[Surgical therapeutic strategy in vital risk polytrauma with multiple organ injuries, case report]. / Strategia terapeutica chirurgicala in plagile cu risc vital cu leziuni multiple de organ. Prezentare de caz.

The medical interest for trauma pathology is incresing, due to the gravity of the given injuries. The surgical therapeutic strategy used is directly related to the localization and to the type of the trauma. The supplementary lesions and their vital risk also matter. The multidisciplinary team approach is the key to resolve this type of lesions with a good outcome. We recently observed an increasing tendency toward the rise of number and variety of patients with trauma, due to the great diversity of the etiopathogenic agents. The most important factor, during the assessment of a politraumatised patient is to diagnose correctly the functional deficits of vital organs and establish the vital prognosis. It is necessary to adopt the best and fast therapeutic strategy in order to obtain rapid life-saving decisions.

Stenting for cervical tracheo-esophageal malignant fistula: a case report.

Esophago-respiratory neoplastic fistulas present serious problems of management, mostly because of the severe status of the patient. The authors present the case of a 49-year-old patient with a malignant eso-tracheal fistula manifesting as mild dysphagia and dyspnoea. An endoscopic palliative treatment of the fistula was performed introducing a metallic coated stent into the esophagus. The multiple stent displacement required a definitive, very high positioning of the stent in the lower pharynx, with significant discomfort. Severe respiratory conditions regressed and the patient survived 6 months after the initial placement. The authors suggest endoscopic palliation with esophageal prosthesis as the therapeutic choice in those cases not amenable to surgery.