RESUMO
Osteosarcomas of the cranial bones need a large surgical radical resection. The best option to reconstruct mandible defect after resection is the free fibula flap. In our patient an acute ischaemic leg occurred just after the free fibula flap harvest for mandible reconstruction. The abnormal distribution of the calf arteries leads to catastrophic consequences. The peroneal artery could be the main dominant artery of the leg in a small number of patients. We reported an extremely rare case of "peronea magna", described in less than 0.2% of the global population. A careful pre-operative workup of the calf vessels is required in all the patients who need free fibula flap harvest.
Assuntos
Transplante Ósseo , Fíbula/cirurgia , Complicações Intraoperatórias , Isquemia/etiologia , Perna (Membro)/irrigação sanguínea , Mandíbula/cirurgia , Procedimentos de Cirurgia Plástica , Coleta de Tecidos e Órgãos/efeitos adversos , Adulto , Feminino , Fíbula/irrigação sanguínea , Seguimentos , Sobrevivência de Enxerto , Humanos , Neoplasias Mandibulares/cirurgia , Necrose , Osteossarcoma/cirurgia , Artéria Poplítea/anormalidades , Artérias da Tíbia/anormalidadesRESUMO
A 72-yr-old man was electively admitted for cardiac revascularisation 6 weeks after an inaugural inferior infarct. His physical examination and laboratory test were unremarkable. According to his coronarography the patient was programmed for an off pump coronary artery by-pass. During surgery the heart was found to be completely herniated in the left chest, passing on the posterior aspect of the phrenic nerve. Symptomatology and complications of congenital pericardial defects are reviewed.