Chirurgia italiana
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The Authors present the results got regarding operations of sympathectomy together with operations of distal by-pass at the Institute of Surgical Pathology of the University of Verona from 1979 to 1983. Among the 106 cases, in 58 (55%) sympathectomy was performed with a aorto-bifemoral or iliac-femoral by-pass at the same time, in 48 (45%) pas performed with more distal by-pass. ⋯ The Authors concluded that the sympathectomy carried out together with other vascular surgical operations is still a good procedure if the patients are within 70 years of age, no diabetics and pith a sufficient perfusion pressure of the ankle. Moreover, paradoxically, the sympathectomy is much more useful on stage II or III than on stage IV.
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Authors describes a new simplified approach of dorsal sectioning of the distal phalanx, with the suture of the nail. That is a simple method of treatment and its give a good results.
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Case Reports
[Traumatic chylothorax (apropos of a case following a closed vertebral-thoracic injury)].
The authors report a case of chylothorax due to blunt trauma with fracture of the spine in a man aged 60. After mentioning the possible pathogenesis and clinics of the case shown, the Authors explain the treatment successfully adopted, that is, the ligature of thorax duct at his inlet in the thorax through right thoracotomy on the 5th intercostal space.
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From 1971 to 1982, 126 blunt thoraco-abdominal trauma were seen: in 9 cases (7,1%), diaphragmatic rupture was present. Automobile accidents were the most frequent cause of diaphragmatic rupture and, in only one case, the injury was single. Diaphragmatic rupture was suspected preoperatively in two patients, who had positive physical and radiologic chest findings. ⋯ Surgical treatment depended on entity of associated intra-abdominal and intrathoracic injuries, especially in patients observed during immediate post-traumatic period. Authors conclude that single diaphragmatic injury, generally, give no surgical or prognostic problems. High mortality rate seen in these patients is due to multiple organ involvement.