Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti
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Haemothorax is frequent consequence of blunt and penetrating thoracic trauma and is usually associated with pneumothorax. The occurence of haemothorax in blunt thoracic trauma patients is estimated between 25-75%. The reason of bleeding is impairment of intercostal arteries or lung parenchyma after trauma of the ribs. Uncontrolled bleeding is the main cause of the death. The article is focused on the treatment of this injury. ⋯ In diagnostics and in treatment of the bleeding in thoracic trauma patients the most important factor is clinical status of the patient. Indication for thoracotomy must be unambigous. Massive haemotorax leads to restrictive ventilation disorder with decreased preload and can be activator of the haemocolaguation disorders. This fact decreases chance for the survival of the patient.
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The aim of the study is to present results showing whether a pelvic injury in polytrauma patients means a high risk of mortality. The retrospective study (January 2001 - December 2006) included 453 polytrauma patients (130 women, 323 men) with ISS exceeding 16 points, hospitalized at the authors' department (Traumacentre Level I). ⋯ A significant difference was recorded between the numbers of deceased patients with and without abdominal trauma (p < 0.001), and between the numbers of patients with and without pelvic injury (p = 0.046). The results of the study have demonstrated a significantly higher rate of mortality in polytrauma patients with ISS > 16 points, with a simultaneous pelvic injury as compared to the patients without pelvic injury.
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Muscle building, gaining in popularity, and availability of anabolic steroids are connected with raised incidence of tendon injuries in uncommon locations. ⋯ The study assessed the role of steroids in development of tendon injuries, as well as their treatment methods. Based on his experience, the author, as well as other authors, favours indication for early surgical management to conservative treatment.
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Case Reports
[Re-expansion pulmonary edema as a complication of a spontaneous pneumothorax drainage--a case review].
Reexpansion pulmonary edema is an iatrogenic complication occurring after reinflation of the collapsed lung of a patient with pneumothorax or fluidothorax. The following risk factors have been associated with reexpansion pulmonary edema: younger age, longer duration of a lung collapse, its large extend and a quick lung reexpansion. We report a case of 26-years-old man. ⋯ Reexpansion pulmonary edema is a rare complication of the chest tube insertion and thoracocentesis because of pneumothorax and fluidothorax. The mortality of reexpansion pulmonary edema reaches up to 20%. Chest tube insertion and thoracocentesis are therapeutic procedures to be performed solely on medical department which can provide artificial lung ventilation.
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Aortocaval fistula is a rare complication of abdominal aortic aneurysms, resulting in the venous bloodstream overpressure and, in the final stage, inthe congestive heart failure. The authors present a case of an abdominal aortic aneurysm rupturing into the inferior vena cava in a 72-year-old male, which was successfully managed using surgical resection.