy is suitable in initial cases and serves primarily to avoid the worsening of the disorder;
b) with surgical treatment, which takes place when the shape has deteriorated and become unresponsive to medical therapy. You can act in three ways: 1. with cryotherapy, whereby the hemorrhoidal nodules are necrotizzati by freezing; 2. with classical excision by scalpel.
The latter is still the most used and safer. 3. With the CO 2 laser surgery, which ensures an intervention under local anesthesia with postoperative pain and immediate resumption of bowel function. There are other methods, such as Sclerosing injections, giving reliance in varicose veins of lower extremities varicose veins but far less in haemorrhoids.

What happens if your hemorrhoids are not covered?

You can check:
bleeding,) that in the long run cause a State of anemia;
b) thrombus formation, i.e., blood clots inside hemorrhoids varicose veins, which are extremely painful.
c) Haemorrhoidal prolapse, in which internal hemorrhoidal nodules protruding from the anal orifice and are no longer able to return;
d) throttle of hemorrhoids, with risk of gangrene;
and nodules and ulceration) risk of infection.

Failure treatment of haemorrhoids can lead to the development of a rectal cancer?

No. You can have the opposite: the sudden appearance of hemorrhoids is sometimes the result of colorectal cancer.

In what cases is required surgical excision of hemorrhoids?

When the appropriate medical therapy did not get any results.

Before surgery, they run more tests?

Yes, normally a proctoscopy in order to ensure that in the rectum, above, hemorrhoids are not morbid processes.

The rettoscopia allows you to discover the presence of a cancerous form?

Yes; This is precisely the main purpose of examination; in some cases you do follow a sigmoidoscopy, a precautionary check to the sigmoid colon.

Rectum-and are painful examinations sigmoidoscopy?

No, just a bit annoying.

Hemorrhoids are a clue sometimes morbid process in place in the lower intestines?

Yes, and that is why your doctor, before deciding whether or not practice excision of hemorrhoids, advises the patient to undergo both rettosigmoidoscopia both radiological examination.

The surgery involves hospitalisation?

Excision of hemorrhoids with the classic method requires a hospital stay varies from four days to a week.

This is a serious surgery?

No.

What chances of full recovery are there?

More than 95%.

The postoperative period is characterized by pain?

During the first two weeks after surgery often have severe pain.

Hemorrhoids can be reformed?

Yes, which occurs in a small number of cases.

How do I perform classic surgery for excision of hemorrhoids (hemorrhoidectomy)?

Varicose veins are isolated from the surrounding tissue, tied and cut with a scalpel.

How long is the surgery?

About 15-20 minutes.

What type of anesthesia is used?

Usually general anesthesia; less frequently or spinal anesthesia.

Special precautions necessary preoperative treatment?

No; you just need to empty the bowel.

What measures should be adopted dietary after excision of hemorrhoids?

No, the postoperative period has elapsed.

How long after surgery bowel function normalize?

After a few weeks.

What steps are usually recommended postoperative?

In the days following the operation it is recommended to take twice a day a lubricant, for example Vaseline oil, and make two or three newspapers sitz baths with chlorine based solutions.

After this surgery, with how often you must submit to inspections?

Approximately every six months.

After excision of hemorrhoids, bowel movements may be accompanied by loss of blood?

Yes, often, and this can last for a few days or a few weeks.

After excision of hemorrhoids, you can:

swim leaving home climbing stairs look after the House driving resume intercourse resumed all physical activities resume after 3-4 days after 4-5 days after 4-5 days after 7-10 days after 2-3 weeks after 3-4 weeks after 2-3 weeks after 4-6 weeks
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ANAL FISSURES

What is an anal fissure?

A slit-shaped ulceration which arose in the mucosa that lines the anus.

What is due?

From excessive tension which the anal mucosa in cases of chronic constipation as a result of which it forms a small ulceration on the surface, this becomes infected because of the passage of stool and bowel movements, in additional strains, fails to heal spontaneously.

What are the symptoms?

Violent pains upon defecation, which may be accompanied by small bleeding and anal sphincter contraction.

How to treat anal fissures?

Using a medical therapy that, if applied with sufficient promptness, in many cases leads to healing and consists in the administration of lubricants (e.g. Vaseline) and in the use of analgesic creams, all associated with a local hygiene. If this treatment does not give any benefit, proceed to surgery.

Which type of surgery is practiced?

The fissure is excised with a elliptical incision and underlying sphincter muscle is cut off to allow the anus to relax for some time.

What measures pre-and postoperative treatment involves a similar procedure?

The same adopted for the operation of hemorrhoids (see relevant paragraph).

What does it take to heal the wound?

From 3 to 4 weeks.

After surgery, bowel functions return to normal and the sphincter heal?

Yes; After a few weeks the healing process ends and defecation resumed normal rhythm.

It is possible to treat anal fissures with laser surgery?

Yes; using the CO 2 laser scalpel in regional anaesthesia (in day hospital).

Anal fissures can be reformed?

Yes, although this occurs rarely.
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ANORECTAL ABSCESSES

The anorectal region is very often subject to abscess formation?

Yes

What caused these abscesses?

From an infection that developed in the anal or rectal mucosa and subsequently spread to underlying tissues.

How to treat?

Through timely incision and drainage.

These abscesses heal ever so final?

No; Some continue for weeks or months to fester and to heal, to lead to Fistula formation.

Their engraving involves hospitalisation?

Only when it is very deep and extensive abscesses, accompanied by violent pains and high fever, because in that case you need to practice the patient a narcosis.
In mild forms the surgeon can practice surgery on an outpatient basis, limited to a local anesthesia.
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Anal itching

What is anal itching?

A chronic itchy skin that is felt in the perianal area.

What caused?

outstanding) skin sensitivity, which is always moist and is contaminated by feces;
b) from a form of allergic reaction of the skin area this irritating SOAP, linen etc.;
c) from pathological disorders in the terminal portion of the intestine, such as hemorrhoids, fissures, colitis etc., which may give rise to an irritation, and then the itching;
d) by psychological factors, as evidenced by the fact that the neurotic and emotionally unstable people suffer more often.

How do we cure it?

Depends on the cause, which must be identified and then deleted. If this is not possible, there are general care: local cleaning (which however must not
lead to excessive use of SOAP) and application of ointments containing cortisone and antipruritic substances.

Excessive use and too frequently in soapy water is harmful for those suffering from anal itching?

Yes, because the skin, irritating, worsen the disorder.

How long can anal itching?

Because it tends to become chronic, many people suffer for years.

May spontaneously regress?

Sometimes Yes.

You can cure it with psychotherapy?

If its origin there is an emotional disorder, Yes.
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Anal fistula

What is an anal fistula?

An abnormal connection or, better, a channel formed as a result of a pathologic process between the inside of the anus or rectum and skin of the perianal area.

What is its impact?

Makes up about 25% of pathological disorders developing in anorectal region.

What is due?

Is the consequence of a purulent infection developed in a spot of anal or rectal wall and then spread on the surface.

There are tubercular origin fistulas?

Yes; in a small percentage of cases the formation of fistulas is associated with pulmonary tuberculosis; However, this is currently quite rare phenomenon.

How does an anal fistula?

In most cases, patients say they have suffered some time before a boil or abscess, localized in the perianal area, who over several weeks had come several times to rimarginandosi and later suppuration leaving finally very little secretion.

What happens if anal Fistula is not treated?

The pathological process of channelling can progress, undermining the perirectal areas area, and finally reach the surface at different points of the perianal area; can also cause serious damage to the sphincter.

How to cure anal fistula?

If it lasts for weeks, without presenting symptoms of healing, through surgery.

What is this surgery?

In excision or stripped of pathological channel, which usually involves the partial excision of sphincter, such as in the operation of sore nipples.

What measures pre-and postoperative treatment requires that intervention?

The same adopted for the operation of hemorrhoids and anal fissures (see relevant paragraph to hemorrhoids).

After the operation, normalizes intestinal functions?

Yes, in the space of a few weeks.

How long does the healing process?

Being a pretty extensive surgery, healing can be completed in a period ranging from 6 to 10 weeks.

You can treat the anal fissure with laser surgery?

Yes.

Healing is considered permanent?

In most cases, healing is permanent. Very large fistulae may be chronic or subject to relapse and require a similar event of a second surgery to achieve a full recovery.
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Rectal prolapse

What is rectal prolapse?

The escape of a segment of the rectum by his natural home, so the mu thing is upside down, outside through the anal orifice, becomes inflamed and swollen appears.

In such cases occur most frequently?

During defecation, due to contractions and pressure exerted on the intestinal wall.

Who is most affected?

Young children and the elderly.

What caused?

Excessive pressure, sometimes connected with diarrhea or constipation, defecation and exerted by a weakening or support muscle relaxation.

How is rectal prolapse?

In some cases, it helps to normalize and regulate bowel function; in other cases, it may be necessary to surgically attach the muscles to support and remove the excess mucous.

What surgeries are practiced in similar cases?

If the prolapse is limited, a plastic operation the anal region; in larger forms, with which you can laparotomy play will shorten the rectum and staring at his muscular support.

Older people undergo these surgeries more often children?

Yes.

Rectal prolapse operations get positive results?

In most cases, Yes; Some shapes however are very serious, and especially if the patient is in old age, even surgical therapy records sometimes failures.
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Rectal polyps

What are polyps?

Growths of anal or rectal mucosa, stalked and mostly similar to warts, ranging in size from that of a pea to that of a golf ball.

Where are they located?

Can form anywhere in the large intestine.

What caused?

Like other cancers, polyps are benign growths, which you do not know the cause.

What is their impact?

Are the most common benign tumors of the intestinal tract.

Who is most affected?

Polyps can develop at any age, but most commonly occurs in individuals between the ages of 40 and 70 years.

The predisposition to development of polyps is hereditary or tends to recur in the family?

Only the so-called multiple polyposis, characterized by the simultaneous presence of several large intestine polyps, constitutes a true familial disease, that it is necessary to distinguish from isolated form.

Depending on which items you can determine if you are suffering from a polyp?

When they are located near the anal orifice, these lesions are sometimes driven outwards from feces and can then be perceived by touch. Their most common symptom, in the absence of other intestinal disease, is however a painless loss of blood from the rectum.

How is the diagnosis of rectal polyp?

Often, by proctoscopy.

How to treat polyps of the anus and rectum?

It is absolutely necessary to remove both, which may be made by the surgeon on an outpatient basis, when it comes to fairly small formations. The therapy involves hospitalization if the polyps have reached considerable size or if they are located in the upper part of the intestinal tract.

As excision is practiced?

Using a sigmoidoscope/proctoscope or, the surgeon places a wire loop around the Octopus and, after having cut off at the base with the Electrosurgical unit, the extracts from the rectum.

What consequences may arise, not treating the polyps?

If you removed them, some may develop into cancer.

How can you determine whether the process of degeneration has already begun?

By biopsy of a fragment of the excised polyp.

How soon is it possible to know the result of the biopsy?

Within 4-7 days.

If the polyp is found to be malicious, what measures do you take?

One can laparotomy play, to remove the affected portion of intestine.

How long you need to stay in hospital?

If it is a normal Octopus, from one to three days.

Excision of an Octopus needs a particular preoperative therapy?

No, the only preparatory measure that is prescribed is the usual bowel cleansing.

What measures are recommended at postoperative patient?

Take a lubricant, for example Vaseline oil, and observe a diet free of irritants.

How long after surgery you can resume normal activities?

Usually after two or three days.

The bleeding may continue for a few days even after the operation?

Sometimes Yes, and there is reason for concern.

After surgery, with what frequency you should undergo checkups?

Approximately every six months.

Polyps can be reformed?

In some cases, Yes.

You can prevent the formation of new polyps?

No, although, as mentioned, the diet rich in fiber and low in fat seems to play a protective action.
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Rectal cancer

Cancer of the rectum or anus is very common?

Yes, it is one of the most common malignancies.

What caused?

You do not know the actual cause; often, however, stems from benign polyps.

You can prevent it developing?

To some extent, Yes, since the rectum exams-and sigmoidoscopici run regularly can lead to the discovery of benign Proliferations, which if not excised, could escalate.

How is rectal cancer diagnosed?

Digital scan) by rectal channel;
b) through biopsy of a tissue fragment.

What are your symptoms?

Alteration of habitual rhythm of defecation, presence, faeces, blood and/or mucus, continuous stimulus having to evacuate.

At what age is reported to occur with greater frequency?

Mostly average and in later years, but can occur at any period of life.

How to treat rectal cancer?

By excision of the rectum and a stretch of the descending colon, and subsequent colostomy. In some cases you can remove the intestinal portion sick and restore the continuity of the intestine, without creating an Ileostomy.

Excision of rectal cancer is surgery dangerous?

Although currently without difficulty is exceeded by more than 95% of patients, this is an operation that lasts more than 3 hours and involves a hospital stay of about 2 weeks.

Ultimate healing is possible?

Yes, no doubt. If the malignant proliferation is discovered in a stadium that has not yet spread to other parts of the body, the ultimate healing is possible on more than half of the cases.

Excision of the rectum affects the ability to lead a normal and active life?

No. The Ileostomy allows a normal social life. The application of
containers details allows you to collect feces when they are issued and achieves effective protection against any inconvenience.
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Salivary Gland Tumors

Are frequent tumors of the salivary glands?

Yes, and in particular the so-called "mixed", involving the Parotid gland.

Parotid gland tumors are usually malignant?

No. Most tumors are benign, but the gland can sometimes be affected by cancerous processes.

Once removed, the Parotid gland tumors tend to reproduce?

Yes; Although they are benign, about 20% of the tumors tend to reproduce.

How can you tell if a salivary gland tumor is benign or malignant?

Benign tumors usually grow slowly and are surrounded by a capsule; many are movable under the skin. Malignant tumors of the salivary glands is
grow quickly and are adhering to the skin and the tissue around it.
Of course, excision and biopsy examination lead to a definitive diagnosis.

An excision of salivary glands interferes with digestion or with adequate saliva production?

No.

Similar operations are dangerous?

No, but excision of Parotid tumours is a long and delicate operation: you must proceed with caution to avoid injury to the facial nerve branches crossing the Parotid gland. The lesion of one of these branches causes a paresis (partial paralysis) of the face.

What is anesthesia for operations on salivary glands?

General anesthesia for major surgery; local minor operations.

Where the incision for Parotid gland operations?

In front of the ear, just below the angle of the jaw, neck.

The scars resulting from an operation on the Parotid gland or sottomascellare are disfiguring?

No; After a few months, when the wounds are completely healed, generally remain very thin lines.

It is always possible to avoid injury to the facial nerve when intervening to excise a tumor of the Parotid gland?

No. A few times to remove a tumor Parotid extended you must affect, or even cut, a branch of the nerve. However this is not a frequent occurrence, and when it happens is justified by much more important concern to remove the dangerous tumor.

What happens if during the operation affects the facial nerve?

The section of the facial nerve causes very visible consequences: a riot of paresis facial muscles, which causes a distortion of the features with lowering and twisting to one side of the mouth. In rare cases it can be damaged a nerve branch that is destined to the eyelid and this injury can cause the patient to fully close the eye.

If there is a lesion of the facial nerve, the face remains permanently deformed?

More or less, although the deformity tend to become less noticeable over time.

Once they have been cut, these nerves you can rejoin getting a good result?

Because these nerves are very small in diameter (some are no bigger than a common thread to sew) is extremely difficult to find the ends and sew them back together. Recently, using ingenious displacements of the attack of muscles and nerve transplants, it was possible to bring the face looks almost normal: to do this you need the performance of a specialist in plastic surgery.

The wounds resulting from these projects heal right?

Yes. Can saliva drain onto the skin for several days or weeks postoperatively; in the end however the drainage ceases and the wounds heal completely.

How long after an operation to the salivary glands can resume eating?

During the first few days after the operation you must observe a liquid diet; Afterwards you can resume normal diet.

How long should you stay in the hospital?

The patient can leave the hospital within a week after surgery.

If you reform a Parotid tumor, you can cure it with a new thread?

Yes. A wider excision of Parotid allows tissue healing in most cases.

How is treated a tumor of submaxillary or sublingual glands?

With total excision of the gland affected.

Interventions to the submaxillary gland tumours or sublingual are successful?

Yes, unless the surgery was done for a malignant tumor in rapid development. Luckily these malignant degenerations are very rare.
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Steatosis

What is fatty liver?

Steatosis, or "fatty liver", is a condition in which the liver has a quantity of lipid components (or FAT) higher than normal.

What are the causes?

Malnutrition, alcoholism, severe anemia, diabetes chemical poisonings.

What are the symptoms?

Usually there are none, except some enlargement of the liver, which can be painful, however, if you do not remove the causes, it can cause severe liver damage, increasing gradually.

How do we cure it?

Eliminating the causes, then with a balanced diet and avoiding alcohol.
•

Viral hepatitis

What is viral hepatitis?

It is a fairly common liver infection caused by viruses.

What are the most frequent forms?

Are basically:
a) hepatitis A (due to A virus);
b) hepatitis B (do receipt to B virus);
c) hepatitis C, formerly known as A-not B not (due to virus C);
d) hepatitis D or delta.
and) and hepatitis;
f) hepatitis g.

Who is most susceptible to this type of disease?

Youth and adults up to 35 years old are now most at risk for hepatitis A virus (HAV) because 80% of those born after 1960 is devoid of natural antibodies. The improvement of social conditions has made it unlikely that the contact with the virus in children, as happened, asymptomatic, in the past. Are at risk for non-immune subjects that go in a developing country where the hygienic conditions are still lacking. At risk for hepatitis B, as well as C, are drug addicts and caregivers; particularly at risk for hepatitis C are the subjects who underwent transfusion. Hepatitis D virus (HDV) only develops in individuals already infected with B virus (HBV). Are finally
risk of hepatitis B, hepatitis C and hepatitis D family members and partners of the respective virus carriers, homosexuals and heterosexuals with promiscuous relations.

Viral hepatitis is a common disease?

Yes, and in recent years has had a significant increase.

How is it transmitted?

For the form from HVA's main street is that fecal-oral: mainly food and drink contaminated; the same route of transmission is employed by the virus E (HEV).
Shapes from HVB, HVC HVD, transmitted by parenteral, sexual.

What causes are thought to be responsible for an outbreak of hepatitis A?

The causes responsible for an outbreak of hepatitis A are essentially four:
poor hygiene conditions);
b) contaminated food and water;
c) overcrowding;
d) malnutrition.

There are strategies to prevent hepatitis A (and hepatitis E)?

Yes. Must be adequate health surveillance on food, on water, on the operators handling food communities, is an extensive information about personal hygiene rules and methods of inactivating viruses (as, for example, the simple boiling water for 5 minutes). Effective protection is ensured by vaccination.

What are the strategies for hepatitis prevention from HBV, HCV and HDV?

Are: the screening of blood donors, monitoring of operators handling blood products, sterilization of medical supplies used in surgical and invasive diagnostic methods, sex education. The vac
cinazione for hepatitis B (and thus also for hepatitis E) is effective and in Italy from 1991 is mandatory for all newborns.

How long after infection to clinical manifestation of the disease?

From 1 to 60 days for hepatitis A; from 1 to 6 months for B and C.

What are the symptoms of viral hepatitis?

The majority of viral hepatitis are asymptomatic or presents nonspecific symptoms.
In other cases (acute hepatitis) the patient begins to lose energy and appetite, feels bad, nausea and a slight fever. This is followed by an enlarged liver that aching pressure, pain in the upper right abdomen, and finally-the fifth or sixth day-jaundice may occur. They can also have gastrointestinal disorders with vomiting and diarrhea; a curious symptom is also one reported by smokers who quit because cigarettes suddenly nauseating.

Always accompanies jaundice viral hepatitis?

No, more often does not develop jaundice hepatitis and is then called anitterica.

How do you make a diagnosis of viral hepatitis?

Noting carefully the symptoms, highlighting an enlarged liver and sore pressure and possible jaundice, and laboratory tests on blood, feces and urine.

Laboratory tests can detect the presence of viral hepatitis as distinct from other liver diseases?

Yes.

How so?

Basically looking for the presence in the blood of antibodies and antigens of viral infection in place.

What are the markers of hepatitis?

Serological data are related to the presence of circulating hepatitis antigens or antibodies directed against them; their trend over time is crucial to follow the course of hepatitis. The best known is the Australia Antigen or HBsAG. For hepatitis C, as well as HCV antibodies, viral DNA search through PCR, especially in case of suspicion of a recent infection.

How long is a viral hepatitis?

From six to twelve weeks.

An individual suffering from this disease should stay in bed?

Yes. The liver is an organ quite bulky and when it is hit by an infection should not suffer trauma; This is only possible in bed.

There are specific medicines for the treatment of viral hepatitis?

No; acute viral hepatitis require no specific therapy. The best cure is to rest and proper diet.

That possibility of healing?

Excellent, although a small percentage of patients died; but typically these have other concomitant diseases or fail to heal properly.

Can become chronic viral hepatitis?

Yes. Hepatitis B, C and D are candidates to become pregnant whilst having cases that resolve completely (Panel standardization of marker and blood indexes of liver function).

As chronic forms evolve?

You can have the form of "chronic persistent hepatitis", which largely goes away within a short span of time; or in the form of "chronic aggressive hepatitis", that over a period of months or years leads to cirrhosis. Liver biopsy is an examination that allows the diagnosis of chronic hepatitis.

There are drug therapies for chronic forms?

Yes, and serve to reduce, or in some cases to cancel, the activity of the disease. Mainly used to prevent the development of cirrhosis-a fatal disorder often associated with hepatic cancer-are formed by interferons, in particular interferon-alpha and semisperimentale, new antiviral drugs such as Ribavirin.

Acute viral hepatitis produces permanent damage to the liver?

No. In the vast majority of cases, the liver takes up fully its functionality.

After complete healing, there is a tendency to have fallout?

No.

Being in contact with a sick person, you can do something to avoid infection?

Yes. It was noted that an injection of gamma globulin, if performed soon has a positive effect in preventing infection. This protection lasts only 4-6 weeks, after which the contagion is possible again, unless practiced another injection.

Gamma-globulin has some effect to "cure" the disease already in place?

No.

Infectious Mononucleosis (or Pfeiffer's disease) can cause hepatitis?

Yes. The disease, the clinical notes and the results of laboratory tests are often indistinguishable from those of a common hepatitis. Accurate diagnosis of Mononucleosis can be done when there is some specific organisations, which indicates a generalized enlargement of the lymph nodes, the presence in blood culture of abnormal white blood cells or a high and rising rate of
•

Toxic hepatitis

What is toxic hepatitis?

This expression indicates that liver damage caused by chemicals or drugs that damage the liver.

As you develop an toxic hepatitis?

May develop suddenly and quickly to ingestion or inhalation of high doses of the offending substance, or it can develop slowly over many years to the accumulation of substances ingested or inhaled in small amounts over time. The individual response to these substances varies greatly from individual to individual: a toxic substance for one can not give any trouble to another.

Toxic hepatitis you can cure?

Depends on how much the liver was damaged; If the damage is slight and recoverable, you come to heal in a relatively short time.
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Cirrhosis

What is cirrhosis?

With this term, quite generic, is a chronic and generalized destruction of liver cells, with organ hardening, resulting in increase of connective tissue. This condition causes a weakening more or less accentuated hepatic functions, blood stagnation with dilation of the veins and ascites (presence of exuding liquid in abdominal cable).

What are the causes?

Any disease that affects the liver can lead to cirrhosis, resulting in destruction of liver cells are replaced by scar tissue. In particular, we recognize the postepatitica cirrhosis and the abuse of alcohol (ethyl).

Alcoholism can cause cirrhosis?

Yes. It is well known the concomitance of alcoholism and cirrhosis; It is thought that the liver damage depends on the combined effect of the toxic effect of alcohol and food deficiency, usually associated with alcoholism.

Drinking moderately can cause cirrhosis?

Usually not, but of course you have to agree on the "moderately". An occasional glass before or during the meal still involves some hepatocyte damage; We must also bear in mind that the alcohol tolerance varies greatly from individual to individual.

What are the symptoms of cirrhosis?

Vary greatly depending on the degree of destruction suffered by the liver and its functional reserves; in many cases the illness lasts virtually without symptoms for years.
As conditions worsen liver, loss of appetite, may be nausea, vomiting and weight loss; There may be also abdominal pain, feeling of tightness in the upper part of the abdomen and digestive disorders. With the progress of the disease appear listlessness and fatigue and loss of energy. When liver damage has become, you can have massive ascites, swelling in the legs, varicose veins in the esophagus, with possible fatal hemorrhages, jaundice, mental confusion and disorientation. The final stage leads to coma and death.

Cirrhosis is always fatal?

Yes, of course over time varies widely.

How can you diagnose cirrhosis?

With an accurate anamnesis, a thorough and appropriate examinations; These include liver function tests, protein electrophoresis, ESR, blood count and, especially, liver ultrasonography or CT. To have a diagnosis of certainty however proceed to liver biopsy, not always feasible.

How do we cure it?

First you need to eliminate possible causes, such as poisons and toxic liver (alcohol), then you should follow a proper, balanced diet. To slow the evolution of the disease takes a drug therapy using interferon-
Alfa and Ribavirin. Cirrhosis cases that do not respond to such therapy can, in certain situations and how extreme possibility, be treated with liver transplantation.

Cirrhosis can be complicated by bleeding?

Yes. Hemorrhages are a typical complication of cirrhosis. In advanced cirrhosis varicose veins in the esophagus bleed frequently; This happens because the blood become engorged veins that normally would have escaped if it hadn't been congested liver from cirrhosis.

The volume increases in liver cirrhosis?

At first Yes, then in the last stages of the disease and shrivels becomes smaller than normal.

In the presence of that disease, the spleen is swollen?

Yes, often, for the presence of portal hypertension. One can thus meet hypersplenism manifested by an overactive spleen cateretica (decrease in red blood cells, and platelets).
•

Liver tumors

The liver can suffer from cancer?

Yes there may be primary forms, in which the liver cells degenerate causing the cancer, and metastatic forms (more frequent), in which cancerous cells originate from other neoplastic foci.

What are the causes of primary forms?

The causes are not well known, but it was noticed that many forms develop in already suffering from liver cirrhosis (often in the form post-epatitica with hepatitis B and C). Also, in a small percentage of cases, have been identified as causes chemical toxins or parasitic forms.

It is usual for the liver metastasis be attacked?

Yes. The liver is the organ most frequently attacked by cancers originating m other organs such as stomach, pancreas, gallbladder, breast, kidney and intestine.

What are the symptoms of a liver tumor?

Symptoms of liver cancer are highly dependent on the extent and nature of the area concerned and by other organs that may be involved. Normally consist of generalized weakness, loss of appetite and weight, trimming of nodular liver. Sometimes there are also all the symptoms of severe cirrhosis, such as jaundice, hemorrhage, edema in the legs, possible coma.

Is there a diagnostic laboratory test for hepatocellular carcinoma?

No, although finding a high level of Alpha-fetoprotein (AFP), a tumor marker, has to ask the suspect.

A liver tumor can be treated surgically?

Yes, in certain cases where the cancer has not spread, but clearly located in a segment of the organ; You can in fact take up half of the liver and allow the patient survival. The other method used is us-guided cryosurgery, in which a probe leads to -200° C the affected area. You can also think about the liver transplant, already implemented in several selected cases; also recently the liver transplant from living donor; the liver can regenerate quickly, i.e. reforming mass, provided it remained at least 4%.
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Gallbladder and biliary tract

What are the causes of gallbladder disease?

a) bacterial infections: can result in acute or chronic inflammation (cholecystitis);
b) functional disorders: the gallbladder fails to empty secreted bile (gall bladder);
c): these calculations, calculations of chemical origin or caused by biliary calculus of cholesterol, may create an obstruction to bile passage along the biliary tract or in the intestinal tract.

Gallstones are always due to biochemical defects within the gallbladder?

No, they can also result from an infection of this organ.

It is common for the formation of gallstones?

It is estimated that 25% of women and 12% of men suffers from gallstones before arriving in sixty years.

There are habits predisposing to gallbladder disease?

Yes. It is believed that a diet rich in fat facilitates the onset of these diseases, but they may appear in different situations.

At what age the first gallbladder disorders?

As a rule, from forty to sixty years, however it is not uncommon to find people much younger.

Pregnancy can be due to the formation of gallstones?

Yes, pregnancy can cause a disruption in the metabolism of cholesterol and gras, and this disruption often results in formation of calculi within months of birth.

Gallbladder disorders are common during pregnancy?

Are quite rare, and are more frequent in women who have already had children.

Gallbladder diseases are recurring in the same family, or even hereditary?

Just because there is a predisposition to physical structure and metabolism, and acquired habits in the family.

What happens when is an acute inflammation of the gallbladder?

Blood circulation in the gallbladder wall may increase to the point of hampering itself, resulting in the formation of pus or even gangrene.

What are the causes of more serious inflammation?

Blocking the cystic duct by a gallstone and gallbladder in a big calculation Solitaire.

What happens when it occurs in chronic inflammation of the gallbladder?

In addition to calculations, resulting legacy both inflammation and bacterial infection both in biochemical disorder of the gallbladder, chronic inflammation and thickening of the walls of the organ. This can lead to a reduced gallbladder operation or even, to his block (gallbladder).

What happens when there are functional disorders of the gallbladder or biliary tract?

This condition is characterized by the inability of the gallbladder to store and make available the bile when it would be needed. Or they can be the common bile duct spasms, which interfere with proper passage of bile into the intestine. The patient suffers from dyspepsia then heartburn and esophagus (heartburn), and fails to digest fats, fried foods and certain fruits and vegetables.

Functional disorders of the gallbladder are always accompanied by formation of calculi?

Not necessarily, although it is very common.

Is there any way to prevent gallbladder disease or a malfunction?

For this purpose it is useful to stick to a moderate diet, trying above all to avoid large amounts of fat and fried foods.

What symptoms indicate the presence of gallbladder disease?

acute inflammation) to the gallbladder (cholecystitis) are accompanied by rising
fever, nausea and vomiting, pain on palpation of the right upper quadrant.
An x-ray may reveal gallbladder organ failure or the presence of gallstones; a CBC, an acute inflammation;
b) Chronic (chronic cholecystitis) accompanied by calculations can cause acute access violent pain in the upper right abdomen (Biliary colic), generally caused by a calculation that is committed to the cystic duct or common bile duct. The pain often radiates to the back and right shoulder. There may be nausea, vomiting and pain to palpation that can suddenly cease, after about half an hour, if the calculation went up in the gallbladder or exceeded the papilla of Vater.
X-ray examinations usually show a gallbladder or excluded the presence of gallstones;
c) functional disorders of the gallbladder are characterized by chronic dyspepsia: inability to digest fatty foods, fried foods and certain raw fruits and vegetables, heartburn. Radiographic examinations show a poor functioning in the filling and emptying of the organ.

We are able to accurately diagnose the functionality of the gallbladder?

Yes, an x-ray exam called colecistocolangiografia. The patient is made to ingest substances opaque to x-rays (also sometimes injected directly into a vein) and after a few hours run radiographs; If the gallbladder is working regularly, fills and contrast substance in the radiograph shown in the image. Radiopaque substances are eliminated with bile; a further x-ray then verifies the emptying of the gallbladder after a meal of stimulants, usually two egg yolks.
Today it is used with greater frequency ultrasonography, allowing a better view of any calculations.

What does a colecistocolangiografia where do you see the gallbladder?

This shows that the gallbladder is not functioning. Often, if you fail to highlight the gallbladder in a first attempt, administering a second and greater dose of radiopaque substances; If the result is negative, it is evident a dysfunction of the gallbladder.

The calculations are always discoverable to a standard x-ray?

No; in some cases there may be numerous non-detectable cholesterol calculi.

The radiograph shows calculations in bile?

Not always; When he suspected the existence, you can perform a retrograde coledocografia, which consists of introducing from the mouth a thin tube (endoscope) whose tip, arrived at the papilla of Vater in Choledochal injects a small amount of liquid barium, which allows you to view any calculations are present in the common bile duct.

This is a dangerous test?

No, it's just annoying.

Depending on what data you decide for a medical rather than surgical therapy?

Functional disorders, if not accompanied by calculations, are usually treated pharmacologically. In the case of cholesterol calculi of modest size, is employed to dissolve, a therapy based on chenodeoxycholic acid and Ursodeoxycholic.

Medical therapy of functional disorders is satisfactory?

Yes, if the patient cooperates closely following medical regulations regarding medications and diet, which usually is quite narrow.

A sufferer of calculations must necessarily undergo a surgery?

Not always; There are many people with calculations that have no symptoms; However, if the calculations give any trouble, it is definitely better to operate. Today you can also use the lithotripsy, methodical grinding ultrasonic calculations.

When the operation is required?

a) In the case of acute inflammation;
b) when there were repeated colic due to the presence of gallstones;
c) where there are gallbladder calculi and the patient suffers from digestive problems
chronic, nausea, flatulence and occasional pains;
d) when there is jaundice (yellowing of the skin) as a result of obstruction of the bile ducts.

What are the medical treatment carried out in gallbladder disease?

drug delivery) based on chenodeoxycholic acid and Ursodeoxycholic;
b) elimination from the diet of fats, fried foods, sauces, some fruit and vegetables;
c) light and power varied with scanty meals;
d) administration of antacids to reduce excessive stomach acidity and antispasmodics to remove Bile Duct spasms.

Surgery always deletes the symptoms caused by functional disturbances, when there are no stones in the gallbladder?

Although a certain percentage of these patients benefit from removal of the gallbladder (cholecystectomy), does not bear any other benefit.

What can happen if you don't work a gallbladder that vice versa should be made?

a) can occur an acute inflammation, resulting in gangrene and organ injury. This in turn can cause organ perforation, peritonitis and death;
b) recurrent colic due to calculus, biliary obstruction, jaundice;
c) if causing obstruction jaundice is not removed surgically, the liver may be damaged and you may have a poisoning by the prolonged stagnation of the bile: consequences can also be fatal.

Jaundice is always caused by calculations?

No. The causes of jaundice are varied and the most common is hepatitis.

How can you distinguish if jaundice is caused from a calculation or other reasons?

There are several tests that can diagnose the exact nature or inflammatory occlusion, a jaundice. A careful history, a thorough examination, x-rays and blood chemical analyses combine to provide an exact diagnosis.

Calculations can promote the formation of gallbladder cancer?

Yes. In approximately 2% of patients with Gallstones may develop a tumor and is this a good reason to make cistifellee with calculations, regardless of the presence or absence of annoying symptoms.

The calculations can be dissolved by medication?

Recent studies have led to the use of certain substances (tauro-acid, and chenodeoxycholic urso-) capable of dissolving, albeit very slowly, only calculations.

Apart from the gall bladder, be sick even bile ducts themselves?

Yes. The most common disease is inflammatory and called angiocholitis or cholangitis.
The cause is a bacterial infection similar to that which causes cholecystitis.
The treatment is similar.
•

Cholecystectomy

What is cholecystectomy?

A surgical procedure that consists in excision of biliary vesicle, or gallbladder.

Because you make?

Because gallbladder conditions, home of calculations, are precarious and arising ailments are no longer controllable by medical care.

Cholecystectomy is a dangerous operation?

No, no more than an appendicitis operation. Moreover, in many cases the surgery is now available in laparoscopy, using a fiber-optic probe inserted into the abdomen through a small incision. It is a minimally invasive technique that involves a shorter hospital stay and convalescence.

In gallbladder stones is always necessary to surgically remove the entire organ?

Almost always the entire gallbladder is removed. However, in some cases it is so inflamed and patients so debilitated that the surgeon may decide to remove only the calculations or drill a gallbladder drainage (colecistotomia).
This surgical technique is faster and less risky.

When the gallbladder is removed, bile also?

No. It must remain a free passage of bile from the liver to the intestine and bile ducts are left on site.

How to remove bile duct calculi?

The surgeon makes a small incision on the duct wall, pull out the calculation (or calculations) with a special clamp and drains the same duct with a rubber tube (Kehr's T-tube); the tubing is left on site from a few days to a few weeks, depending on the progress of the postoperative period.

How long will it take to complete a cholecystectomy?

Three quarters of an hour to an hour and a half, depending on the severity of the inflammatory process.

What type of anesthesia is used?

General anesthesia, or, very rarely, spinal.

What measures are necessary preoperative treatment before cholecystectomy?

Normally there is no need for special measures; However, if you are experiencing an acute inflammation, jaundice or you require some precautionary measures.

What measures are being adopted in these cases before surgery?

introduces) through the nose and esophagus, a feeding tube into the stomach to ensure that the latter is completely empty during the speech;
b) are injected intravenously prior to the operation, glucose and vitamins, particularly vitamin K in case of jaundice, to avoid possible postoperative bleeding;
c) administering antibiotics in case of gallbladder or biliary tract very inflamed.

You also practice blood transfusions?

Generally no; only in more complicated cases.

How long do I have to stay in hospital?

Ten to fifteen days.

Where are the incisions gallbladder surgery?

The engravings gallbladder surgery are of two types. You practice both vertically in the upper right abdomen, below the ribs horizontally to the right; the cut is typically 12-16 cm long.

The wound is usually drained?

Yes. After the operation are typically one or two drain tubes, which remain in situ for eight to ten days.

Cholecystectomy is particularly painful?

No. You may experience some pain breathing deeply and coughing in the days immediately following surgery, but the injury is not particularly painful.

How soon after surgery you can get out of bed?

In normal cases, after a day or two.

What measures follow postoperative?

in the ordinary operations) for cholecystitis characterized by chronic inflammation with calculations, there are special instructions to be observed. The patient can begin to feed with liquid foods the day after the operation, excluding of course all fatty foods, fruit and vegetables etc.;
b) administering antibiotics as a precautionary measure to prevent possible infections, and sometimes introduces a feeding tube into the stomach (through the nose) to relieve the discomfort of swelling;
c) in the case of interventions for acute inflammation or jaundice, drip and drainage of the stomach, vitamin K are used to combat jaundice and massive doses of antibiotics for a few days. Sometimes they are also blood transfusions.

How long does the wound to heal?

Twelve to fourteen days.

You can lead a normal life after gallbladder removal?

Yes.

Bile functions change, and how, after gallbladder removal?

Bile flows directly from the liver to the intestines and most functions of the gallbladder are assumed by bile.

It is normal for the digestive problems remain after surgery?

Yes, for a few weeks.

A woman I've excised the gallbladder, may face a new pregnancy?

Yes.

After the gallbladder removal, you have to have special concerns in your diet?

Yes. You have to follow the same diet that had been prescribed prior to surgery, a light diet, and low in fat.

How long after the removal of a calculation from the common bile duct disappears jaundice?

After a few weeks, you need to delete accumulated bile pigments in the blood and tissues.

Characteristic symptoms of gallbladder disease can persist or recur after a surgery?

Yes; in about 10% of cases. They are thought to be caused by spasms of the end of the common bile duct (biliary dyskinesia).

Calculations can be reformed after being removed?

If the gallbladder is excised, the calculations cannot obviously be reformed in the gallbladder, but in some rare cases calculations are formed directly into the hepatic ducts common bile duct or the cystic duct stump remained on site.

In that case, what should I do?

You need a new one. The project is quite challenging but the vast majority of patients recover fully.

You can do something to prevent the reformation of math?

Nothing specific, if not try to avoid any form of infection and follow the appropriate diet.

Gallbladder excision shortens life?

Absolutely not.

What chance has a cholecystectomy to fail?

The mortality rate for these surgeries is less than 1%, and lethal outcomes are due or particularly complicated cases or late intervention.

When you have to go to the doctor for a checkup after a cholecystectomy?

Six months and one year after the operation.
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Pancreatitis

Pancreatitis is a serious disease?

Yes, especially in the acute form. It is an inflammatory process that affects the pancreas and which may be associated with severe hemorrhage, necrosis of the organ, shock and be fatal. Despite the severity of the symptoms framework, most patients however overcome this disease.

From what usually originates in the acute inflammation of the pancreas?

In some cases, can be caused by a reflux of bile, infected or not, in pancreatic ducts; It is often related to alcohol abuse, sometimes with some forms of hyperlipidemia.

What are the symptoms and signs of acute pancreatitis?

fever);
b) barrier to pain upper abdomen, abdominal wall voltage initially not very accentuated, intestinal occlusion;
c) nausea and vomiting;
d) in severe cases, symptoms of shock, caused by bleeding and Liberation of several proteolytic and lipolytic enzymes;

) and increasing the amount of lipase and amylase, two pancreatic enzymes, blood;
f) increase in the blood sugar;
g) reduction in serum calcium.

What is the symptoms of recurrent pancreatitis or chronic form?

A relapse of the disease usually takes the course of an acute attack. the chronic form is usually associated with difficulties and persistent indigestion, a feeling of swelling and pain is not well defined in the upper abdomen, in some cases even a slight jaundice. Often also are symptomatic of this disorder a weight loss and diarrhea.

How to cure acute pancreatitis?

to) if the patient is in a State of shock, you must first take action against that State;
b) by the administration of drugs designed to soothe the pain (analgesics);
c) discontinuing oral feeding and practicing the patient a drip, to provide the body with the necessary supply of glucose (sugar) and liquids;
d) by facilitating the Elimination of gastric juice and duodenal ulcers using a probe introduced into the stomach of the patient through the nose;
and) through the adoption of measures to eliminate intestinal occlusion;
f) if inflammation is caused by bacteria, using antibiotics.

Acute pancreatitis may necessitate recourse to surgery?

Yes; in the acute stage, applies solely a medical therapy, but if complications arise, such as an abscess, a strong bleeding or the formation of cysts, an operation may be required; in the case of cysts or concomitant diseases of biliary tract, surgical therapy is applied after the disappearance of acute symptoms. Often, moreover, it is considered appropriate because surgery op, not having been able to make a precise diagnosis, you want to exclude the possibility of other abdominal diseases involving a timely operation.

What techniques are adopted in the case of pancreatitis?

Depends on the circumstances: If the inflammatory process caused the spillage of liquid
in the abdominal cavity, or an abscess has formed, in both cases the drainage; in case of bleeding, the blood vessel is tied; If part of the glandular tissue is destroyed (i.e. necrotizzata), we proceed to its removal. If the gallbladder or bile ducts are suffering from gallstones, which are deemed to have contributed to the development of pancreatitis, there shall be an appropriate surgical intervention as soon as the patient has passed the acute phase.

Gallbladder diseases biliary system or give rise to often an inflammation of the pancreas?

Yes; about 50% of people with chronic pancreatitis suffer from gallstones and many doctors believe that they constitute a major cause of these rashes.

Pancreatitis tends to relapse?

Yes, if the condition on which it is based-for example, a condition of colecistinon is deleted.

It is possible, and how, to prevent the onset?

Yes, and the best way is to follow a light diet, low in fat, and avoid heavy meals and alcohol abuse. You also need to cure radically any gallbladder disease or biliary tract.

Pancreatitis is often associated with the onset of diabetes?

Yes, in the presence of the acute form, there is a temporary increase in blood sugar in 55% of cases; chronic pancreatitis is associated with diabetes in 23% of cases.
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Pancreatic abscess

In which cases is mostly form an abscess of pancreas?

After acute pancreatitis.

Is a frequent phenomenon?

No, the formation of an abscess occurs usually after serious cases, in which pancreatitis resulted in necrosis of a portion of the gland.

How is such an abscess?

Days or weeks after the regression of acute pancreatitis, the patient is suffering from back pain in the upper abdomen, with swelling and pressure sensitivity and contemporary fever these symptoms lead to eco-control or allowing of tomographic diagnosis.

How do we cure it?

Pancreatic abscess is treated with antibiotics and surgical drainage of the abscess.

Surgery leads to healing of pancreatic abscess?

In most cases, Yes; under certain conditions, however, it may be necessary to drill the drainage for a prolonged period.
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Pancreatic cyst

From what originated, and how often are formed, pancreatic cysts?

It is assumed that the formation of cysts can be caused by occlusion of a pancreatic duct (chronic pancreatitis), or as a result of acute pancreatitis.
These cysts occur quite rarely, and may have varying sizes than those of a grape to a watermelon.

Similar cysts are dangerous?

No; though small in size, it can ignore them; If well developed, require the adoption of appropriate therapeutic measures may compress adjacent organs, compromising the functions.

How can be diagnosed?

Some cysts can be perceived size on palpation by your doctor including rounded swellings, pain-free and located in the upper abdomen.
Diagnostic examination is, however, abdominal ultrasonography.

Which surgery is appropriate practice in similar cases?

Excision of the cyst; If the size or location of the cyst itself does not allow excision, simply drain the fluid contained within it.
In some cases, the cyst wall is sutured to the stomach, duodenum or jejunum, so that the content can be poured directly into the stomach; with this method you get often a speedy recovery.

Pancreatic cysts leave lasting consequences?

No; digestion and gland function normalize usually within a few weeks or months.

What is cystic fibrosis of the pancreas?

occur in the pancreas severe changes, so the gland atrophy, becoming a multiplicity of small cysts, and fails the action of pancreatic juice, leading to digestive disorders. In such a case, you can get some improvement with enzyme preparations.
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Benign tumors of the pancreas

What is the most common benign tumor of the pancreas?

Adenoma, which originates from a proliferation of islets of Langerhans

These benign tumors can degenerate?

Yes, and this is one of the main reasons why it is necessary to intervene surgically if you suspect the presence of a pancreatic tumor.

What size have adenomas of the pancreas?

These are small tumors, having a diameter of not more than one or two centimeters, whose presence cannot be felt on palpation.

Besides, pancreas adenomas may develop other benign tumors?

Yes; adenomas can be formed which lead to the formation of gastrin: this stimulates overproduction of stomach acid, resulting in the development of ulcers
gastroduodenal. The simultaneous presence of a pancreatic tumor and this type of ulcer is the so-called Zollinger-Ellison syndrome.

Treatment of Zollinger-Ellison Syndrome?

If pancreatic cancer is isolated and well located, is necessary to effect its removal. Usually, unfortunately, is not pancreatic formation delimitabile and, in similar cases, using the removal of the entire stomach (gastrectomy), to prevent the formation of new ulcers.
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Carcinoma of the pancreas

Pancreatic cancer is very common?

Unfortunately is one of the most common malignant neoplasms of the abdominal organs, and has the lowest permanent healing.

From what originated?

You do not know the cause. However, there are some risk factors: smoking, alcohol, diabetes mellitus, chronic pancreatitis, cirrhosis.

Where are these localized growths usually?

In most cases, the head of the pancreas, the portion in contact with the duodenum. Most benign tumors occur in the body or tail of the gland.

What causes symptoms of pancreatic cancer?

Its onset is insidious because initially does not produce symptoms. As a result of causes that pain from the upper abdomen usually radiate to the back; Moreover, since (as you said) usually localized in the head of the gland, its size increases the cancer end up compressing the bile ducts, causing obstruction and, consequently, the slow onset of jaundice. In this case, the patient is suffering from loss of appetite, weight loss and lack of progressive forces.

What chance of recovery may have who is suffering from a similar formation?

Not many. Although surgical techniques have been developed that allow to remove both the pancreas and the duodenum portion of neighbouring, is unfortunately rarely possible, even with such an extensive operation, remove radically the carcinoma. In fact, diagnosis is usually late, so surgery, radiotherapy and chemotherapy don't generally have a decisive effect.

The patient has been excised pancreas, is poised to become diabetic?

Yes; in such cases, however, the regulation of sugar metabolism is in part accomplished by other glands, so diabetes usually assumes a course that they threaten the life of the person concerned.

Which likely duration of survival may have a person who has been diagnosed with pancreatic cancer?

Approximately six to eighteen months. However, that are known since goli cases where radical excision of the pancreas has led to permanent healing.

Is there a diagnostic laboratory tests for pancreatic cancer?

Not exactly, though in recent times has become available the method to measure a tumor marker, particularly specific for adenocarcinoma of the pancreas, said GANGARAM (gastrointestinal tumor-associated Antigen).

You can transplant pancreas?

Yes. In certain cases can also be performed pancreatic islet grafts by injection into the portal.