[Surgical treatment of war injuries of the veins]. / Kirursko lijecenje ratnih ozljeda vena.

Between April 1991 and December 1995, 118 patients were treated for wartime venous injuries. There were 108 (91.5%) venous injuries combined with arterial ones, and 52 (49%) with bone fractures. A total of 85 (72%) venous repairs were done and 33 (27.9%) were treated by ligation. Arteriovenous fistulas were found in 20 (16.9%) venous injuries. Venous injuries were associated with 10 (62.5%) amputations and 5 (45.4%) deaths. In the early postoperative period the authors found 15 (17.6%) thromboses of venous reconstructions.

[War injuries of the arteries]. / Ratne ozljede arterija.

The experience with military vascular injuries in the recent war in Crotia is reviewed. From April 1991 to October 1995, 197 wounded persons with 231 injuries of arteries were admitted to the University Hospital Rebro. The most common injuries were of lower extremity arteries (54.5%), and the most frequent method of repair was revascularisation with saphenous vein graft interposition. Fasciotomies were performed in 34% because of frequent associated injuries of bones (34.5%) and veins (46.7%). In 20.7% casualties pseudoaneurysms and arteriovenous fistulas were found. Postoperative thrombosis (9%) was a consequence of local infection, massive necrosis and sepsis. Amputation rate was 7.7%, and mortality 5.3%. These results are very satisfactory in comparison with the results in literature. This is a result of good organization of our war surgical service: rapid transportation of wounded persons to convenient surgical centres and high surgical skill.

Military vascular injuries in Croatia.

A single-centre experience of military vascular injuries in the recent conflict in Yugoslavia is reviewed. From 1 April to 13 December 1991, 1020 casualties were admitted to the Surgical Clinic at the Teaching Faculty of the University in Zagreb, Croatia. A total of 120 injured blood vessels in 76 patients were treated in the department of vascular surgery. Casualties were transported to the hospital after treatment by forward surgical facilities. The transportation time ranged from 3 to 18 (mean 7) h. The most common injuries were to the popliteal artery (12.5%) and brachial veins (10.0%). After segmental resection, arterial and venous revascularization with saphenous vein graft interposition was the preferred option. Twenty-six fasciotomies were performed because of compartment syndrome. Indications for six amputations included sepsis, deep vein thrombosis and extensive myonecrosis. Concomitant bone fractures were stabilized by an external fixator in 90.4% of cases. Vascular injuries were repaired before orthopaedic stabilization. Completion arteriography was used to delineate concomitant distal lesions.

[War injuries of the thorax]. / Ratne ozljede prsnog kosa.

Chest injuries are very common in war circumstances. Chest injury is commonly associated with other injuries of intrathoracic organs and development of shock, which has to be treated immediately. Our patients with war chest injuries are presented, along with our approach to the treatment of these injuries. "The conservative treatment" is stressed, with particularly importance of proper chest drainage, as a corner stone of proper and successful therapy. Shock treatment and prevention of atelectasis does present an unavoidable procedure of this type of therapy.

[War injuries of the blood vessels]. / Ratne ozljede krvnih zila.

In this article the authors review their personal experience with shotgun injuries to the blood vessels. To date literature demonstrates a significant difference between the military injuries to the blood vessels versus the peacetime ones in the terms of healing. Injuries from high velocity missiles as well as blast injuries produce a massive damage of the tissue, muscles, bones, nerves and blood vessels. Therefore, such injuries demand a careful and appropriate primary surgical treatment and urgent revascularization within the ischemic tolerance of the tissue.

[Non-occlusive mesenteric ischemia]. / Problem neokluzivne mezentericke ishemije.

Critical survey of functional anatomy of the upper mesenteric artery, patophysiology of the mesenteric ischemia, and the diagnostic procedures are assessed from the viewpoint of possibilities of operative correction and the author's hitherto experience in the upper mesenteric surgery. Comparison of diagnostic with operative management in two patients points to common causes of the disease, as well as to some of the preoperative misunderstandings. The indication for revascularization of the upper mesenteric artery and consequent amelioration of postoperative course in the patient with non-occlusive mesenteric ischemia is explained. Each of the described facts is of great importance for the postoperative course without fatal complications.

Interrenal coarctation of the abdominal aorta.

We report a case of congenital, segmental, hypoplastic interrenal abdominal aortic coarctation with inadequate collateral circulation. After preoperatively evaluating renal function and intraoperatively measuring vascular pressure, the coarctation was bridged with an aortico-aorta bypass; and an additional bypass graft was placed between the prosthesis and superior mesenteric artery. In this way, besides the successful surgical correction of coarctation, the inverse blood flow in the superior mesenteric artery was reversed to normal.

[Surgical reconstructive treatment of blood vessels in the popliteal region]. / Operativni rekonstruktivni zahvati na krvnim zilama potkoljenice.

Severe occlusive disease frequently includes the popliteal artery and origin of the trifurcation vessels with reconstruction of one or more of the crural arteries. We made femorocrural bypass 23 times. Our indications for operation continue to be relief of pain or salvage of extremity. Of the 23 grafts during of one year period block recurred in 8 patients. Five times we made amputation and good results we had in 15 patients. In one patient we used Gore-tex prosthesis with succses in 4 month period.