Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti
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Case Reports
[Obturator bypass--a method of extra-anatomic reconstruction in the region of the femoral trigone].
The authors present the case-history of a patient admitted on account of haemorrhage in the right groin during an infectious complication after an aortobifemoral bypass. The authors selected an obturator bypass as the method of choice for extraanatomical reconstruction and as an example how to resolve this serious complication in vascular surgery.
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The difficulties in detecting vascular injuries associated with penetrating limb trauma are greater than generally appreciated. Any delay in diagnosis will compromise management and potentially may lead amputation. Traumatic arteriovenous fistulas (AV fistula) produce several profound pathophysiological and structural changes in the circulatory dynamic of the vessel associated with fistula. ⋯ However, in longstanding AV fistulas, irreversible degenerative changes occur in the arterial wall and result in dilation and thrombosis. This can make late closure technically difficult. This report presents a case of a femoral AV fistula persisting for three years durations.
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The authors discuss different forms of acute scrotal syndrome in child age, its symptomatology, differential diagnosis and treatment. They emphasize in particular the importance of the time factor in torsion of the testis and the necessity of urgent surgery and the difficulty of differential diagnosis. ⋯ Inflammatory diseases predominated (39%), torsion of the testicular and epididymal appendages was recorded in 28%, and torsion of the testis in 14%. Children with testicular torsion came to the hospital on average 20 hours after the onset of symptoms, all were operated but only 58% of the testes were saved.
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Derived from Ender's elastic nail and from other fixation techniques, elastic stable intramedullary nailing (ESIN) provides a combination of elastic mobility and stability. The operation uses only small incisions, is rapid, blood loos is minimal and physeal area stands intact. ⋯ The guider and the nails from finest quality steel were made for us by the czech firm Medin, a. s. to order. We report about our good experiences with the ESIN-method.
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In last three years 27 injured patients were operated in Traumatological hospital Brno for associated pelvic trauma. This trauma was associated with injury of urinary tract in 8 patients, with traumatic lesion in area of the colon in 6 cases and with injured big vessels of the retroperitoneum in 8 patients. ⋯ Authors put stress in diagnostic analysis and early indication of surgical operation on careful anamnestic clinical examination, they utilize the contribution of the sonographic and CT examination with contrast, in indicated cases the selective angiography and retrograde urethrocystography, too. Authors prefer early reconstructional operations.