Acta chirurgica Iugoslavica
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The routinely monitored variables in shock stages include: arterial pressure, heart rate, central venous pressure, pulmonary artery wedge pressure and cardiac index. With vigorous therapy it is possible to bring these values back into the normal range in both survivors and nonsurvivors. The therapeutic goal in septic shock stages is to maximize the values of cardiac index, O2 delivery (DO2) and O2 consumption (CO2). ⋯ Fifteen patients with septic shock were treated in order to maximize the value of CI, DO2 and VO2. We compared the levels of these parameters between the survivors and nonsurvivors and found no significant differences after 24 hours. High levels of DO2 and VO2 do not exclude tissue hypoxia in the early stage of septic shock.
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On 36,536 abdominal operations, in 36 patients (0.1%) there was necessary to perform a relaparotomy due to intraabdominal hemorrhage, of whom in 28 patients this complication arised after emergency surgical interventions, while in 8 cases after elective surgery. The cause of bleeding in 26 patients were technical mistakes during the first intervention, in two the overdosage of anticoagulants, in other two a fibrinolysis, and in one patient haemophilia. In 5 patients the origin of the hemorrhage could not be verified at relaparotomy. ⋯ Hemoperitoneum arised in 6 patients, but without anemia, and in the other five remaining patients, a circuscripted intraabdominal hematoma was formed. In 8 patients laparocentesis was diagnostically successful. (The re-laparotomy was lifesaving for 26 patients). 12 patients died. The authors believe that well knowning of parameters of central hemodynamics, together with prolonged paresis of the gut, hyperthermia and hyperleucocytosis it is possible to recognize the predominant signs of acute postoperative hemorrhage.
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Pancreaticopleural fistula is an uncommon complication of chronic pancreatitis or pancreatic trauma. Clinical features include pleural effusion and resulting pulmonary symptoms. ⋯ As in this case, computed tomography and endoscopic retrograde cholangiopancreatography may provide complementary diagnostic information in the evaluation of this condition. A discussion of the pathophysiology, diagnosis and management of pancreaticopleural fistula is presented.
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The interdisciplinary transplant team on Medical faculty--Novi Sad is formed at the beginning of the 1986, and first successfully cadaver binephrectomy was performed in April 1986, and kidneys was transported in Transplant Centre in Belgrade. The first human renal transplantation with cadaveric kidney was performed 20, May 1986, and result was excellent. The first human renal transplantation with living related kidney was performed 27, Sept 1986, and result also was excellent. ⋯ In this paper we discuss our organization of human renal transplantation, and technique of donor-neprectomy (cadaveric and living-related) and cold perfusion of kidney with Collins solution. Our rules for implantation are shown as the Algorythm. At the end of this paper we present our results, based on three year's experience and list of the members of our interdisciplinary transplant team.
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The authors observed twenty patients having thoracic outlet syndrome diagnosed and operated upon in Neurosurgical clinic in Sarajevo. Clinical presentation of this neurovascular compression and significance of particular symptoms and findings have been discussed through and through. At the end the best operative treatment was discussed and proposed for each kind of thoracic outlet neurovascular compression.