The consequences of high infrarenal thrombosis of the abdominal aorta, the possibilities of treatment, per- and post-operative complications.
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Biomedical subjects
Publications and source records attributed to Z Silhart.
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Meticulous examination of patient treated for infertility with clinical signs of coagulopathy reveals lienal artery aneurysm. Such presentation of mentioned pathology is very rare. Surgical resection of aneurysm enabled to cure coagulopathy and very probably infertility as well.
The bleeding from esophageal varices is at 85-90% cases stopped by conservative (i.e. non surgical) approach. The method of choice is endoscopic sclerotisation or ligation. Less often is necessary to perform TIPS. The rest of cases is necessary to resolve by one of surgical techniques of hemorrhage control--devascularisation operation or perform emmergently porto-systemic shunt. The authors stress the importance of devascularisation operations for theirs simplicity. On the case report they illustrate the advantage of combination of both surgical techniques.
Retroperitoneoscopy is a minimal invasive surgical technique enabling the diagnostics of the disease, as well as operative treatment of retroperitoneal organs. It is a very promising method especially for urologist, but of interest for general, vascular surgeon or gynecologist. The method is known since the end of sixties. Its routine introduction was enabled by technical advancement of laparoscopic surgery.
The development of revascularization techniques of the distal lower extremity dramatically diminished the need of lumbar sympathectomy. Which is indicated when patient with rest pain or with a profound gangrene of toes (which does not exceed the line of metatarsal articulation) could not be treated by vascular reconstruction. Lumbar sympathectomy could be done surgically or chemically, the efficiency of which is about 50%. The second to the fourth lumbar sympathetic ganglion could be resected with minimal invasivity, retroperitoneoscopically. This approach to lumbar sympathectomy opens further possibilities for operating in retroperitoneal space. Retroperitoneoscopy is well tolerated by patients.
The authors present five cases where a cell saver was used in rupture of an aneurysm of the abdominal aorta. During the peroperative collection they obtained 830 +/- 150 ml of autologous red cell concentrate. They assume that this blood is an invaluable source of volume replacement during urgent operations on the abdominal aorta.
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