[Ischemic left colitis. Late complications of aortoiliac or iliac surgery].
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to J Dermer.
Explore the source record for details and available documents.
Radiation therapy seldom induces large arteries injuries. When it occurs, their consequences are serious and their treatment is difficult. In six patients, arterial disease followed radiotherapy with cutaneous and subcutaneous fibrosis. Three were located on the carotid arteries and three in the aorto-iliac vessels. In four cases, radiation was the main causal factor; in one case it was one of the contributive factors; in the last case it was nothing else than an association. In all cases, surgical treatment was difficult because the cutaneous, subcutaneous and periarterial fibrosis. Radiation effects induced risks of cutaneous unhealing, anastomotic rupture and arterial infection. The carotid arterial stenosis were cured in one patient by two gore-tex bypass from the aorta to the carotid arteries and in the two others by three venous bypass from the common carotid arteries to the internal carotid arteries. The aorto-iliac obliterations were treated by different methods: one by-pass from the thoracic aorta to the deep femoral arteries, one aorto-bifemoral bifurcation and one medical treatment in a patient with poor condition. All patients have good results several years after treatment.
Two cases of arterial complications after inguinal hernia repair were revealed by a post-operative septic hemorragia and in the other case by a late intermittent claudication complicated by a distal emboly. Both were cured by replacement of the damaged artery with an autologous saphena. Twenty-three similar cases were found in literature. They were discovered either during operation, or post-operatively, or after recovery. In post-operative course, a late diagnosis in some cases lead to amputations or death. Actual treatment is arterial replacement by autologous vena because the length of arterial damagement and good resistance of vena in septic area. Prevention during inguinal hernia repair needs a correct exposure, the use of small needles and widening of the exposure in case of hemorragia.
Positioning of the intra-esophageal prothesis under fibre-endoscopic control sets up a simple and effective method as a palliative treatment of dysphagia in patients with esophageal cancers unable to take advantage of curative treatment. It makes the short survival of those patients more comfortable with a low mortality rate. An X-Ray-therapy may be associated.
Explore the source record for details and available documents.