Biomedical subjects
Publications and source records attributed to M Kazibudzki.
We described a case of abdominal aortic aneurysm ruptured into duodenum. It was diagnosed successfully before laparotomy using duodenoscopy. We think that gastrointestinal endoscopy allows to make a correct diagnosis.
The paper presents authors experience and indications for an elective relaparotomy performed as the second-look laparotomy after primary operation. 12 patients with vascular or surgical diseases were operated on for: abdominal neoplastic tumors (2 patients), elective abdominal aneurysm (2 patients), ruptured abdominal aneurysm (2), abdominal aneurysm ruptured into the inferior caval vein (1), ruptured aneurysm of the iliac artery (1), abdominal aortic coarctation with visceral arteries abnormality (1), thrombosis of the superior mesenteric artery (1) and peritonitis because of intestinal ischaemia and necrosis (2 patients). In all cases an elective relaparotomy was done on the 1st or 2nd postoperative day. 5 patients died, in 4 cases complications found during second look relaparotomy required surgical treatment (2 of this patients died, two other were successfully treated). The authors discuss indications and advantages of elective second-look laparotomy in abdominal surgery according to the anticipated risk factors and patients condition.
Pregnancy and puerperal period are favorable factors for appearance of or deterioration of peripheral vessels diseases and simultaneously limits ability of treatment. In the case of varicose veins the compressing therapy is the method of choice. The appearance of thromboemboli is the indication to the long time heparin treatment and according to other authors even to the surgery. In some cases implantation of the special filter to the inferior vena cava is necessary to prevent the pulmonary embolism. The worst form of thrombosis-phlegmasia cerulea dolens is the absolute indication to surgery. Pregnancy at patients with previous reconstructions in the aorto-iliac segment needs frequent examination of fetus and blood flow in the graft to avoid many dangerous complications. At pregnant women with peripheral vessels diseases examination using color ultrasonic doppler is method of choice. In some cases pregnancy should be treated as a high risk pregnancy and should remain under obstetrician and vascular surgeon care.