A technique is described for reinforcing and sealing a microvascular anastomosis by using a detached vessel segment as a cuff around the anastomosis. This may allow fewer microvascular sutures to be used. This would allow a simpler, less traumatic, and more rapid repair and may allow "more vessels to be ...

Nineteen intra-aortic balloon (IAB) ruptures occurred in sixteen patients during a three-year period. Perforation occurred secondary to abrasion with material failure or mishandling of the device during insertion. To avoid serious sequelae, it is important to be aware of the possibility of IAB rupture and to remove any defective device ...

The loss of ejaculation is the most serious postoperative complication of patients having stage I non-seminomatous testicular tumours. In order to preserve the capability for ejaculation even after retroperitoneal lymphadenectomy (RPA) the preservation of paravertebral sympathetic ganglia but that of the sympathetic nerves in the territory of aortic bifurcation and ...

Having had surgical repair of aortic coarctation at the age of 12 years, and re-operation at the age of 19 years for stenosis at the site of the previous repair, a 29 years old man presented as an emergency with a 24 hour history of interscapular pain, haemoptysis and collapse. ...

We report two cases of innominate artery involvement in patients with Ehlers-Danlos syndrome. In the first patient, spontaneous dissection of the innominate artery was treated successfully. In the other, the patient died of spontaneous rupture of the innominate artery in the early postoperative course after operation for aneurysm of the ...

To determine the prevalence, demographics and morbidity of vein patch rupture, the authors polled members of the Western Vascular Society. Forty-eight surgeons (53% of the members) reported an experience with 23,873 carotid operations. A vein patch was used in 1,760 operations (7.4%), and rupture of the patch occurred in 13 ...

Surgical reconstruction is the treatment for acute traumatic aortic rupture and should be accomplished immediately in most patients. In patients in whom concomitant injuries or the development of life-threatening complications preclude safe and successful aortic reconstruction, pharmacological intervention to reduce the risk of free aortic rupture may be considered. Surgical ...

A 15-year-old girl presented with severe fecal peritonitis due to a large spontaneous colonic perforation. The sigmoid colon was the site of a cluster of white serosal lesions with omental adhesions, of an appearance identical to that of the edges of the perforation. Her father had died at 30 years ...

The CT appearance of mycotic abdominal aortic aneurysms leading to eventual rupture has been well described. On the other hand, ruptured nonaneurysmal bacterial aortitis has not been demonstrated in the CT literature. We present two cases with subsequent rupture documented on CT. The characteristic findings of periaortic density and adjacent ...

Traumatic rupture of aorta is a serious complication in accidents, mainly road accidents, with a high mortality unless an immediate diagnosis and surgical correction is made. A case of traumatic rupture of the aorta shown in the acute phase by Doppler-echocardiography is reported. This technique can be of great value ...

A report is presented of a patient who died of a spontaneous rupture of the external iliac artery. She had had a complicated abdominal hysterectomy two years before. Light microscopy disclosed the evidence of EDS type IV, which was proven afterwards by culturing skin fibroblasts from her youngest son. The ...

A patient involved in a high-speed motor vehicle accident presented paraplegic to the emergency department. He was noted to have an abnormal chest x-ray and, subsequently, underwent aortography which revealed aortic transection. The patient's paraplegia resolved spontaneously prior to definitive aortic repair hours later. Aortic rupture presenting as paraplegia is ...

An Arabian mare was referred with traumatically induced complete transection of the trachea. A temporary airway was established through the open wound at the site of the rupture. Resection of devitalized tissue including 3 tracheal ring segments, and anastomosis of the tracheal ends was subsequently performed under general anesthesia. Wound ...

The intermediate zone (IZ) of nonperfused and perfused spleens in three species of primitive mammals (shrew, mole, platypus) was studied morphologically. The IZ is a tissue zone consisting of plexiform vessels, probably venous capillaries, and is located transitionally between the white and red pulp. The IZ is separated from the ...

Ehlers-Danlos syndrome is a connective tissue disorder characterized by skin hyperelasticity and friability, hyperextensible small articulations, vascular fragility, and ocular and visceral symptoms. Ten types of Ehlers-Danlos syndrome have been described to date. Type IV is characterized by isolated arterial involvement with the risk of rupture, making diagnosis difficult. A ...

The present study deals with the question whether an insufficient vascular supply of certain areas can be made responsible for ruptures in the biceps tendon. The macroscopic and microscopic examination shows that the blood supply of the tendon in the part most prone to ruptures, that is in the bicipital ...

We report a case of fatal rupture of a false aneurysm of the ascending aorta during aortographic injection. The aneurysm had formed at the site of aortic cannulation done for a cardiac bypass at an earlier date. The rupture manifested as hemoptysis as the false aneurysm had burrowed and ruptured ...

We have previously reported that aortic tissue elastase increases with operative trauma unrelated to direct aortic injury in rabbits and that increased tissue elastase may be responsible for abdominal aortic aneurysm (AAA) rupture in humans. In the current study we studied the levels of human neutrophil and serum proteolytic activity ...

Several investigations have indicated that rupture of the thoracic aorta is one of the leading causes of immediate death in victims of road traffic accidents. In Finland in 1983, 92% of front-seat passengers were seat belt wearers on highways and 82% in build-up areas. The mechanisms of rupture of the ...

A case of intra-angiography rupture of an aneurysm, a rarity, is reported. It was confirmed by CT Scan and autopsy. The aneurysm ruptured despite taking all precautions recommended in the literature. This complication may be reduced by the use of non-ionic contrast media and slow flow rate injections.

A case is described of sudden death occurring after the use of a noradrenaline-containing local anaesthetic. Autopsy revealed a massive subarachnoid haemorrhage following a ruptured cerebral aneurysm. The noradrenaline in the local anaesthetic is thought to be an important factor in the cause of the rupture. It is recommended that ...

In our preliminary experience with transabdominal chorionic villus sampling, we encountered a patient with a uterus bicornis bicollis and anterior fundal placenta, which posed particular technical difficulties for the transcervical approach, but in whom sampling was easily accomplished by the transabdominal route. A description of this case, as well as ...

Complete diphallia was detected in a six-month-old Poodle cross dog. Duplication of the urinary bladder, right renal hypoplasia, bifurcation of the descending colon and bilateral cryptorchidism were also present. The left urethra was patent, and emptied the left urinary bladder; the right urethra ended blindly at a point 2.5 cm ...

Emergency cardiac surgery in children can be successfully carried out even when cardiopulmonary bypass is either not feasible or not available quickly enough. Hypothermia induced with ice-water bags, complete circulatory arrest, near-total body exsanguination, and rewarming with a heating blanket and heating lamps, were used twice successfully in the repair ...

Traumatic rupture of the main pulmonary artery in a surviving patient is very rare. The case history of a 37-year-old man who sustained blunt chest trauma in a motor vehicle accident is presented. A persistent, bloody right pleural effusion led to the diagnosis of a ruptured right main pulmonary artery, ...

Spontaneous arterial subdural haematoma is arguably a rare condition. We report on three patients who presented with progressive neurological deficit or coma and who had been initially diagnosed as strokes. Explanations for the development of this condition are reviewed and it is suggested that it is not as rare as ...

Computed tomography in a patient with unsuspected rupture of the left mainstem bronchus revealed shift of the trachea to the right, with the remainder of the mediastinum being shifted to the left. The left mainstem bronchus was visualized only in its most proximal course. The combination of deviation of the ...

Clinical and necropsy findings in 138 patients (69 men and 69 women) with rupture of the left ventricular (LV) free wall during acute myocardial infarction (AMI) (rupture group) were compared with 50 patients who died during their first AMI without rupture (nonrupture group). The frequency of systemic hypertension (55 vs ...

Classical teaching suggests that placement of a tracheostomy tube through the second or third tracheal rings will safeguard the innominate artery in the majority of patients. A tracheotomy was performed on ten fresh, adult cadavers through a vertical incision in the second and third tracheal rings. A series of measurements ...

Aneurysms of the intracavernous portion of the internal carotid artery may become very large, but they very rarely rupture. A case is described in which rupture of such a lesion resulted in a lethal massive subdural hematoma with transtentorial herniation. This is the second reported case of substantiated intracranial rupture ...

A man with a crush injury of his upper abdomen developed bilateral pulmonary empyema after repair of tears of the oesophagus and liver. Attempts to withdraw chest drains led to recurrent septicaemia, treated by reinsertion of the drains plus administration of antibiotics. The communication of the empyema space with both ...

Superior pancreaticoduodenal artery aneurysms are rare; their rupture often leads to sudden death. We report a case of a 59-year-old hypertensive man who died of a massive retroperitoneal hemorrhage following rupture of an aneurysm of the superior pancreaticoduodenal artery. We also discuss this unusual vascular lesion and review the pertinent ...

A previously unreported association of pneumothorax and the use of a tracheoesophageal voice prosthesis is presented. A review of 44 cases revealed that two patients developed a pneumothorax requiring chest tube placement. Pulmonary barotrauma is believed to be the cause of the injury. In those patients in whom the tracheoesophageal ...

Transcatheter arterial embolization (TAE) was performed in 20 patients with ruptured hepatocellular carcinoma (HCC). Bleeding was improved in all patients, but only four survived for over three months. Rerupture occurred in seven patients (35%) and the prognosis was extremely poor. TAE should be considered the treatment of choice for ruptured ...

Of 123 patients who had suffered blunt trauma to the chest traumatic aortic rupture was eventually confirmed in 61 and absent in 62 patients. The chest radiographs of these patients were examined for 15 signs reported in the literature as being associated with traumatic aortic rupture. Although many individual signs ...

A 14-year-old male pedestrian was hit by a truck and admitted with respiratory distress and subcutaneous emphysema. Aortography revealed disruption of the ascending aorta. Bronchoscopy revealed rupture of the left main bronchus at the carina. Both lesions were repaired using a median sternotomy, cardiopulmonary bypass, and a transpericardial approach for ...

Carotid artery exposure and rupture is one of the most feared complications of head and neck surgery. The ideal method for preventing rupture of an exposed artery should be easy to perform, safe, effective and should spare local and regional flaps for later use in reconstruction. Isobutyl-2-cyanoacrylate (Bucrylate) is a ...

The interpretations of 314 thoracic aortograms obtained over a 4 1/2-year period for possible traumatic rupture were reviewed to determine the frequency and causes of false-positive examinations. The radiographs and clinical records of all patients whose aortograms were abnormal or equivocal were examined. Two hundred consecutive thoracic aortograms that had ...

Using Sushruta's lateral perineal approach, 54 prostatectomies were carried out between August 1985 and March 1986. This approach to the prostate is short, safe, simple and direct. The same approach has been used in 6 patients with ruptured posterior urethras and found to provide a simple access to the urethra.

Untreated traumatic rupture of the aorta generally results in sudden death. A case with 14 years' survival after an unrecognized traumatic rupture of the aorta is presented. Chronic traumatic aneurysm of the aorta should be kept in mind in a patient who develops sudden symptoms of arteriosclerotic heart disease months ...

Twenty Adult traumatic paraplegics with neurologically complete lesions between C8 and T12 have ambulated using a ParaWalker (adult hip guidance orthosis), for a minimum of 6 months at home. At follow up, on average 20 months from the date of issue of the orthosis, 17 patients (85%) were still regularly ...

We describe a child with Brown-Sequard syndrome beginning at C8-T1, immediately following Harrington rod instrumentation for idiopathic scoliosis. We believe this is most likely related to either a common variation of the branches of the anterior spinal artery to one side or due to rupture of the ipsilateral spinal vein. ...

Intrapulmonary haematomas occurred during mechanical ventilation of two patients with advanced chronic obstructive pulmonary disease and bullous dystrophy. In both cases, the haematomas were revealed by blood-stained aspirates, a fall in haemoglobin level, and the appearance of radiological opacities. Haematoma occurrence in the area of a bulla which recently has ...

We reviewed initial chest radiographs of 21 patients with, and 26 without, aortic rupture, and examined the presence or absence of individual signs previously cited to be associated with aortic rupture. Using stepwise logistic regression, the three most significant signs associated with rupture were loss of aortic contour, tracheal deviation, ...

An 8-yr-old child suffered traumatic bilateral pneumothoraces and a ruptured right main bronchus. Surgical repair of the bronchus was postponed for 18 h after a definite diagnosis was established due to severe hypoxemia and hypercarbia. Only left endobronchial high-frequency ventilation with muscle relaxation corrected this pulmonary dysfunction sufficiently to enable ...

A young otherwise healthy man presented with bilateral spontaneous pneumothorax that resulted in near respiratory failure and severe cardiac dysrhythmia. The magnitude of the patient's clinical manifestations resulted from his severely compromised pulmonary function with its attendant cardiovascular compromise. Prompt bilateral tube thoracostomy relieved his cardiopulmonary distress. This rare clinical ...

Spontaneous rupture of the esophagus (Boerhaave's syndrome) is a very rare but the most lethal perforation of the gastro-intestinal tract. A 62-year old male was successfully treated for this condition developing on the second post-operative day after coronary artery bypass. Two hours after extubation respiratory insufficiency and circulatory collapse necessitated ...

Glycogen deposition in vascular smooth muscle has been demonstrated previously in alpha-glucosidase deficiency but has not been clinically significant. Three sons of healthy, nonconsanguineous parents developed progressive proximal muscular weakness secondary to alpha-glucosidase deficiency. Each patient developed a fusiform basilar artery aneurysm, which was complicated by fatal rupture in two ...

Following the repair of a ruptured anterior communicating artery aneurysm, a patient had a severe anterograde amnesia with sparing of other intellectual functions, apathy and loss of volition, altered arousal, and partial diabetes insipidus. Postmortem examination of the brain revealed bilateral destruction of the septal gray, nucleus accumbens, and nucleus ...

We report a case of traumatic rupture of the thoracoabdominal aorta that was successfully repaired 3 days following the accident. Associated lesions included rupture of the left renal and celiac arteries. This rare lesion should be suspected in the victims of violent hyperextension of the body with or without a ...