Purtscher-like retinopathy associated with acute pancreatitis at Vilnius University Hospital Santariskiu Klinikos

2013 ◽  
Vol 91 ◽  
pp. 0-0
Author(s):  
R PAULAVICIENE ◽  
E STRELKAUSKAITE ◽  
R ASOKLIS ◽  
R STRUPAITE
Keyword(s):  
Acute Pancreatitis ◽  
University Hospital ◽  
Vilnius University

scholarly journals Ūminio pankreatito etiopatogenezė

2006 ◽  
Vol 4 (2) ◽  
pp. 0-0
Author(s):  
Audrius Šileikis
Keyword(s):  
Acute Pancreatitis ◽  
Abdominal Surgery ◽  
Key Words ◽  
The Other ◽  
University Hospital ◽  
Key Words Acute Pancreatitis ◽  
Scientific Investigations ◽  
Vilnius University

Audrius ŠileikisVilniaus universiteto ligoninės Santariškių klinikųPilvo chirurgijos centras,Santariškių g. 2, LT-08661 VilniusEl paštas: [email protected] Ūminis pankreatitas – tai liga, kurios metu pažeidžiama ne tik kasa, bet ir kiti organai, o sutrikus jų veiklai žmogus gali mirti. Todėl žinant ligos priežastis ir jos raidos mechanizmą galima išvengti mirtinų komplikacijų. Per pastaruosius du dešimtmečius atlikta nemažai mokslinių tyrinėjimų, leidusių geriau pažinti procesus, vykstančius sergant ūminiu pankreatitu. Jie ir pateikti šiame straipsnyje. Reikšminiai žodžiai: ūminis pankreatitas, citokinai Etiopathogenesis of acute pancreatitis Audrius ŠileikisCenter of Abdominal Surgery,Vilnius University Hospital "Santariškių klinikos",Vilnius, Santariškių str. 2, LT-08661 Vilnius, LithuaniaE-mail: [email protected] Acute pancreatitis is a disease which damages not only the pancreas, but also the other organs, through the functional derangement of which a person may die. Thus, the knowledge of the causes of the disease and the mechanism of the development of the illness itself may help to avoid the threatening inevitable complications. A number of scientific investigations, which contributed to understanding the processes going on in the course of acute pancreatitis have been carried out within the recent twenty years; they are discussed in the paper. Key words: acute pancreatitis, cytokine

scholarly journals Ūminis pankreatitas – dažniausia endoskopinės retrogradinės cholangiopankreatografijos komplikacija

2008 ◽  
Vol 6 (1) ◽  
pp. 0-0
Author(s):  
Laura Mašalaitė ◽  
Tomas Poškus ◽  
Gintautas Radžiūnas ◽  
Jonas Valantinas
Keyword(s):  
Risk Factors ◽  
Acute Pancreatitis ◽  
Pancreatic Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
University Hospital ◽  
Common Complication ◽  
Contrast Injection ◽  
Endoscopic Retrograde ◽  
Therapeutic Ercp ◽  
Vilnius University

Laura Mašalaitė1,  Tomas Poškus2, Gintautas Radžiūnas2, Jonas Valantinas11 Vilniaus universiteto ligoninės Santariškių klinikų Hepatologijos,gastroenterologijos ir dietologijos centras, Santariškių g. 2, LT-08661, VilniusEl paštas: [email protected] Vilniaus universiteto ligoninės Santariškių klinikų Centro filialo 3-iasis pilvo chirurgijos skyrius,Žygimantų g. 3, LT-01102 Vilnius Tikslas Ūminis pankreatitas yra dažniausia endoskopinės retrogradinės cholangiopankreatografijos (ERCP) komplikacija. Rizikos veiksniai, padidinantys pankreatito po ERCP išsivystymą, yra skirstomi į susijusius su pacientu ir susijusius su pačia procedūra. Visiškai išvengti ūminio pankreatito išsivystymo po ERCP neįmanoma, todėl ieškoma įvairių būdų sumažinti šios komplikacijos riziką. Mūsų darbo tikslas – išnagrinėti ūminio pankreatito, išsivysčiusio po diagnostinės ir gydomosios ERCP, dažnį, išsivystymo laiką, diagnostikos ir gydymo metodus, taip pat įvertinti rizikos veiksnius, galėjusius lemti pankreatito išsivystymą. Ligoniai ir metodai 1999–2004 metais 619-ai pacientų buvo atlikta 690 ERCP procedūrų. Retrospektyviai buvo išanalizuotos šių pacientų ligos istorijos. Rezultatai Iš viso per 5 metus buvo padaryta 690 diagnostinių ir gydomųjų ERCP procedūrų 619 pacientų: 41,5% vyrų ir 58,5% moterų; amžiaus vidurkis 62 metai. Po ERCP komplikacijų buvo 55 ligoniams (7,9%). Ūminis pankreatitas išsivystė 17 pacientų (2,46%) ir sudarė 31% visų komplikacijų po ERCP. Dažniausiai (70,6%) pankreatitas pasireiškė per pirmas 24 valandas po procedūros. Dauguma ligonių (88,2%) buvo gydyti konservatyviai, du ligoniai buvo operuoti. Vienas ligonis (5,9%), kuriam po ERCP išsivystė ūminis pankreatitas, mirė no dauginio organų nepakankamumo, visi kiti ligoniai (94,1%) pasveiko. Reikšmingi pankreatito rizikos veiksniai buvo jaunesnis kaip 40 metų amžius, kraujavimas po papilosfinkterotomijos ir dėl to atlikta hemostazė bei kontrasto injekcija į kasos lataką. Išvados Ūminis pankreatitas – dažniausia ERCP komplikacija, kuri išsivystė 2,46% ligonių. Statistiškai reikšmingi pankreatito rizikos veiksniai buvo jaunesnis negu 40 metų amžius, kraujavimas procedūros metu bei kontrasto injekcija į kasos lataką. Ūminis pankreatitas padidina sergamumą ir mirtingumą po ERCP, todėl labai svarbu atrinkti pacientus procedūrai remiantis griežtomis indikacijomis, o išsivysčius komplikacijoms svarbi ankstyva jų diagnostika ir tinkamas gydymas. Pagrindiniai žodžiai: endoskopinė retrogradinė cholangiopankreatografija (ERCP), komplikacijos, ūminis pankreatitas, rizikos veiksniai, profilaktika Acute pancreatitis – the most common complication after endoscopic retrograde cholangiopancreatography Laura Mašalaitė1,  Tomas Poškus2, Gintautas Radžiūnas2, Jonas Valantinas11 Vilnius University Hospital "Santariškių Clinics", Center of Hepatology,Gastroenterology and Dietology, Santariškių str. 2, LT-08661 Vilnius, LithuaniaE-mail: [email protected] Vilnius University Hospital "Santariškių Clinics", Central Branch,III Department of Abdominal Surgery, Žygimantų str. 3, LT-01102 Vilnius, Lithuania Background / objective Acute pancreatitis is the most common complication after endoscopic retrograde cholangiopancreatography (ERCP). Risk factors for pancreatitis are both patient-related and procedure-related. Because post-ERCP pancreatitis can not be prevented completely, the prophylaxis of pancreatitis remains very important. The aim of our study was to investigate the incidence, diagnosis, treatment results and risk factors for pancreatitis after diagnostic and therapeutic ERCP procedures. Patients and methods Between January 1999 and January 2004, 619 patients underwent 690 diagnostic or therapeutic ERCP procedures, and a retrospective analysis of their case histories was performed. Results In the study period 619 patients underwent 690 diagnostic or therapeutic ERCP procedures and 55 patients (7.9%) developed complications after this procedure. Acute pancreatitis, the most common complication after ERCP (31% all complications) developed in 17 patients (2.46%). The most frequent (70.6%) symptoms of pancreatitis developed on the day of the procedure. Of these patients, 88.2% were treated conservatively, two patients were operated on. One patient died because of multiorgan failure, all other patients (94.1%) recovered. Risk factors for pancreatitis were age < 40 years, bleeding after papillosphincterotomy, and pancreatic duct contrast injection. Conclusions Acute pancreatitis, the most common complication after ERCP, developed in 17 patients (2.46%). Risk factors for pancreatitis were age < 40 years, bleeding after papillosphincterotomy, and pancreatic duct contrast injection. ERCP should be considered only for strong indications, and the risk factor analysis, early diagnosis and adequate treatment of post-ERCP pancreatitis are important. Key words: endoscopic retrograde cholangiopancreatography (ERCP), complications, acute pancreatitis, risk factors, prophylaxis

scholarly journals Varikocelės gydymas naudojant mikrochirurginį metodą

2012 ◽  
Vol 10 (1-2) ◽  
pp. 0-0
Author(s):  
Tigran Zotov ◽  
Deimantas Šukys
Keyword(s):  
Surgical Treatment ◽  
Sperm Quality ◽  
Testicular Volume ◽  
University Hospital ◽  
Adult Males ◽  
Sperm Analysis ◽  
Postoperative Control ◽  
Vilnius University ◽  
The Republic ◽  
E Mail

Tigran Zotov, Deimantas Šukys Respublikinės Vilniaus universitetinės ligoninės Urologijos skyrius, Šiltnamių g. 29, LT-04130 Vilnius El. paštas: [email protected] Įvadas Varikocelė yra gan dažna liga, nustatoma 10 proc. suaugusių vyrų, ir net 25 proc. tų vyrų, kurie tiriami dėl nevaisingumo. Varikocelė mažina sėklidžių apimtį, blogina spermos kokybę ir Leidigo ląstelių funkciją. Po varikocelės gydymo sėklidė padidėja, pagerėja spermos kokybė. Respublikinėje Vilniaus universitetinėje ligoninėje buvo pradėta naudoti mikrochirurginė varikocelės gydymo metodika. Metodai Nuo 2009 m. balandžio iki 2011 m. gegužės buvo atliktos septynios varikocelektomijos operacijos naudojant mikrochirurginę techniką. Rezultatai Intraoperacinių ar ankstyvųjų pooperacinių komplikacijų nebuvo. Iškvietus pakartotinio patikrinimo operuotus pacientus nerasta nė vieno varikocelės recidyvo. Išvados Varikocelė yra gan dažna liga, galinti lemti nevaisingumą. Dėl nevaisingumo besikreipiantiems vyrams, kuriems yra klinikinė varikocelės raiška ir nenormalius spermos tyrimas, indikuojamas operacinis gydymas. Jei yra galimybė pasinaudoti operaciniu mikroskopu, tikslinga atlikti mikrochirurginę varikocelektomiją, o jei tokios galimybės nėra, pirmučiausia alternatyva yra laparoskopinė varikocelektomija. Reikšminiai žodžiai: varikocelė, chirurginis gydymas. Varicocele treatment by the microsurgical method Tigran Zotov, Deimantas Šukys Republican Vilnius University Hospital, Department of Urology, Šiltnamių Str. 29, LT-04130 Vilnius, Lithuania E-mail: [email protected] Background Varicocele is a rather frequent disease found in 10% of adult males and in 25% of infertile men. Varicocele reduces the testicular volume, declines sperm quality and the function of the Leydig cells. After varicocele treatment, the testicular volume increases and sperm quality improves. Varicocele treatment by the microsurgical method was started at the Republic Vilnius University Hospital. Methods Seven varicocelectomies by the microsurgical way were performed from April 2009 till May 2011. Results No intraoperative or early postoperative complications were observed. There was no varicocele recurrences found on postoperative control visits. Conclusions Varicocele is a rather frequent disease which can cause infertility. Its surgical treatment is indicated in cases of a clinically apparent varicocele and abnormal sperm analysis. If possible (where a surgical microscope is accessible), microsurgical varicocelectomy is the preferred way of treatment. Laparoscopic varicocelectomy is the method of choice if there is no possibility to perform a microsurgical procedure. Key words: varicocele, surgical treatment

scholarly journals Management of acquired benign tracheoesophageal fistula in adults: a twelve-year experience

2013 ◽  
Vol 12 (4) ◽  
pp. 196-203
Author(s):  
Nerijus Šileika ◽  
Vytautas Jovaišas ◽  
Žymantas Jagelavičius ◽  
Ričardas Janilionis
Keyword(s):  
Tracheoesophageal Fistula ◽  
University Hospital ◽  
Tube Placement ◽  
Endoscopic Management ◽  
Tracheal Resection ◽  
Management Options ◽  
Surgical Closure ◽  
General Thoracic Surgery ◽  
Vilnius University ◽  
Simple Repair

Background / ObjectivesAcquired nonmalignant tracheoesophageal fistula (TEF) in adult patients develops in a variety of conditions, the predominant being postintubation. Several management options have been suggested, while the optimal strategy remains controversial.The aim of this review is to present our clinical experience and to find the optimal management for TEF.MethodsThis study is a retrospective review of all patients who underwent management for benign TEF at the Vilnius University Hospital between January 2000 and December 2012.ResultsSeven patients (three female and four male) with a benign TEF were referred to the Department of General Thoracic Surgery of the Vilnius University Hospital from January 2000 to December 2012. Their mean age was 48.3 ± 11.4 years. PostintubationTEF accounted for six fistulas (85.7%), while one patient (14.3%) suffered from injury during percutaneous dilational tracheostomy. Five patients underwent TEF closure (71.4%). Four patients underwent a simple repair of the fistula, while one patient required tracheal resection and reconstruction. Endoscopic management with tracheal dilation and T tube placement was performed to one (14.3%) and additional jejunostomy was done also to one patient (14.3%). Four patients (57.1%) hadpostoperative complications. Two postoperative deaths occurred (28.6%).ConclusionsSingle-stage surgical repair with or without tracheal resection and reconstruction can be successfully performed after the weaning from mechanical ventilation in patients with acquired nonmalignant TEF.Key words: tracheoesophageal fistula, surgical closure, tracheal resection, nonmalignant fistulaĮgytos tracheoezofaginės jungties gydymas: dvylikos metų patirtis Įvadas / tikslasĮgytos nenavikinės kilmės tracheoezofaginės jungties (TEJ) priežastys yra įvairios, dažniausia iš jų – pointubacinė. Yra pasiūlyta keletas gydymo metodų, tačiau dėl geriausios gydymo taktikos vis dar diskutuojama. Šios apžvalgos tikslas – išnagrinėtimūsų klinikinę patirtį ir rasti optimalų gydymą tų ligonių, kuriems nustatyta TEJ.MetodaiRetrospektyviai išanalizuoti ligoniai, kurie 2000–2012 m. buvo chirurginiu būdu gydomi Vilniaus universiteto ligoninės Krūtinės chirugijos skyriuje. Rezultatai2000–2012 m. nuo nenavikinės kilmės TEJ gydyti 7 ligoniai (3 moterys ir 4 vyrai), kurių amžiaus vidurkis buvo 48,3±11,4 metų. Pointubacinė TEJ nustatyta šešiems ligoniams (85,7 %), vienam ligoniui (14,3 %) TEJ atsirado po perkutaninės dilatacinės tracheostomijos. Penki ligoniai gydyti chirurginiu būdu (keturiems ligoniams trachėja atskirta nuo stemplės, o jų sienų defektai užsiūti; vienam ligoniui papildomai atlikta trachėjos rezekcija ir rekontstrukcija). Endoskopinis trachėjos spindžio plėtimas ir stentavimas T formos endoprotezu taikytas vienam ligoniui (14,3 %); maitinimui skirta jejunostoma atlikta taip pat vienam ligoniui (14,3 %). Keturiems ligoniams pasitaikė pooperacinių komplikacijų (57,1 %). Po gydymo mirė du ligoniai.IšvadaVienmomentė TEJ šalinimo operacija su trachėjos rezekcija ir rekonstrukcija arba be jos gali būti sėkmingai atlikta savaime kvėpuojantiems ligoniams, kuriems yra nenavikinės kilmės TEJ.Reikšminiai žodžiai: tracheoezofaginė jungtis, trachėjos rezekcija, nenavikinės kilmės jungtis.

CYP450 Enzymes Genetic Polymorphism Influence on Treatment of Affective Disorders

2017 ◽  
Vol 41 (S1) ◽  
pp. S167-S168 ◽  
Author(s):  
A. Lengvenytė ◽  
R. Strumila ◽  
E. Dlugauskas ◽  
A. Utkus
Keyword(s):  
Genetic Polymorphism ◽  
Side Effects ◽  
University Hospital ◽  
Substantial Part ◽  
Pharmacogenetic Testing ◽  
Unsuccessful Treatment ◽  
First Choice ◽  
Vilnius University ◽  
Competing Interest ◽  
Intermediate Metabolizer

IntroductionIndividualized treatment decisions in psychiatry may be important, since substantial part of first choice drugs are ineffective or cause side effects. Polymorphic variants of genes that code CYP450 enzymes cause differences in their activity and therefore in efficacy and safety of drugs that are metabolized by them.Aim of the studyDetermine whether pharmacogenetic testing of CYP2D6, CYP2C19 and CYP2C9 polymorphism would have had influence on selected patients’ treatment courses.MethodsFive patients that were diagnosed for treament-resistant mood disorders in Vilnius university hospital Santariskiu clinics centre of neurology, department of psychiatry were invited to give blood samples for genetic testing retrospectively. Patients’ CYP2C19, CYP2D6 and CYP2C9 enzymes genetic polymorphism results were compared with previous empirical pharmacological treatment courses of these patients.ResultsIn four out of five cases significant polymorphism of CYP2C19 enzyme allele was detected. In all of these cases 1*/2* variant, that conditions intermediate metabolizer phenotype, was identified. Alterations in CYP2D6 and CYP2C19 regions were not found. In three cases the presence of varied genetic variant could have been clinically relevant. In two of these cases Sertraline and valproates, that are both metabolized by CYP2C19 enzyme, were taken by patients and side effects were observed. Unsuccessful treatment was repeated without effect, both in clinical and outpatient environment. Continuous rehospitalization took place until appropriate empirical treatments were established.ConclusionsPharmacogenetic testing could have had influence on treatment choices for three out of five selected patients leading to less side effects and rehospitalizations.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Pancreatoduodenectomy for Periampullary Tumors Presenting with Acute Pancreatitis

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Xuefeng Cao ◽  
Xixiu Wang ◽  
Xiaoliang Xu ◽  
Yanmin Lu ◽  
Baolei Zhao ◽  
...  
Keyword(s):  
Acute Pancreatitis ◽  
Operative Time ◽  
Laboratory Data ◽  
Biliary Fistula ◽  
University Hospital ◽  
Control Group ◽  
Study Group ◽  
Course Of Disease ◽  
Periampullary Tumors ◽  
Medical University

Background. Periampullary tumors (PT) may rarely present as acute pancreatitis (AP) or acute recurrent pancreatitis (ARP). Unlike other cases of AP and ARP, these conditions necessitate pancreaticoduodenectomy (PD), and timely diagnosis is crucial. Materials and Methods. A retrospective review of clinical, radiological, surgical, and pathological data was conducted for patients admitted to the Binzhou Medical University Hospital during the period from January 2010 to December 2017, for AP or ARP caused by PT. All patients included in the study group had undergone PD. The perioperative data for these patients was compared with data for patients with PT but without AP or ARP who underwent PD during the same period (control group). Results. During the study period, 412 patients with AP or ARP were treated; among this group, 15 patients had PT. Compared with controls, patients in the study group were younger in age and had a longer course of disease, more frequent hospitalizations, and more severe derangements in laboratory data (P<0.05). Operative time and intraoperative blood loss were significantly higher in the study group, but the incidence of postoperative outcomes such as pancreatic/biliary fistula, abdominal infection, postoperative hospital stay, and mortality were similar between groups (P>0.05). Conclusions. Neither AP nor ARP has any adverse impact on the outcomes of PD. However, in the treatment of younger patients suffering from AP or ARP, unexplained pancreatic duct dilation and weight loss should raise the suspicion of PT. EUS and EUS-FNA may be helpful in making the diagnosis.

scholarly journals Use of Magnetic Resonance Imaging in Evaluating Fetal Brain and Abdomen Malformations during Pregnancy

Medicina ◽  
2019 ◽  
Vol 55 (2) ◽  
pp. 55 ◽  
Author(s):  
Nomeda Valevičienė ◽  
Guoda Varytė ◽  
Jolita Zakarevičienė ◽  
Eglė Kontrimavičiūtė ◽  
Diana Ramašauskaitė ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Fetal Brain ◽  
Fetal Mri ◽  
University Hospital ◽  
Resonance Imaging ◽  
Internal Organs ◽  
Intravenous Contrast ◽  
Vilnius University ◽  
Magnetic Resonance Imaging Mri

Magnetic resonance imaging (MRI) is used as a clarifying technique after a high-resolution ultrasound examination during pregnancy. Combining ultrasound with MRI, additional diagnostic information is obtained or ultrasound diagnosis is frequently corrected. High spatial resolution provides accurate radiological imaging of internal organs and widens possibilities for detecting perinatal development disorders. The safety of MRI and the use of intravenous contrast agent gadolinium are discussed in this article. There is no currently available evidence that MRI is harmful to the fetus, although not enough research has been carried out to prove enduring safety. MRI should be performed when the benefit outweighs the potential side effects. The narrative review includes several clinical cases of fetal MRI performed in Vilnius University Hospital Santaros Clinics.

scholarly journals The Pattern of Colorectal Cancer Surgery in Lithuania in 2005: Do Results Meet Expectations?

Medicina ◽  
2013 ◽  
Vol 49 (3) ◽  
pp. 20 ◽  
Author(s):  
Eligijus Poškus ◽  
Saulius Mikalauskas ◽  
Valdemaras Jotautas ◽  
Paulius Žeromskas ◽  
Tomas Poškus ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Postoperative Complications ◽  
Demographic Data ◽  
Preoperative Evaluation ◽  
University Hospital ◽  
Pathological Examination ◽  
National Database ◽  
Resection Margins ◽  
Neoadjuvant Radiotherapy ◽  
Vilnius University

The aim of this study was to expose the pattern of the surgical treatment of colorectal cancer in Lithuania in 2005. Material and Methods. A retrospective analysis of 590 patients treated for colorectal cancer in the surgical departments of the Hospital of Lithuanian University of Health Sciences, the Institute of Oncology of Vilnius University, and Vilnius University Hospital Santariškių Klinikos in 2005 was performed. Demographic data, preoperative evaluation, postoperative complications assessed according to the Clavien-Dindo classification, the quality of pathological examination, and survival rates were analyzed. Results. A total of 590 patients, 269 women (45.6%) and 321 men (54.4%), were included in this study; the mean age was 68.3 years (SD, 11.2). Tumors were found in the colon of 274 patients (46.4%) and in the rectum of 316 patients (53.6%). An abdominal ultrasound scan was preoperatively performed in 516 patients (87.5%) and a chest x-ray in 316 patients (53.6%); 35 patients (5.9%) underwent abdominal computed tomography. Endorectal ultrasound was done in 99 (31.7%) cases. Neoadjuvant radiotherapy for T3 and T4 rectal tumors was applied in 42 cases (18.1%). Besides, 211 patients (35.8%) developed postoperative complications with an anastomotic leak emerging in 20 cases (3.4%). Death occurred in 7 patients (1.18%). On the average, 11.15 lymph nodes (SD, 6.02) were found in pathological specimens. Circumferential resection margins were assessed in 58 cases (18.4%). The overall 5-year survival rate was 52.06%. Conclusions. The preoperative evaluation and the treatment of patients with colorectal cancer were not sufficiently consistent in Lithuania in 2005. In order to improve the treatment of colorectal cancer, standardization or the national database of colorectal cancer is necessary.

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