[Segmental portal hypertension as a rare cause of gastric hemorrhage--case report]. / Segmentalna portalna hipertenzija kao retki uzrok krvavljenja iz zeluca--prikaz bolesnika.

Segmental portal hypertension is a rare pathologic condition, which produce gastric bleeding. Spleen vein thrombosis is more often caused by pancreatic disease (inflammations, tumors). Diagnosis is difficult to perform. Initial treatment is conservative. After successful conservative treatment early surgery should be planned. Unsuccessful conservative treatment indicates surgery. Splenectomy absolutely eliminates risk from rebleeding. Prognosis of these patients depends from etiology of pancreatic disease. We present a 46 old woman who successfully operated in our Department of Surgery due to massive upper gastrointestinal bleeding caused by isolated portal hypertension.

[Reconstructive surgery of the colon and rectum following war injuries]. / Rekonstruktivne operacije kolona i rektuma posle ratnih povreda.

The results were presented of the retrospective analysis of the treatment of 116 patients' with colostomies following war injuries. Reconstructive operations were performed on these patients between November 1 1991 and November 1 1994. Operations were performed on 8 patients with caecostomy, 47 with transversocolostomy, 45 with colostomy on the descendant and sigmoid colon and on 16 patients with Hartmann procedure. The average age of patients was 33.77 years. The occlusion of colostomy was performed in 81 patients, and in 19 of them the resection with T-T anastomosis was done with difficulties due to technical problems caused by adhesions, ventral hernias, defects of mesenterium and abdominal wall. Occlusion was also performed in 16 patients with Hartmann procedure. The complications encountered were: ileus in three patients, stercoral fistula in 3 (healed with conservative therapy), dehiscence of anastomosis in 1 patient (cured after reoperation, exteriorization of both ends of colon), and wound infections in 21 patients. There was no lethal outcomes.

Total hip arthroplasty in juvenile rheumatoid arthritis.

A series of 17 primary total hip arthroplasties in patients with juvenile rheumatoid arthritis (JRA) were performed at a mean age of 18 years with an average follow-up period of 9.3 years. There were 13 cemented prostheses and four noncemented. All patients were satisfied with their hip surgery and reported either slight or no hip pain according to the Harris hip rating system. Ambulation improved postoperatively and all but one patient was at least a limited community ambulator (able to ambulate short distances outside the home with crutches, walker, or cane). Roentgenogram evaluation showed five cemented hips that were believed to be definitely loose with impending failure. All were functioning well. One acetabular component has been revised to date. No femoral components have been revised. The four noncemented hips with an average follow-up period of five years were functioning well.

Early failure of noncemented porous coated anatomic total hip arthroplasty.

From July 1984 through October 1987, 63 consecutive primary Porous Coated Anatomic total hip arthroplasties were performed. Follow-up observation ranged from one to four years, with a mean of 2.4 years. The mean postoperative Harris hip score in 81 cases was 38% excellent results, 23% good results, 6% fair results, and 23% poor results. Eight percent of hips required revision of the femoral component related to subsidence. Persistent thigh pain was found in 33% and persistent limp in 58%. Poor clinical outcome was correlated with persistent thigh pain and 3 mm or more subsidence of the femoral component. Subsidence occurred despite adequate canal fill. This high percentage of early failure is unacceptable when compared with standard techniques of total hip replacements with cement fixation.