Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti
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Therapeutic endoscopy is mostly primary method in treatment of biliary tree obstruction with its various complications. A case review describing an oncological pacient examined for obstructive icterus, with recognised pneumoscrotum after endoscopic examination (ERCP). In discussion we try to point out the need of knowledge of clinical examination, clinical signs of duodenal lesions and optimal treatment measures.
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Case Reports
[Surgical repair of bladder rupture associated with the pelvic fracture without suprapubic tube--a case report].
The authors are presenting a case of 42-year-old polytraumatized man with pelvic fracture associated with extraperitoneal urinary bladder rupture. This was verified by intraoperative retrograde cystography and treated with suture without making suprapubic tube drainage. Urinary draining was assured with a transurethral permanent urinary catheter. ⋯ Suprapubic tube is not beneficial in surgical repair of urinary bladder rupture. However, it is normal practice that the suprapubic tube associated with bladder suture is indicated according to urology department tradition or by an individual physician - urologist himself. In the choice of surgical treatment tactics in these types of injuries proper communication between the urologist and the surgeon dealing with complex pelvic trauma is important.
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Vertebral hemangiomas (VH) are usually asymptomatic and, therefore, are commonly detected as accidental findings on spinal imaging. No treatment is indicated in these cases. Nevertheless, some hemangiomas may clinically manifest as axial pain and neurological deficit and may require surgery or other treatment. The aim of this study was to assess outcomes of surgical management of symptomatic vertebral hemangiomas at two neurosurgical clinics. ⋯ Vertebroplasty resulted in pain score improvement in all patients with symptomatic vertebral hemangiomas. Combinations of vertebroplasty and decompression had positive impact on myelopathic symptoms in all the patients concerned.