1/232. Iliac to popliteal artery bypass through the iliac wing: An alternative extracavitary route for management of complex groin injuries.Extracavitary bypass through the iliac wing allows placement of the grafts into the posterior thigh and is another alternative route when an obturator bypass is not possible, or an axillary-popliteal bypass is to be avoided. The transiliac wing bypass is relatively simple and easy to perform. The bypass route is short and direct, has excellent inflow, and is accompanied by minimal neurological or bleeding risks. An illustrative case is presented with a complete description of the operative technique. review of the literature is also included.- - - - - - - - - - ranking = 1keywords = artery (Clic here for more details about this article) |
2/232. pulmonary artery bullet injury following thoracic gunshot wound.Thoracic trauma occurs frequently but seldom requires surgery (10-20%, [1]). The mortality rate for gunshot wound of the chest varies from 14.3 to 36.8% [2]. We report, herein an example of bullet injury to the pulmonary artery (PA) following a thoracic gunshot wound. This patient had previous history of coronary surgery. Absolute and relative indications for exploratory thoracotomy in emergency will be reviewed.- - - - - - - - - - ranking = 1.25keywords = artery (Clic here for more details about this article) |
3/232. Entrance, exit, and reentrance of one shot with a shotgun.The case being reported is one of a homicidal shotgun fatality with an unusual wound pattern. A 34-year-old man was shot at close range with a 12-gauge shotgun armed with No. 5 birdshot ammunition. The shot entered the left axillary region, exited through the left infraclavicular region, and thereafter penetrated the left side of the neck, causing tearing of the left common carotid artery and the right internal carotid artery. The entrance wound in the axilla was larger than the other wounds, and before autopsy it was believed that the shotgun had been fired twice, causing one wound in the neck and one wound perforating the infraclavicular region and exiting through the left axillary region. Thus, this case shows that unusual wound patterns in shotgun fatalities can easily lead to incorrect assumptions with regard to number and direction of shots fired unless thorough investigation is carried out postmortem.- - - - - - - - - - ranking = 6.3841153778306keywords = carotid artery, carotid, artery (Clic here for more details about this article) |
4/232. Double layered autogenous vein graft patch reconstruction of the common carotid-internal jugular fistula caused by gunshot wound.Hereby we present a case with a common carotid-internal jugular fistula caused by gunshot wound. The patient was a 32-year old male who had an entrance hole of a bullet on his right anterior cervical area, at the C4 level with a hematoma surrounding it. The exit hole could be detected at the sublingual area. By palpation a thrill and on auscultation a souffle was noted. Neither crepitation, nor any neurologic deficit or any symptom of Horner's syndrome was present. The emergency digital subtraction angiography (DSA) showed a fistulisation to internal jugular vein (IJV) approximately 0.5 cm below the common carotid artery (CCA) bifurcation level. During the operation a hematoma and a false aneurysm was observed on the CCA. Also, proximally to the bifurcation, a communication of CCA with IJV was noted. The wall of the JJV was rather thinned and the size of the vessel had considerably enlarged. Following the evacuation of the hematoma and debridement, the integration of the artery was achieved by placing a double layered autogenous vein graft patch over the 0.5 x 1.5 cm defect. The 0.3 x 1.5 cm defect laterally over the IJV was primarily sutured. The patient was discharged on the fifth day. The control DSA taken on the twelfth day showed a perfect integration of the vessels. We considered the case noticeable due to its rather rare incidence and the double layered autogen vein patch graft reconstruction.- - - - - - - - - - ranking = 10.02742687875keywords = carotid artery, carotid, artery (Clic here for more details about this article) |
5/232. Five-year study on the injury of the great thoracic vessels after penetrating chest injury.In the cases of penetrating injury of the heart and the great thoracic vessels, 80% of the patients die before reaching the hospital care, nevertheless patients with sufficient vital functions can be rescued. Between 01. 01. 1994 and 31. 12. 1998 four patients were operated for penetrating injuries of the great vessels in the 2nd Department of Surgery, University Medical School of Debrecen. The left subclavian vein, arcus aortae and the pulmonary artery (2 cases) were injured. In this study authors report a detailed case operated for gunshot injury of the pulmonary artery. On the base of the situation of the projectile on X-ray picture and on the base of the entrance wound of the projectile on the skin we supposed the injury of the great thoracic vessels and we performed an urgent operation. After thoracotomy we found haemopericardium, bleeding wounds on the anterior and posterior haemorrhagic wall of the left pulmonary artery. We found the projectile inside the wall of the bronchus impacted. The bleeding wounds were finger-tamponaded and sutured. On the tenth postoperative day the patient was discharged from our clinic without complaint. The surgical approach to specific thoracic great vessels is also described.- - - - - - - - - - ranking = 0.75keywords = artery (Clic here for more details about this article) |
6/232. Pseudoaneurysm of the internal carotid artery after shrapnel injury in World war II: demonstration by CT angiography with 3D MIP reconstruction.A case of pseudoaneurysm of the left internal carotid artery (ICA) after shrapnel injury is demonstrated by intra-arterial digital subtraction angiography (DSA) and computed tomography angiography (CTA) with subtraction technique. Although the pseudoaneurysm was well demonstrated by intra-arterial DSA, CTA was the only modality to demonstrate the three-dimensional shape of the perfused part of pseudoaneurysm and the aneurysmal neck, which affected the therapeutic strategy. The CTA technique is useful in the assessment of large pseudoaneurysms and for therapeutic planning.- - - - - - - - - - ranking = 15.960288444576keywords = carotid artery, carotid, artery (Clic here for more details about this article) |
7/232. Carotid artery-sygmoid sinus fistula: a rare complication of gunshot wound on the base of the cranium.Vascular lesions without clinical manifestation may occur in cranial-facial wounds produced by bullets that course the base of the cranium. This work describes a rare kind of vascular complication in cranial-facial gunshot wound. The authors present the case of a patient, the victim of a cranium-maxillary gunshot wound. Carotid angiography revealed a carotid-sygmoid sinus fistula that filled the sygmoid and transverse sinuses, concomitant to the arterial angiographic phase. A direct communication between the external carotid artery and the sygmoid sinus was disclosed. We are not aware of any other description of this vascular complication in cranial gunshot wound. It is important to recognize this kind of complication in cases of cranial-facial gunshot wound, because new factors harmful to the brain perfusion systems are introduced, in addition to the alterations to venous return and intracranial pressure, caused by the primary trauma. The new non-invasive vascular diagnostic methods are proving useful in filling the gap left by arteriography, which is no longer used in these cases.- - - - - - - - - - ranking = 5.5091315268822keywords = carotid artery, carotid, artery (Clic here for more details about this article) |
8/232. Surgical management of a pulmonary artery missile embolism after an air rifle wound to the liver.Missile embolism to the pulmonary artery is rare, and controversy persists about whether to remove the missile. We describe a case of a pellet embolism from the liver (via hepatic vein) to the left pulmonary artery. In this case, the pellet was removed surgically.- - - - - - - - - - ranking = 1.5keywords = artery (Clic here for more details about this article) |
9/232. war injury to the liver. A case report.We report a case of a war thoracoabdominal gunshot wound associated with severe injury to the liver and hemorrhagic shock. Immediately upon admission to the second Echelon Surgical Unit, the patient was operated on with two separate surgical approaches: right thoracotomy and subcostal laparotomy. The patient was transferred to rear hospital for recurrent postoperative hemorrhages. He was eventually transferred to our Department, where he underwent reoperation by the surgical approach through right thoracophrenolaparotomy. liver lesion debridement and hepatic artery ligation were performed. The early and late postoperative course was normal, and the patient achieved satisfactory recovery on discharge. The case shows that the management of severe liver injuries requires special knowledge and experience from the surgeon.- - - - - - - - - - ranking = 0.25keywords = artery (Clic here for more details about this article) |
10/232. superior mesenteric artery syndrome in traumatic paraplegia: a case report and literature review.superior mesenteric artery syndrome (SMAS) is a relatively rare condition thought to be caused by the functional obstruction of the third part of the duodenum as it passes between the superior mesenteric artery and the aorta. The following case report describes a patient who developed SMAS in the setting of traumatic paraplegia. The patient began to exhibit symptoms consistent with SMAS (epigastric pain, postprandial epigastric fullness, nausea, emesis) shortly after his injury and during home therapies. On admission to an inpatient rehabilitation hospital, the patient's symptoms persisted and prevented participation in any therapies. When radiographic studies demonstrated the existence of SMAS, conservative and surgical management were discussed with the patient and the family. The patient was managed conservatively with positional changes during feeding and the administration of metoclopramide (10mg orally, three times a day) before meals and before sleep. The patient was able to meet or exceed all short-term physical and occupational therapy goals with one episode of postprandial nausea noted. The patient returned home 21 days after admission to the rehabilitation hospital with home therapies. The patient was able to perform transfer skills and most self-care tasks.- - - - - - - - - - ranking = 1.5keywords = artery (Clic here for more details about this article) |
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