RESUMEN
The presence of any pulsatile mass suggests an underlying aneurysm. When such masses occur in the buttock, the differential diagnosis includes aneurysms arising from branches of gluteal vessels or aneurysms developing in a persistent sciatic artery (PSA). The investigation and management of two patients with pulsatile masses are described. Review of the embryologic aspects of these masses and the important literature on the subject led to the conclusions that when a pulsatile buttock mass is encountered, an anomalous PSA should be suspected. A gluteal artery aneurysm can be treated by ligation or occlusion, but for a sciatic artery aneurysm surgical ablation is necessary and distal perfusion must be achieved postoperatively.
Asunto(s)
Aneurisma/diagnóstico , Nalgas/irrigación sanguínea , Adulto , Anciano , Aneurisma/terapia , Aneurisma Falso/diagnóstico , Aneurisma Falso/terapia , Diagnóstico Diferencial , Humanos , MasculinoRESUMEN
A retrospective case-control study was carried out to assess the importance of lymphatic fistulas that develop after vascular reconstruction and to determine the risk factors associated with them. The authors compared 35 patients who had lymphatic fistula after vascular reconstruction with 70 control patients, taken from the same database. They found a significant difference between the two groups only in age and indication for surgery: lymphatic fistulas were more likely to develop in older patients and in patients who underwent aortobifemoral bypass for limb salvage rather than for claudication (p less than 0.05).
Asunto(s)
Fístula/etiología , Enfermedades Linfáticas/etiología , Complicaciones Posoperatorias , Enfermedades Vasculares/cirugía , Anciano , Estudios de Casos y Controles , Femenino , Estudios de Seguimiento , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Factores de Riesgo , Infección de la Herida Quirúrgica/etiologíaRESUMEN
To assess the prevalence of coexisting abdominal aortic aneurysm (AAA) within certain families, a retrospective review was carried out of patients who had undergone AAA repair over a 5-year period. Contact was made with 305 families (52%) and a positive history of an affected, first-degree relative was obtained in 34 (11%). A known AAA was reported to affect approximately 20% of siblings at risk when the proband had an affected parent or sibling. Siblings of patients with an affected first-degree relative represent a high-risk group that may benefit from a screening program for earlier detection and elective management of AAA.
Asunto(s)
Aneurisma de la Aorta/genética , Aorta Abdominal/cirugía , Aneurisma de la Aorta/cirugía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Linaje , Estudios RetrospectivosRESUMEN
A technique of orthotopic liver transplantation in the pig is described in which the main feature is the accomplishment of four of the five anastomoses by the use of the Vogelfanger NRC vascular suturing instrument. The advantage of this instrument is the rapid accomplishment of safe leak-proof anastomoses.
Asunto(s)
Trasplante de Hígado , Engrapadoras Quirúrgicas , Animales , Arteria Hepática/cirugía , Hígado/irrigación sanguínea , Vena Porta/cirugía , Porcinos , Factores de Tiempo , Trasplante Homólogo , Vena Cava Superior/cirugíaRESUMEN
Six years' laboratory work resulted in devising a satisfactory experimental technique of direct left gastric-left renal diversion for esophagogastric venous decompression. The procedure was accomplished by interposing an autogenous vein graft between the distal transected left gastric and left renal veins, employing mechanical stapling for the venous anastomoses. A refined technique of left gastric caval diversion provided uniform late patency in a suitable animal model.
