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Biomedical subjects

V Radonić

Publications and source records attributed to V Radonić.

At least 19 recordsLinked to original sources
PubMed2001

Traumatic false aneurysm of the subclavian artery treated by insertion of Memotherm stent.

Traumatic aneurysms of the left subclavian artery and transverse cervical artery, subsequent to penetrating gunshot wound were diagnosed by angiography in 35-year-old patient. Subclavian artery aneurysm was treated by insertion of the Memotherm bare stent, whereas the false aneurysm of the transverse cervical artery was embolized with Gianturco's coils. The follow up examinations at 6 and 12 months showed good patency of subclavian artery.

Adult↗
PubMed2000

Laparoscopic and laparotomic cholecystectomy: a randomized trial comparing postoperative respiratory function.

BACKGROUND: The fact that pulmonary complications occur in 20-60% of the patients subjected to abdominal operations clearly indicates that the lungs are the most endangered organ during the postoperative period. OBJECTIVE: The aim of this study was to demonstrate the impact of cholecystectomy on postoperative respiratory disturbances by comparing the laparotomic cholecystectomy with laparoscopic gallbladder removal. PATIENTS AND METHODS: A hundred cholecystectomized patients were included in the prospective randomized clinical trial. Half of the patients were operated on by the laparotomic procedure, whereas the other half underwent laparoscopic cholecystectomy. Spirometric parameters, arterial blood gases, and acid-base balance were determined before the operation, and at 6, 24, 72 and 144 h postoperatively. Abdominal distension was assessed by auscultating intestinal peristaltics, abdominal circumference measurement, and time interval to restitution of defecation. RESULTS: Six hours postoperatively, the values of ventilation parameters decreased on average by 40-50% from the baseline preoperative values in both groups of patients. The group of patients submitted to laparotomic cholecystectomy had significantly lower spirometric values and slower recovery of the ventilation parameters than the laparoscopic cholecystectomy group. Abdominal circumference was significantly greater and the time needed for restitution of peristaltics and defecation was significantly longer in the laparotomic cholecystectomy group compared to the group of laparoscopic cholecystectomy. CONCLUSIONS: Statistically significant impairments including hypoxia, hypocapnia and hyperventilation were observed in the patients submitted to laparotomic cholecystectomy, indicating the presence of objective respiratory risk, especially in elderly patients and patients with obstructive pulmonary diseases or cardiac insufficiency.

Abdomen↗
PubMed2000

Popliteal artery entrapment syndrome: diagnosis and management, with report of three cases.

Popliteal artery entrapment syndrome is an important albeit infrequent cause of serious disability among young adults and athletes with anomalous anatomic relationships between the popliteal artery and surrounding musculotendinous structures. We report our experience with 3 patients, in whom we used duplex ultrasonography, computed tomography, digital subtraction angiography, and conventional arteriography to diagnose popliteal artery entrapment and to grade the severity of dynamic circulatory insufficiency and arterial damage. We used a posterior surgical approach to give the best view of the anatomic structures compressing the popliteal artery. In 2 patients, in whom compression had not yet damaged the arterial wall, operative decompression of the artery by resection of the aberrant muscle was sufficient. In the 3rd patient, operative reconstruction of an occluded segment with autologous vein graft was necessary, in addition to decompression of the vessel and resection of aberrant muscle. The result in each case was complete recovery, with absence of symptoms and with patency verified by Doppler examination. We conclude that clinicians who encounter young patients with progressive lowerlimb arterial insufficiency should be aware of the possibility of popliteal artery entrapment. Early diagnosis through a combined approach (careful physical examination and history-taking, duplex ultrasonography, computerized tomography, and angiography) is necessary for exact diagnosis. The treatment of choice is the surgical creation of normal anatomy within the popliteal fossa.

Adult↗
PubMed1999

War injuries to the chest.

AIM: Presentation of our experiences in the treatment of war injuries to the chest at the Split University Hospital, Croatia, during the 1991-1995 war in Croatia and Bosnia-Hercegovina. METHODS: Retrospective analysis of clinical and surgical data on 439 (16.3%) patients with war injuries to the chest among 2693 treated battle casualties in general. The medical data from evacuation unit, transportation, emergency department and follow-up were observed and processed by basic statistical analysis. RESULTS: There were more explosive wounds than gunshot and puncture wounds (ratio 251/158/30). Penetrating injuries were found in 348 (79%) patients and nonpenetrating in 91 (21%) patients. There were 401 (91%) men and 38 (9%) women. Thoracotomy was performed in 98 (22.3%) patients, whereas conservative surgical methods (wound treatment, chest-tube drainage, appropriate fluid therapy, antimicrobial and atelectasis prophylaxis) were used in 341 (77.7%) patients. Mean time elapsed between injury and definitive surgical repair was seven hours (range, 1 to 48 hours). Recovery on discharge was recorded in 411 (93.6%) patients, 19 (4.3%) patients were referred to other institution for further treatment, and 9 (2%) severely wounded persons died. CONCLUSIONS: The treatment of respiratory insufficiency and haemorrhage shock, and prevention of infection are the basis of management of these injuries. Prompt transportation, appropriate diagnostic methods and an adequate surgical treatment can markedly reduce mortality and complications rate in war injuries to the chest. Most war wound of the lung can be successfully managed by "conservative" surgical treatment. The recovery of lung function was similar in conservatively and operatively treated patients.

Bosnia and Herzegovina↗
PubMed1997

War injuries of the femoral artery and vein: a report on 67 cases.

During the war in Croatia (from May 1991 to December 1995), 67 patients with war injuries of the femoral vein and/or artery were treated at the Surgical Clinic of Split Clinical Hospital. All the wounded were admitted directly from the battlefield or from front-line hospitals. There were five women and 62 men with a median age of 29 (range 15-54) years. There were 70 arterial (28 isolated) and 49 venous injuries (six isolated). Forty-six arterial injuries were repaired by reverse vein graft. Four proximal profound femoral arteries were reconstructed. Major venous injuries were repaired, 11 by compilation autogenous vein graft. No synthetic grafts were used. Repair of veins with large defects using compilation saphenous vein grafts gave good results. Six profound femoral veins and two superficial femoral veins were ligated. Vein ligation should be avoided unless another life-threatening injury demands priority. Twenty-one patients required open prophylactic fasciotomy. Two patients died (3%) and three ultimately underwent amputation (5%). Intermittent hyperbaric oxygen therapy was given to 18 heavily wounded patients with beneficial effect. The results support an immediate and coordinated approach to femoral vascular trauma with repair of arterial and venous injuries.

Adolescent↗
PubMed1997

Envenomation by the horned viper (Vipera ammodytes L.).

Snake venom poisoning is a medical emergency that requires urgent therapeutic procedures. The treatment of venomous snakebites is still controversial because of unclear therapeutic modalities. Choice of treatment is dictated in part by regional characteristics with regard to patient population and types of venomous snakes. The purpose of the study presented here was to report regional experience with venomous snakebites and to describe first-aid, pre-hospital, and hospital therapeutic procedures for horned viper bite. During a 16-year period, from 1980 to 1996, at the Clinical Hospital Split (Croatia) we collected data on 389 victims of horned viper bite. Incidence of the local and general complications is presented. We also reviewed therapeutic modalities and outcome with special attention to compartment syndromes and the indications for fasciotomy.

Adult↗
PubMed1995

Advances in diagnostics and successful repair of proximal posttraumatic superior mesenteric arteriovenous fistula.

Posttraumatic arteriovenous fistulas affecting the superior mesenteric artery and vein are extremely rare. Twenty-four cases of posttraumatic superior mesenteric arteriovenous fistulas (SMAVFs) have been reported. We presented two cases of SMAVFs occurring in a young woman and man secondary to a gunshot and a grenade shrapnel wound in the epigastrium, respectively. Nausea, heartburn, emesis, and cramping abdominal pain were the clinical signs of SMAVF. Abdominal pains, particularly after meals, tense and meteoristic abdomen, frequent liquid bowel movements, oliguria, subfebrility, abdominal thrill, and bruit were also present. Abdominal duplex ultrasonic scanning and computed tomograms with a contrast agent were especially useful screening tools. As our results demonstrated, those methods were not only suitable for clinical use, but were also as good as arteriography in defining both the exact location and the extent of the mesenteric vessel involvement. However, the superior mesenteric arteriogram remains mandatory for complete preoperative evaluation. Arteriovenous fistulas were successfully treated by suturing the arterial and venous sides of the fistula in one case, and resectioning the fistula and end-to-end anastomosis in the other case.

Adult↗
PubMed1994

A war injury to the thoracic trachea.

The authors present a case of war injury to the thoracic trachea with the defect involving more than half of its circumference. After minor difficulties in establishing the right diagnosis, we passed to the surgical procedure and managed the lesion by simple suture. The patient's postoperative course at the Intensive Care Unit was uneventful. Both early and late follow-up roentgenograms, computerized tomography of the trachea and bronchoscopy showed normal findings.

Adult↗
PubMed1994

Military injuries to the popliteal vessels in Croatia.

OBJECTIVE: The paper reviews military popliteal vascular injuries in Croatia. SUMMARY BACKGROUND DATA: Popliteal vascular injuries still pose difficult problems for vascular surgeons despite improvements in resuscitation, surgical techniques and wound coverage. Popliteal vascular injuries, both arterial and venous, with a high incidence of associated musculoskeletal injuries are presented in patients with military injuries in South Croatia. METHODS: 26 wounded with popliteal vascular injuries are presented. Explosive injuries are found in 21 and associated fractures in 9 cases. In immediate repair group the time interval between trauma and surgery was 2 to 30 hours (average 9.8 hours). In the delayed repair group the interval between trauma and surgery was 11 days to 24 days. RESULTS: 21 out of 26 patients with popliteal vascular injuries had combined arterial and venous injuries; 4 patients had isolated popliteal arterial injuries, while 8 patients had other vascular injuries along with the popliteal ones; 8 amputations resulted (30.8%). CONCLUSION: Popliteal vascular injuries caused by typical military mechanism during the war in Croatia present large and extensive defects of tissues and bones, are often associated with other injuries and require more extensive surgical therapy. Evacuation of the wounded under very difficult conditions as well as considerable organization and transportation problems are characteristic for this war and greatly affect the success of vascular reconstruction. Hyperbaric oxygen therapy offers a safe noninvasive method of improving wound healing and decreasing edema formation in popliteal vascular injuries.

Adult↗
PubMed1993

Organization and functioning of the front-line surgical station at Rama in Bosnia and Herzegovina.

The war in the Republic of Bosnia and Herzegovina has imposed specific tasks upon civil surgical work and forced it to adapt to war conditions. To this end, mobile surgical teams were formed, functioning within the front-line surgical stations. The organization and the results of work of such a front-line surgical station at Rama in the Republic of Bosnia and Herzegovina are described. In the course of more than 5 months (April 9-September 23, 1992), 179 wounded persons were retained for further treatment in the stationary unit of the station, while 10.6% were transported to the nearest hospital. The mortality of the wounded was 1.7%; it would have been significantly lower had there been the possibility of air transport for the wounded.

Bosnia and Herzegovina↗
PubMed1990

[Splenorrhaphy and partial splenectomy as an alternative to splenectomy in trauma--overview].

For many year splenectomy was considered to be the only possible surgical treatment for all laceration of the spleen, whether resulting from abdominal contusion or not. Such factors have led to changes in practical attitudes to splenic lacerations but it would seem that indications for a conservative approach must be based upon the underlaying condition and the precise nature of the lesions. Splenectomy should be done promptly in cases of concomitant splenic and cerebral injury and in patients with injury of multiple organ systems. Present knowledge of the complications of anesplenia has led to new surgical techniques for conservation of splenic tissue. Splenorrhaphy was a frequently used treatment in the non-complicated traumatic lesions. The decision of whether or not to remove an injured spleen is one which must be made intraoperatively by the surgeon. Operative splenic repair and preservation of the spleen often requires considerable experience. We conclude that surgical splenic preservation is a viable and safe procedure, especially in infants and young children.

Humans↗
PubMed1989

[Injuries of the urinary bladder].

The authors analyse 32 patients with injuries of the urinary bladder treated in Clinical Hospital Centre "Firule" in the period from 1976 to 1988 (Figure No 1). There were: 10 contusions of the bladder (31%), 5 extraperitoneal ruptures (16%), 16 intraperitoneal ruptures (50%), and 1 combined extra and intraperitoneal rupture (3%). The isolated injuries of the bladder are rare. Extraperitoneal ruptures most of them are connected with the pelvic fractures. The intraperitoneal ruptures of the bladder were connected with splenic rupture in 7 cases, with the rupture of the rectum in 1 case, with the vaginal rupture in 1 case, with the rupture of the aorta in 1 case, with the rupture of the ovarian cyst in 1 case and with the rupture of the ileum in 1 case. All the patients with the urinary bladder rupture were operated, what got sufficient drainage of the urine, and drainage of the perivesical space and closure of the defect of the bladder.

Adolescent↗
PubMed1989

[Retroperitoneal hematoma as a consequence of blunt abdominal injury].

In our examination we have used clinical material of 448 cases treated in our clinics for blunt abdominal trauma in period from 1976. to 1988. with special care on the group of 172 patients in who the retroperitoneal haematoma was founded. In the group of 172 patients we have examined the frequency on way to age, sex, and presence of the retroperitoneal haematoma in clinical picture of the blunt abdominal injury, and frequency of the retroperitoneal haematoma in abdominal injury connected with the injuries of the other organs.

Abdominal Injuries↗
PubMed1989

[Traumatic arteriovenous fistula].

Three cases of arteriovenous fistulae and one iatrogenic observed in recent years at the University of Split's Surgical Clinic, and of different site and aetiology, are presented. Their clinical signs, diagnosis and vascular surgical access are discussed.

Adult↗
PubMed1989

[Bilateral malignancy of the breast].

The breast cancer is the most common malignant disease in women, and makes 26 percent of all malignant diseases in women. Bilateral breast cancer is very rare, especially simultaneous one. We analyzed 420 operated breast cancers in Surgical Clinic in Split within five years period. There were 8 patients with simultaneous or metachronous bilateral breast cancer. Their incidence, difficulties in diagnostics and treatment, pathologic findings and prognosis are discussed. It is justifiable to follow the contralateral breast of patients with the breast cancer.

Adult↗
PubMed1989

[Fatal postsplenectomy sepsis (OPSI syndrome)].

The cases of postsplenectomy sepsis are described at the Clinical Hospital Centre Split. Overwhelming postsplenectomy infection is a unique clinical entity distinguishable from other infections. It may occur during the lifetime of any asplenic patient. The aggressive approach to splenic preservation is a way by reducing the risk of subsequent overwhelming postsplenectomy sepsis. In the case of necessary splenectomy, should be given long-term prophylactic antibiotics preoperative and polyvalent pneumococcal vaccine to it would be given shortly after operation. Autologous splenic implantation is generally recommended when total splenectomy is necessary.

Adolescent↗
PubMed1989

[Permanent decrease in immune function in patients with splenectomy for trauma].

The authors describe the peripheral blood analyses in patients splenectomized for trauma in consideration on the concentration of the immunoglobulins total complement CH50 levels, T and B lymphocyte populations and compare this with the control group. The levels of the IgM were significantly decreased (p0.001) in splenectomised while the levels of the IgA and IgG were significantly increased (for IgA - p0.001, for IgG p0.01). Total lymphocyte count averaged 54501999 in splenectomized, with number of T cells 2463930 and B lymphocyte 460236. The control group showed total lymphocyte count 460236. The control group showed total lymphocyte count 520235 (p0.001) with number of T cells 314147 (p0.001) and number of B cells 7434 (p0.001), what is significantly less than in splenectomized population. The level of total complement CH50 in splenectomized population was 11216 (p0.01), what is significantly less than in the control group 12515. These data demonstrate persistent abnormalities in immune function and suggest a possible explantation for the increased rizu of sepsis in this group of patients.

Adolescent↗