1/19. Transient myocardial ischemia may occur following subendometrial vasopressin infiltration.A case of transient myocardial ischemia following subendometrial vasopressin infiltration in intractable intra-operative postpartum bleeding due to placenta accreta is described. In our experience, the rate of this side effect is one in 14 patients (rate of 7.1%). We believe that the benefits of the treatment outweigh the risks, since the uterus was saved in all 14 patients. Nevertheless, this case emphasises that extreme precaution is needed with subendometrial vasopressin infiltration. It should be emphasised that the needle must not be within a blood vessel because intravascular injection of vasopressin solution can precipitate acute arterial hypertension, bradycardia and even death. We suggest that local vasopressin infiltration into the placental site is indicated in cases of intractable bleeding at cesarean section after other conventional obstetric and pharmacological maneuvers have failed.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
2/19. Arterial embolization to preoperatively manage pulmonary disease associated with inflammation.Preoperative arterial embolization is used in pulmonary disease to reduce intraoperative blood loss resulting from exposure of extensive adherent pleura due to repeated inflammation. Between January 1996 and February 2001, 5 patients underwent surgery with this procedure. Underlying diseases were 3 cases of aspergilloma and 1 each of chronic expanding hematoma and lung cancer. All embolization was permanent, involving coil insertion. Surgical treatment was successful in all 5 patients without mortality. Such preoperative management proved useful in reducing intraoperative blood loss in hypervascular collateral feeding vessels in the area of resection or decortication.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
3/19. Atraumatic bloodless removal of intramedullary hemangioblastomas of the spinal cord.OBJECT: The goal of this study was to summarize the author's personal experience in the surgical treatment of 19 patients with intramedullary spinal cord hemangioblastomas. methods: All cases were from the author's private practice and were treated between 1967 and 1990. In all cases the intramedullary hemangioblastomas were totally removed by using a unique microsurgical technique of bipolar coagulation, which is fully described in this paper. A bipolar forceps was used to shrink each tumor and detach it from its feeding and draining vessels. Tumor resection was successfully accomplished in all patients. Blood loss was minimal, averaging less than 100 ml, and what little bleeding occurred did so during laminotomy or laminectomy. No bleeding occurred during tumor removal, and no transfusions were given. All patients were symptomatic preoperatively, and all recovered or improved following surgery. CONCLUSIONS: The technique described in this paper makes tumor removal safe, effective, and relatively easy.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
4/19. Rapid communication: laparoscopic Anderson-Hynes dismembered pyeloplasty using the da Vinci robot: technical considerations.PURPOSE: To present our initial experience with laparoscopic pyeloplasty utilizing the da Vinci robot for upper tract reconstruction. Case Report: A four-port transperitoneal approach was used in a 73-year-old man. The ureteropelvic (UPJ) obstruction was identified with a crossing vessel. After dismemberment of the UPJ, the renal pelvis was trimmed and reconstructed using the da Vinci robot. The total operative time was 5 hours; the time spent for reconstruction was 45 minutes. Blood loss was <150 mL. The postoperative analgesic requirement was 8 mg of morphine and 25 mg of hydrocodone. There were no intraoperative or postoperative complications. CONCLUSION: The da Vinci robot can serve as a vital surgical tool during pyeloplasty with extensive reconstruction.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
5/19. Colonoscopically placed hemoclips as treatment for massive appendiceal stump bleeding.Massive bleeding from an appendiceal stump is a rare but occasionally seen severe complication. The bleeding may drain into the abdominal cavity, the retroperitoneum, or the digestive tract. gastrointestinal hemorrhage may occur early or even years after appendectomy. The typical management includes ligation of the bleeding vessel or cecal resection done by either emergency laparotomy or laparoscopy. An alternative treatment option would be an angiographic embolization of the bleeding vessel. We report on a 33-year-old woman with severe lower gastrointestinal hemorrhage 1 day after an apparently uncomplicated appendectomy for acute phlegmonous appendicitis with ligation and invagination of the appendiceal stump. Hemoglobin level dropped to 6.3 g/dl and made blood transfusion necessary. The cause of bleeding was a small intramural branch of the appendiceal artery at the appendiceal stump, which was diagnosed by emergency colonoscopy. The hemorrhage could be controlled endoscopically by placing hemoclips on the distinct vessel in combination with a biological tissue adhesive. The patient recovered thereafter without further intervention. Endoscopic clipping for the treatment of appendiceal stump bleeding is a novel, effective, and safe procedure. Thereby, conventional emergency laparotomy or laparoscopy or angiographic embolization can be avoided.- - - - - - - - - - ranking = 3keywords = vessel (Clic here for more details about this article) |
6/19. Tourniquet technique prevents profuse blood loss in placenta accreta cesarean section.AIM: Profuse bleeding in placenta accreta is life-threatening even under well-prepared cesarean sections. methods: We used a tourniquet technique to temporally shut off blood flow through the uterine and ovarian vessels at the level of the uterine cervix. The tourniquet consisted of manual compression followed by a rubber tube. RESULTS: Total blood loss in cesarean section and hysterectomy in the two cases in which we applied this technique was significantly reduced compared with that in the two cases without it. CONCLUSION: This technique not only prevented massive bleeding from the accreted placentation, but also allowed physicians time to consider the necessity of subsequent hysterectomy.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
7/19. Surgical importance of highly located innominate artery in neck surgery.Massive hemorrhage is an unusual complication of tracheotomy, and the most common causes are injury to the anterior jugular veins and the thyroid isthmus, or unrecognized variations of the vascular structures, such as the arteria thyroidea ima. We present a case of high-running innominate artery that ascends until the third tracheal ring and courses horizontally anterior to the trachea in a patient with laryngeal carcinoma. If not noticed during tracheolaryngeal surgery, trauma to this vessel and subsequent hemorrhage may be fatal. In this report, the case is presented and the surgical significance of this anomaly is emphasized.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
8/19. Orbital perforating branch of the infraorbital artery: an important landmark in orbital surgery.The orbital branch of the infraorbital artery is an important surgical landmark but is frequently omitted from texts that discuss orbital anatomy and surgical technique. This report reviews the anatomy of this artery to familiarize the reader with its existence and location to reduce the risk of intraoperative hemorrhage from this vessel.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
9/19. Preoperative embolization in the treatment of choroid plexus papilloma in an infant. Case report.The authors report a case of preoperative embolization and resection of a choroid plexus papilloma of the lateral ventricle in a 4-month-old boy. These vascular tumors of the central nervous system present a significant intraoperative bleeding risk. Attempts at preoperative embolization to reduce the bleeding risk have rarely succeeded because of the small and tortuous vessels feeding these tumors in infants. The case presented here supports the feasibility of preoperative embolization as a therapeutic adjunct in infants.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
10/19. Temporary amaurosis with persistent visual field defect following acute blood loss.Visual loss and field defects commonly occur after acute blood loss. We present a case of bilateral permanent visual field defect in a 30-year-old man after a massive hemorrhage caused by large vessel injury during a right nephrectomy. His postoperative visual acuity decreased significantly, and his visual field showed peripheral constriction and inferior altitudinal field defect in both eyes. A year and a half after the operation, visual acuity recovered to the preoperative level, but the field did not show improvement. We advance that this is a possible result of extensive injury to the occipital area, excluding the corresponding area of the macula.- - - - - - - - - - ranking = 1keywords = vessel (Clic here for more details about this article) |
| | Next -> |