ABSTRACT
The authors review the case of a fifty-three-year-old cirrhotic patient. He was admitted to the emergency unit with symptoms of acute abdomen and haemorrhagic shock. Abdominal bleeding of unknown origin was revealed by UH and CT imaging. After circulatory resuscitation, urgent abdominal exploration was indicated. During operation arterial bleeding of a ruptured cirrhotic nodulus was found. Tacho-Comb (a human fibrinogen/thrombin coated collagen patch) was applied onto the hepatic wound. Prompt haemostasis was achieved. The patient was discharged after an uneventful postoperative period.
Subject(s)
Abdomen, Acute/etiology , Aprotinin/therapeutic use , Fibrinogen/therapeutic use , Hemostasis, Surgical/methods , Liver Cirrhosis/pathology , Liver Cirrhosis/surgery , Thrombin/therapeutic use , Abdomen, Acute/surgery , Drug Combinations , Humans , Liver Cirrhosis/complications , Male , Middle Aged , Rupture, Spontaneous/complications , Rupture, Spontaneous/surgery , Treatment OutcomeABSTRACT
AIMS: The authors scrutinize the results of elective large-bowel operations, comparing the healing of handsewn and stapled anastomoses. A brief history of large-bowel surgery is also presented. METHODS: Altogether 710 elective colonic anastomoses were made between 01. January 1979. and 31. December 2004. are evaluated. The complications and mortality rate after these operations are also mentioned. The 710 large-bowel anastomoses were performed under standard personal and material conditions 2/3 of them handsewn, while 1/3 by the stapled method. RESULTS: According to the operation results no significant differences in morbidity and mortality were found between the two technics. CONCLUSION: Stapled anastomoses are more expensive, but in case of recto-sigmoid tumours, particularly in low rectum resections, the instruments are indispensable.