Bøger af Kamel Hail

L'appendicite rimane la patologia digestiva più frequente tra le emergenze chirurgiche addominali. La diagnosi di questa patologia non è sempre facile. In passato, si basava principalmente sulle manifestazioni cliniche e sui risultati biologici, ma circa la metà dei pazienti presentava una sindrome appendicolare atipica, rendendo impossibile la conferma della diagnosi. Oggi, gli esami di imaging come l'ecografia o la TAC sono sempre più utilizzati per confermare o escludere rapidamente la diagnosi ed evitare interventi chirurgici abusivi. Tuttavia, il trattamento rimane chirurgico e prevede un'operazione d'urgenza, associata a una terapia antibiotica, la cui durata dipende dalla gravità dell'infiammazione. L'analisi anatomopatologica dell'appendice è fondamentale per non trascurare una diagnosi associata o sottostante, in particolare una patologia infiammatoria o tumorale.

Die Appendizitis ist nach wie vor die häufigste Erkrankung des Verdauungstrakts bei chirurgischen Notfällen im Bauchbereich. Die Diagnose dieser Erkrankung ist nicht immer einfach. Früher stützte sie sich hauptsächlich auf die klinischen Manifestationen und die biologischen Befunde, doch bei etwa der Hälfte der Patienten lag ein atypisches Appendizitis-Syndrom vor, sodass die Diagnose nicht bestätigt werden konnte. Heute werden zunehmend bildgebende Verfahren wie Ultraschall oder Computertomographie eingesetzt, um die Diagnose schnell zu bestätigen oder auszuschließen und übertriebene chirurgische Eingriffe zu vermeiden. Dennoch bleibt die Behandlung chirurgisch und erfordert einen Notfalleingriff in Verbindung mit einer Antibiotikatherapie, deren Dauer von der Schwere der Entzündung abhängt. Die anatomisch-pathologische Analyse des Blinddarms ist entscheidend, um keine Begleit- oder Grunddiagnose zu übersehen, insbesondere Entzündungs- oder Tumorerkrankungen.

Appendicit ostaetsq naibolee chastoj patologiej organow pischewareniq sredi äxtrennyh hirurgicheskih wmeshatel'stw w brüshnoj polosti. Diagnostika ätogo zabolewaniq ne wsegda prosta. V proshlom ona osnowywalas' w osnownom na klinicheskih proqwleniqh i rezul'tatah biologicheskogo issledowaniq, no primerno u polowiny pacientow nablüdalsq atipichnyj appendikulqrnyj sindrom, chto delalo newozmozhnym podtwerzhdenie diagnoza. Segodnq wse chasche ispol'zuütsq wizualiziruüschie issledowaniq, takie kak UZI ili KT, pozwolqüschie bystro podtwerdit' ili isklüchit' diagnoz i izbezhat' necelesoobraznyh hirurgicheskih wmeshatel'stw. Tem ne menee, lechenie ostaetsq hirurgicheskim i wklüchaet w sebq äxtrennuü operaciü w sochetanii s antibiotikoterapiej, dlitel'nost' kotoroj zawisit ot tqzhesti wospaleniq. Anatomopatologicheskij analiz appendixa imeet reshaüschee znachenie, chtoby ne propustit' soputstwuüschij ili osnownoj diagnoz, w chastnosti wospalitel'nye ili opuholewye patologii.

Appendicitis remains the most frequent digestive pathology among abdominal surgical emergencies. Diagnosis of this condition is not always straightforward. In the past, diagnosis was based primarily on clinical manifestations and laboratory results, but in around half of all patients an atypical appendicular syndrome was present, making it impossible to confirm the diagnosis. Today, imaging tests such as ultrasound and CT scans are increasingly used to confirm or exclude the diagnosis quickly, and avoid unnecessary surgical intervention. Nonetheless, treatment remains surgical and involves emergency surgery, combined with antibiotic therapy, the duration of which depends on the severity of the inflammation. Anatomopathological analysis of the appendix is crucial, so as not to overlook an associated or underlying diagnosis, notably inflammatory or tumoral pathologies.

A apendicite continua a ser a patologia digestiva mais frequente entre as urgências cirúrgicas abdominais. O diagnóstico desta patologia nem sempre é fácil. No passado, baseava-se principalmente nas manifestações clínicas e nos resultados biológicos, mas cerca de metade dos doentes apresentavam uma síndrome apendicular atípica, o que impossibilitava a confirmação do diagnóstico. Atualmente, os exames imagiológicos, como a ecografia ou a TAC, são cada vez mais utilizados para confirmar ou excluir rapidamente o diagnóstico e evitar intervenções cirúrgicas abusivas. No entanto, o tratamento continua a ser cirúrgico e envolve uma operação de emergência, combinada com antibioterapia, cuja duração depende da gravidade da inflamação. A análise anatomopatológica do apêndice é fundamental, de forma a não negligenciar um diagnóstico associado ou subjacente, nomeadamente patologias inflamatórias ou tumorais.

L'appendicite demeure la pathologie digestive la plus fréquente des urgences chirurgicales abdominales. Le diagnostic de cette affection n'est pas toujours aisé. Autrefois, il reposait essentiellement sur les manifestations cliniques et les résultats biologiques, mais environ plus de la moitié des patients présentaient un syndrome appendiculaire atypique, ne permettant pas de le confirmer. Actuellement, les examens d'imagerie tels que l'échographie ou le scanner sont de plus en plus utilisés pour confirmer ou exclure rapidement le diagnostic et éviter les interventions chirurgicales abusives. Néanmoins, le traitement reste chirurgical et implique une intervention en urgence, associée à une antibiothérapie dont la durée dépend de la gravité de l'inflammation. L¿analyse anatomopathologique de l¿appendice est cruciale, afin de ne pas négliger un diagnostic associé ou sous-jacent, notamment les pathologies inflammatoires ou tumorales.

Enhanced rehabilitation after colorectal surgery is a veritable medical revolution. Clinical studies published to date clearly demonstrate its feasibility, safety and effectiveness. In addition to the obvious benefits for patients, such as reduced complications and improved postoperative comfort, this approach also has a positive impact on healthcare costs, by reducing expenditure on care and stays. However, for this approach to be widely adopted, significant changes in our perioperative practices are required. These changes are based on solid scientific evidence, but must take into account organizational aspects, where the commitment of all professionals involved in care, as well as the active participation of the patient himself, play an essential role in the success of the program. We hope that this book will contribute to a better understanding of enhanced rehabilitation among healthcare professionals, and encourage its widespread integration in all surgical specialties.