[Diagnosis of spontaneous arteriovenous fistula complicating aortoiliac aneurysm using spiral CT. Report of 3 cases]. / Diagnóza spontánní arteriovenózní pístele u aortoilického aneuryzmatu pomocí spirálního CT. Tri kazuistiky.

Acute spontaneous arterio-venous fistula complicating atherosclerotic abdominal aortic aneurysm (AAA) is rare. This life-threatening setting is observed in 1-2% of all AAAs and 2-4% of ruptured of AAAs. The triad of abdominal or lower back pain, pulsatile abdominal mass, and continual abdominal machinery-like bruit is seen only in half of cases. Currently, CT angiography is a noninvasive technique which enables a rapid and exact preoperative diagnosis. The authors describe three cases of aortoiliac aneurysm complicated by an acute arteriovenous fistula which were diagnosed using spiral CT.

[Ultrasonography in the diagnosis of acute appendicitis]. / Cena UZ vysetrení v diagnostice akutní appendicitis.

By analysis of as group of 147 patients operated in 1996 at the Surgical Clinic of the Faculty Hospital in Hradec Králové on account of acute appendicitis the author evaluates the importance of ultrasonographic examination for the diagnosis. Its sensitivity was, consistent with data in the literature, 64.1%. US examination is valuable in particular in doubtful clinical diagnosis, the clinical examination remains however the basis in the diagnosis of acute appendicitis.

[Blunt injury of the kidney--personal experience and present views on its therapy]. / Tupá poranení ledvin--vlastní zkusenosti a soucasné názory na jejich lécbu.

Between 1972 to 1994 there were admitted 105 patients with blunt trauma of the kidney, 89 men and 16 women with median age 32 years. In 53 patients the left kidney was affected and in 52 of them the right side was injured. According to the grade of trauma we evaluated in 77 patients a contusion (73.3%), by 16 patients a laceration (15.2%), in 11 patients a rupture of the kidney with fragmentation of the parenchyma and in one the renal artery was injured. The mechanism leading to the blunt trauma of the kidney was following: traffic accident in 52 patients (49.5%), during sport in 20 patients (19.5%). 16 patients were injured in own home (9.5%) and 7 patients in work (6.7%). In 28 patients the trauma of the kidney was serious, by 5 of them we have done nephrectomy (17.8%), in two suture of the parenchyma (7.1%) and in further two patients heminephrectomy. After considering clinical status, grade of hypovolemic shock and finding on CT scan we prefer lately conservative steps in the treatment serious trauma of the kidney.