Isolated left sided superior vena cava draining into the left atrium associated with recurring intracerebral abscesses. A case report.

A case is reported of recurrent intracerebral abscesses occurring in a patient with isolated drainage of a persistent left superior vena cava to the left atrium without causing cardiac symptoms or arterial desaturation. The diagnosis and therapy are discussed.

Pulmonary embolism confirmed by transoesophageal echocardiography.

A 60-year-old patient suffered a pulmonary embolism following the application of an Esmarch and pneumatic tourniquet before arthroscopy of the knee. The diagnosis was suspected because of sudden hypotension, ECG changes, a decrease in end-expiratory carbon dioxide concentration and oxygen desaturation as indicated by pulse oximetry. Before performing a sternotomy and cardiopulmonary bypass for removal of pulmonary artery clots, the diagnosis was confirmed by the demonstration of severe right ventricular strain using transoesophageal echocardiography.

Anesthesia for trauma.

Anesthesia of polytraumatized patients represents a considerable risk for them. The proper treatment of a polytraumatized patient comprises the rapid stabilisation of all his vital functions. At the same time, the attempt must be made to achieve a complete picture of all his injuries in order to be able to select a reliable and safe anesthetic procedure. Over and beyond this, a continuation of all intensive care measures, in particular the optimalization of blood volume, the maintenance of gas exchange, the support of the cardiac, and the balancing of the acid-base and electrolytes, is of the greatest importance for an effective treatment of the polytraumatized patient.