Acute dissecting aneurysm of the ascending thoracic aorta causing obstruction and thrombosis of the right pulmonary artery.

We present the case of a 69-year-old man with a history of hypertension and a recent pelvic fracture who presented with acute chest pain, shortness of breath, and severe hypotension. The history of recent pelvic fracture and the clinical manifestations, including the sudden onset of acute respiratory distress, hypotension, and hypoxemia, indicated pulmonary embolism; however, at surgery the patient was found to have an acute dissection of the ascending aorta with obstruction and thrombosis of the right pulmonary artery. This case emphasizes the need to consider such a diagnosis in patients who have unilateral absence of perfusion to the right lung.

The arterial blood supply of the pancreas: a review. III. The inferior pancreaticoduodenal artery. An anatomical review and a radiological study.

This article is the third part of a comprehensive review on the pancreatic arterial blood supply and deals with the inferior pancreaticoduodenal a. The aim of this review is to summarise the anatomical studies, starting from Haller's reports, and to supply as far as possible, with original material, angiographic evidences for the classic anatomical notions. For this purpose, the overall research was carried out by picking out and studying 1015 selective angiographies (celiac trunk and its branches, superior mesenteric a.) taken from the angiographic archives of the Institutes of Radiology of Siena, Rome (Catholic University), and Perugia. Angiographically, the authors observed the inferior pancreaticoduodenal a., present in most instances, as arising from the superior mesenteric a., from the right accessory hepatic a., or from a common trunk with the first or the first two jejunal aa. Some variations of the course have been shown. The authors underline and discuss the discordant opinions still existing regarding the incidence of the different ways the inferior pancreaticoduodenal a. arises and the surgical importance of the variation of origin of this artery.

The arterial blood supply of the pancreas: a review. II. The posterior superior pancreaticoduodenal artery. An anatomical and radiological study.

The present paper is the second part of a comprehensive review of the arterial blood supply of the pancreas and deals with the posterior superior pancreaticoduodenal artery. The aim of this review is to summarise the anatomical studies, starting from Haller's reports, and to supply as far as possible, with original material, angiographic evidences for the classic anatomical notions. For this purpose, the overall research was carried out by picking out and studying 1015 selective angiographies (celiac trunk and its branches, superior mesenteric a.) taken from the angiographic archives of the Institutes of Radiology of Siena, Rome (University of Sacro Cuore, Catholic University), and Perugia. Angiographically, many possible different sources of the posterior superior pancreaticoduodenal a. (superior pancreaticoduodenal a., proper hepatic a., right hepatic a., left hepatic a., superior mesenteric a., accessory and replaced right hepatic a. coming from the superior mesenteric a.) have been demonstrated, as have rare variations of the course and a small number of collateral branches (retroduodenal a. and ventral commissural a.). Moreover, the authors underline the discordant opinions still existing regarding the incidence of the different ways the posterior superior pancreaticoduodenal a. arises.

[Various cases of direct connections between the celiac artery and the superior mesenteric]. / Alcuni casi di connessione diretta fra le arterie celiaca e mesenterica superiore.

The authors produce three cases in which an anastomotic arterial trunk between the coeliac artery and the superior mesenteric artery was present. Although this finding is rather rare (0.4% in vivo) it is important for the surgeons who operate upon the pancreas.

[Althesin - Fentanyl combination as anesthetic in patients with Parkinson's disease]. / L'associazione Althesin Fentanyl nell'anestesia del parkinsoniano.

An association of Althesin and Phentanyl succinylcholine is proposed as anaesthetic in patients with Parkinson's disease. This method has two advantages: it does not have an adverse effect on the drugs normally given to such patients, so that the postoperative neurological symptomatology is not altered in any way; its anesthetic effectiveness is allied with case of employment and a wide margin of safety.