RESUMEN
To evaluate the feasibility and results of using serosal patch of small bowel for repair and replacement of inferior vena cava [IVC] after resection of a part of infra-renal IVC in an animal model, as it may be encountered in extensive tumors of retroperitoneal and trauma patients
Methods: Five healthy sheep of both sexes were prepared. After general anesthesia and laparotomy, a defect with 1 cm width and 4cm length was made on anterior aspect of infra-renal IVC, and then an adjacent loop of small bowel was brought and sutured continuously to cover the defect of IVC as a patch graft. The observation period was two months
Results: Three of five IVCs were macroscopically patent without stenosis and thrombosis. Pathologic assay revealed complete endothelialization of serosal surface of the patch of small bowel loop. One of IVCs was completely occluded in gross evaluation and fibrous formation in pathologist review. The sheep had no sign of venous hypertension and edema of limbs. One sheep died at the night of first operation due to internal bleeding
Conclusion: Serosal patch of small bowel is an accessible and feasible alternative in repair and reconstruction of IVC especially when there is restriction for use of prosthetic material in a contaminated space of abdomen
RESUMEN
A 50-year-old lady presented with bloody vomiting and melena since four days prior to admission. Her medical history was significant only for hypertension which was controlled by a 5 mg daily dose of amlodipine. She occasionally took NSAIDs. On admission, the physical exam revealed only mild tachycardia and pallor. Hemoglobin was 9.7 g/dl, which subsequently declined to 7.9 g/dl. The first upper gastrointestinal [GI] endoscopy was remarkable for a paraesophageal hiatal hernia, with no site of bleeding detected. The second upper GI endoscopy did not find any source for bleeding. A third endoscopic examination revealed a new finding [Figures A and B]