[Care of thoracic injuries in cases of massive trauma and war].
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Biomedical subjects
Publications and source records attributed to D Dimković.
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The authors analysed 516 injuries of the thorax. treated in a ten year period (1968-1977). These injuries were 2,2% of 23.300 injuries treated by this Clinic during this time period. The etiology shows that 63,9% of these cases were caused through traffic accidents. In 516 of this cases, there were 5% penetrating injuries. A big percent of polytrauma (42,6%), traumatic, haemorrhagic shock (21,5%) and the difficultes in mechanics of breathing or respiration function (61,2%), shows the difficulties and importance of the medical attitude in curing these injuries in peace time, and in war, or during massive injury. The authors have also stressed the necessity of education for professional medical staff, equipment for the staff and its organization during peace time. This also serves the goals for national defence.
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Liver abscesses represent a rare complication of inflammatory and calculous disease of the biliary system and are enhanced by tardy or delayed removal of the primary cause. Being the result of liver necrosis and depending on its extension they appear in polymorphous pattern and have the tendency to spread through the diaphragm into the chest. The differential diagnosis is not easy: from common cholangitis to sporadic necrosis of liver malignancy, suppurated hydatid cyst and other diseases. The best prophylaxis and the highest recovery rate is achieved by taking up an active surgical approach at the first signs of severe infection, especially in cases of relapse and of prolonged septic evolution in spite of the use of antibiotics and/or the (first) operative procedure. The choice of surgical procedure depends on local findings. An exceptional diagnostic difficulty represent the cases of suppurated intraheptic lithiasis.
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