ABSTRACT
Colonic complications following pancreatitis are unusual events ranging from 1% to 15%. In a patient with a hostile abdomen and multiple previous laparotomies, surgical management of a closed-loop large-bowel obstruction risks significant morbidity and mortality for the patient, necessitating other strategies for management. Caecostomy in the management of large bowel obstruction is an often forgotten weapon in the general surgeons' armoury.
Subject(s)
Cecostomy , Colonic Diseases/surgery , Gallstones/complications , Intestinal Obstruction/surgery , Pancreatitis/complications , Abdominal Pain/etiology , Acute Disease , Cecostomy/methods , Cecum/surgery , Colonic Diseases/etiology , Humans , Intestinal Obstruction/etiology , Male , Middle Aged , Pancreatitis/etiologyABSTRACT
Injuries to the hypoglossal and vagus nerves are the most commonly reported injuries during carotid endarterectomy. While unilateral single nerve injury is usually well tolerated, bilateral or combined nerve injuries can pose a serious threat to life. This study aims to increase awareness of the inferior pharyngeal vein, which usually passes posterior to the internal carotid artery but sometimes crosses anterior to it. Injury to either or both hypoglossal and vagus nerves can occur during control of unexpected haemorrhage from the torn and retracted edges of the inferior pharyngeal vein. We recommend careful ligation and division of this vein. In addition, we observed in 9 (17.3%) of the 52 operations that the pharyngeal vein formed a triangle with the vagus and hypoglossal nerves when it passes anterior to the internal carotid artery.
