Regarding laparoscopy-associated mesenteric vascular events: descript of an evolving clinical syndrome.
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Biomedical subjects
Publications and source records attributed to R T Schorr.
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The retrograde radial fascial forearm flap may be used to provide appropriate tissue coverage for nerve, tendon, or soft tissue defects in the forearm and hand. The procedure is differentiated from the standard radial forearm flap in that the radial artery remains intact when the retrograde radial fascial flap is designed. The rationale, technique, and clinical application of the flap are presented in order to allow surgeons to maintain the radial arterial trunk in continuity while obtaining the advantage of appropriate soft tissue cover in this critical area.
Mesenteric visceral infarction occurring after laparoscopic procedures in the upper abdomen may be a direct result of physiologic changes induced by carbon dioxide pneumoperitoneum and other technical elements with these procedures. The reported case is characteristic of a seemingly successful operative result interrupted by this devastating complication.
The risk of operation during pregnancy is a concern to both patients and surgeons. Operative treatment for gallstone disease during pregnancy is therefore performed only when the severity of symptoms exceeds the tolerance of the patient. The insufflation of the abdomen during laparoscopy and the concerns regarding adequate exposure are significant in the performance of such operations. When the indications are appropriate, laparoscopic cholecystectomy can be conducted safely during the course of an intrauterine pregnancy.
Glucagon use as a muscle relaxant is common in radiologic and endoscopic examinations in which smooth-muscle spasm has interfered. Glucagon also provokes catecholamine release from an unsuspected pheochromocytoma, as occurred in a 60-year-old patient undergoing biliary tract surgery. To prevent hypertensive crisis and ventricular tachyarrhythmia after intraoperative glucagon administration, appropriate pharmacologic catecholamine antagonists must be immediately available.
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