Annales de chirurgie
-
Annales de chirurgie · Jan 1993
Case Reports[Traumatic rupture of the pericardium with left intrapleural luxation of the heart in a patient with multiple trauma].
Traumatic rupture of the pericardium is a rare lesion usually associated with violent thoracic trauma and sudden deceleration. The case described herein is one of left intra-pleural luxation of the heart secondary to trauma which was asymptomatic for nine hours and was revealed by acute symptoms due to mobilisation of the patient. ⋯ The most severe complication is extra-pericardic luxation of the heart with strangulation or volvulus, depending on the site and size of the pericardial tear. While all proven cases of pericardial rupture should be explored surgically, treatment varies for different teams according to the site and the size of the rupture.
-
This article is a review of recent data concerning: plexus and peripheral nerve blocks for the upper and lower limbs, intravenous regional anesthesia, and medullary, epidural and spinal anaesthesia. We have focused on the advantages and disadvantages of each technique which should be taken into account for their selection. Regional anaesthesia techniques are not without risks, and advantages are perhaps not as obvious now as was reported in the past, especially in the case of medullary spinal or peridural anaesthesia.
-
The authors report one case of bilateral traumatic dislocation of the testes. A rapid analysis of literature enable to emphasize the usual mechanism (motorcycle accident), different anatomic types and therapeutic behaviour; immediate closed reduction and more often, surgical orchidopexy.
-
A prospective study was conducted to determine the best position of patients undergoing esophageal hiatus surgery. Three positions were compared: 1) use of a cushion; 2) use of the operating table block, and 3) the ordinary supine position. ⋯ The angle determined by the xiphoid process and a horizontal line passing through the hiatas area was 14 degrees and 8 degrees, more when the cushion and the block were used, respectively, as compared with the supine position (p < 0.01). We recommend the use of the cushion in hiatal surgery, affording better exposure and therefore a more comfortable approach to the hiatal area as compared with the supine position.
-
Annales de chirurgie · Jan 1993
Case Reports[Para-hiatal gastric strangulation after Toupet's operation].
An exceptional case of incarcerated para-hiatal hernia with gastric necrosis, developing 7 years a Toupet procedure, is reported. To our knowledge, this is the first reported case of this complication after a surgical anti-reflux procedure without diaphragmatic counter incision. The mechanism, diagnostic difficulties and treatment are discussed.