Management of Colonic Trauma: Six-Year Experience at Henry Ford Hospital

Surgical management of 114 patients with colonic injuries related to trauma who were treated over a six-year period is reviewed. Eighty-three (73%) injuries were secondary to gunshot wounds. Twenty-six patients (24%) had isolated colonic injuries. The majority of patients (60%)) were treated with colostomies: exteriorization of the injury, repair with proximal colostomy, or resection with colostomy and mucous fistula. Exteriorization of repaired colon, primary repair, and resection with primary anastomosis were performed in 40% of the patients. Six patients (5.3%) in our series died, and 24% had complications directly related to the colon injury. Based on this study, no standard method for treatment of colonic trauma is advised. Colostomy is recommended for patients with massive multiple intra-abdominal injuries and gross fecal contamination. In selected patients, primary repair may be performed

PATHOLOGIES INTERTRIQUEES ET THERAPEUTIQUES APPROPRIEES: A PROPOS D'UN CAS PARTICULIER

The authors report a 'classical' case of congenital or hereditary lymphedema. They emphasize the interest and importance of the diagnosis and of the treatment associated of the osteoarticular pathologies.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Test thermographique prédictif de l'action de la sympathectomie lombaire

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Traumatic asphyxia: An unusual cause of traumatic coma and paraplegia. Case report

An unusual case of traumatic asphyxia with cerebral and spinal cord symptoms is presented. A survey of the literature indicates that a primary cord lesion is very rare as a consequence of such a trauma. The possible pathogenetic mechanisms of these neurological manifestations are discussed.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

LA CLAUDICATION INTERMITTENTE JUSTIFIE-T-ELLE UNE INTERVENTION CHIRURGICALE?

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Femoropopliteal bypass with a compliant, composite polyurethane/Dacron graft: short-term results of a multicentre trial

A new, compliant, highly porous, non-woven, polyurethane vascular prosthesis has been developed in an effort to improve on the performance of currently available prosthetic grafts for infrainguinal reconstruction. From April 1990 to August 1991, 57 femoropopliteal bypass grafts were implanted in 47 patients by surgeons at five university centres. In all instances, the saphenous vein was unavailable, unusable or reserved for use elsewhere. An empirical perioperative risk score for acute occlusion (0-20) was developed, based on such factors as severity of clinical ischaemia, quality of inflow and outflow, site of distal anastomosis and associated drug therapy. Primary cumulative patency was calculated according to standard life-table analysis. Poor inflow and a distal anastomosis below the knee were significant factors affecting graft patency (P = 0.001 and P= 0.001 respectively). Six-month cumulative patency for the 25 grafts with good inflow and above or mid-knee anastomoses (79%) was superior to the cumulative patency for all 57 grafts (59%). There was a significant improvement in patency rates between 'low' (22 grafts) and 'medium risk' (27 grafts) patients and 'high risk' (eight grafts) ones (risk scores 0-10 and 11-20 respectively) at a level of P = 0.001. There were two operative deaths (4%). Of the 19 postoperative occlusions, six occurred within 30 days and 18 within 6 months. These data indicate that the patency rates achieved with this new graft compare favourably with other available prosthetic grafts. In addition, the graft demonstrates superior handling characteristics and eliminates bleeding through suture holes. There is also the possibility that rapid tissue ingrowth, neointima formation and compliance will reduce intimal hyperplasia and increase long-term patency. © 1993.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

INDICATION ET TECHNIQUE DE FIBRINOLYSE LOCO-REGIONALE DANS LE TRAITEMENT DE L'ISCHEMIE AIGUE DES MEMBRES: A PROPOS D'UNE SERIE DE 22 PATIENTS

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Chirurgie des ischémies sévères et des infections du pied chez le diabetique. (Place de la revascularisation artérielle).

From overall data on 54 diabetic patients, who, over a period of 7 years, underwent operations to save their feet from ischaemia (whether linked or not to infection), the authors study 31 cases of revascularization through arterial bridging in the diabetic's lower limbs. The lesions were identified by doppler examination followed by arteriography. Various types of bridging were undertaken: 24 femoro-popliteal bridges, including 16 super-articular and 8 sub-articular ones; and 7 femoro-distal bridges on the leg artery trunks. For the post operational period, only one amputation, resulting from precocious thrombosis in the graft, had been noted. All the patients had been followed up, and the authors remarked that, after an average lapse of 43 months, actuarial survival without amputation of the lower limb amounted to 94.97% after 7 years, and the level of actuarial permeability of the bridges amounted to 72.61% after the same period. The authors stress that revascularization indications should be the same for atheromatous diabetics as for non diabetics.SCOPUS: ar.jinfo:eu-repo/semantics/publishe

Indications and technique of loco-regional fibrinolysis in the treatment of an acute ischaemic limb. Report of a series of 22 patients

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Risque myocardique chez le patient subissant une intervention carotidienne follow-up à moyen terme

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