Acta chirurgica Scandinavica
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In six patients in whom a femoro-popliteal vein bypass graft was performed for intermittent claudication, the relationship between the haemodynamic state of the leg and the femoral venous oxygen saturation before and after local vasodilatation was investigated. The study was undertaken with special reference to the known influence of hypovolaemia on the leg blood flow. It is concluded that a femoral venous oxygen saturation below 70%indicates that the leg blood flow is less than 200 ml/min and that the bypass flow is less than 100 ml/min and thus within a range in which the incidence of early thrombosis is high. Furthermore, an increase in femoral venous oxygen saturation of 10% or more on local vasodilatation indicates a state of hypovolaemia, necessitating further blood substitution.
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A case report of a 15-year-old boy hit by a single low-velocity gun shot is presented. He sustained injuries to the small bowel, colon, appendix, iliac vessels, femoral nerve and ureter. The injury mechanism and the treatment are discussed, and the importance of exploring a retroperitoneal hematoma is emphasized.
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We have presented a retrospective study of the surgical management of 299 patients bleeding from duodenal ulcer, gastric ulcer or gastritis. The overall mortality rate was 15%-5% for elective and 25% for emergency operations. The mortality increased with age and reached 50% for emergency operations in patients over the age of 70. ⋯ A Billroth I gastric resection proved to be the safest operative procedure. Based on our results, we are supporting a program calculated to reduce the mortality attending gastroduodenal bleeding, especially in those patients requiring an emergency operation. The basic principles of this program are constant observation, prompt diagnosis and early surgical intervention.
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The records of 57 patients with abdominal stab wounds, treated at the Surgical Departments of the Sahlgrenska Hospital, Göteborg, between 1969-1974, were revised. Fifty-five patients were males and 2 females. The wounds were situated in the upper abdomen in 72% of the patients. ⋯ Liver injuries were found in 45% of the operated patients. No complications occurred in the patients with negative laparotomy findings. One patient with multiple intra-abdominal lesions succumbed from an irreversible septic shock.