Phlebologie
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A limited number of tomodensimetrical sections, MRI or echographical according to the fundamental, frontal, sagittal or horizontal plans makes possible the exploration of the sub-renal part of the lower vena cava. The comparison of pictures with the corresponding anatomical sections makes possible a detailed analysis of all the visualized structures, around the lower vena cava.
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Anaesthesia exposes the practitioner to the obligation of being answerable for his responsibility if he commits an error which leads directly to damage to the patient. He can be forced to pay compensation for the damage. Quite apart from this, there is also the unpleasant process of being called before a disciplinary hearing for "involuntary injury". ⋯ In every case, the patient ought to be informed of all risks and benefits. The anaesthetic cannot be performed by any person other than the practitioner or an anaesthetist nurse, in the presence of the practitioner. The surgery where this is performed must be equipped with all the apparatus necessary for good anaesthetic procedure, monitoring, and recuperation in case of patient distress.
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Regional anesthesia represents a selective method for surgery of the lower limbs because of its simplicity and its handiness. The various techniques of regional anesthesia are analysed with their risks and benefits. ⋯ Nervous blocks of the lower limbs represents also safe techniques especially for elderly patients and for day-case surgery. Intravenous regional anesthesia does not represent an usefull technique because of the possible toxicity due to a great volume of local anesthetic drugs.
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There are, as well as the more common coagulopathies such as deficiency in antithrombin III or Protein C, certain rare disorders complicated simultaneously by haemorrhage and thrombosis--such as dysfibrinogenemia--which can present very special therapeutic problems.