Chirurgia Bucharest
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Chirurgia Bucharest · Sep 2008
ReviewComplications of clavicle fracture and acromioclavicular joint rupture. What the general surgeon should know.
Fractures of the clavicle and acute dislocations of the acromioclavicular joint are common seen in the emergency room. Displaced or comminuted clavicle fractures and acromioclavicular joint ruptures (types III-VI) are associated with complications, such as subclavian vessels injury, hemopneumothorax, scapula-thoracic dissociation or brachial plexus paresis. Herein we discuss the usually complications seen after these injuries and underline whatever a trauma surgeon should know in order to avoid fatal situations.
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Chirurgia Bucharest · Sep 2008
Randomized Controlled Trial[Multimodal analgesia in elective laparoscopic cholecystectomy. A double-blind randomized controlled trial].
The aim of this study was to test the effects of preincisional parietal and intraperitoneal infiltration with ropivacaine (R) on postoperative pain after elective laparoscopic cholecystectomy. ⋯ Ropivacaine shows significant favorable effects on postoperative pain after laparoscopic cholecystectomy when using both parietal and intraperitoneal instillation in combination with perioperative i.v. paracetamol.
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Acute mesenteric ischemia is not an isolated clinical entity, but a complex of diseases, including acute mesenteric arterial embolus and thrombus, mesenteric venous thrombus, and nonocclusive mesenteric ischemia. These diseases have common clinical features caused by impaired blood perfusion to the intestine, bacterial translocation, and systemic inflammatory response syndrome. There is substantial evidence that the mortality associated with acute mesenteric ischemia varies according to its trigger cause. ⋯ Mesenteric venous thrombosis is much less lethal than acute thromboembolism of the superior mesenteric artery and nonocclusive mesenteric ischemia. In this articles we presents an overview of acute mesenteric ischemia, based on the research. Although the mortality rates, in acute mesenteric ischemia, have remained high over the last few decades, accumulated knowledge on this condition is expected to improve its prognosis.
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Chirurgia Bucharest · May 2008
Case ReportsIntraperitoneal cerebrospinal fluid pseudocyst. A rare complication of ventriculoperitoneal shunt.
The abdominal intraperitoneal cerebrospinal fluid pseudocyst is a rare but important complication in patients with ventriculoperitoneal shunts. We report a case of a 31-year-old female, in which a large abdominal pseudocyst was developed 1 year after insertion of a ventriculoperitoneal shunt for hydrocephalus. The abdominal CT scan and the ultrasonographical evaluation of the abdomen showed a well defined, cystic mass lesion with a volume of 50 cm3, in the recessus hepato-renal. ⋯ The previous symptoms improved 4 weeks later and a new catheter was placed intraperitoneally in a different quadrant. The postoperative course was uneventful. We suggest that chronic inflammation or subclinical peritonitis is a predisposing factor for this complication.
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The authors present one case of acute mesenteric ischemia appeared to the patient 70 years old, with HTA and coronary heart disease with heart arrhythmia treated with angiotensin-converting-enzyme inhibitor, anti arrhythmia agents and antithrombin therapy (trombostop). Acute mesenteric ischemia is not an isolated clinical entity, but a complex of diseases, including acute mesenteric arterial embolus and thrombus, mesenteric venous thrombus and nonocclusive mesenteric ischemia. ⋯ We discuss about the nonocclusive mesenteric ischemia is the most lethal form of acute mesenteric ischemia because of the poor understanding of its pathophysiology and its nonspecific symptoms, which often delay its diagnosis. Although acute mesenteric ischemia is still lethal and in-hospital mortality rates have remained high over the last few decades, accumulated knowledge on this condition is expected to improve its prognosis.