Role of CT scan in evaluation of abdominal aortic aneurysms

Thirty four cases with Abdominal Aortic aneurysms were studied by preoperative contrast enhanced C.T scan. The latter accurately diagnosed the presence, the size, supra-renal extension, involvement of iliac arteries, the presence of retroartic renal vein, dissection, leakage and associated pathology with a specificity and sensitivity of 100 percent. This made it superior to other imaging techniques namely ultrasonography and arteriography, limiting their use to special situations

Infra popliteal arterial reconstruction

The results of thirty-eight infrapopliteal bypass for limb salvage were reported. The patency rate was 77.8% on discharge. There were four above knee amputations for whom a synthetic graft was used, so the saphenous vein is only graft suitable. There were six cases for whom minor amputation was done. Diabetes mellitus did not appear to influence the results unfavorably, so patients suffering from diabetes should be considered for operation

Popliteal artery injuries

Analysis of 20 cases of popliteal artery injuries over the period 1980-1985 showed that this type of injury still carries a very high amputation rate [45%].Delayed presentation, associated popliteal vein injury, delayed treatment of compartmental hypertension and associated extensive bone and soft tissue injuries were the main causes of this high amputation rate. Early fasciectomy before vascular reconstruction lead to marked improvement in the results. Early exploration and repair of associated venous injury are essential to have better prognosis

Delayed arterial embolectomy

Studying ninety cases of delayed arterial embolectomy showed that the operation should be done so long as the limb is viable and the color changes are not fixed. Good results were achieved in sixty patients and minor amputation was done in five patients. Fasciotomy to relieve compartment hypertension was done in the proper time. Immediate heparinization is essential in every case. Direct embolectomy over the site of embolism gave better results than the conventional distant embolectomy. Care should be paid also towards the adverse effects of revascularization; namely, acidosis and acute renal failure by inducing brisk diuresis, alkalinization and ECG tracing

Distal spleno-renal shunt in the management of acute Variceal haemorrhage

Emergency Warren's operation proved to be effective in the control of acute variceal hemorrhage in contrast to Warren's and Gibson's opinion. However, care in the technique should be paid towards dissection of the left renal vein and position of the stoma.The results of the operation is much more better in bilharzial cases than post-hepatitic cases especially cases of chronic active hepatitis