ABSTRACT
Infected vascular grafts are associated with very high rates of limb loss and mortality. "Classic" treatment has invariably included graft excision. Recent reports have suggested that a more conservative approach may be indicated in selected cases, leaving the graft in place and using an aggressive local treatment associated with appropriate intravenous antibiotics. The authors report their experience with two patients with infected prosthetic vascular grafts in the groin. They both had purulent drainage from the groin wound, with the graft exposed close to the femoral anastomosis. They were both treated successfully without graft removal, and both graft maintained patency, with a follow-up of 22 and 19 months.
Subject(s)
Blood Vessel Prosthesis/adverse effects , Escherichia coli Infections/therapy , Leg/blood supply , Prosthesis-Related Infections/therapy , Staphylococcal Infections/therapy , Aged , Combined Modality Therapy , Female , Humans , MaleABSTRACT
The authors report on a case of hepatic vein thrombosis or Budd-Chiari syndrome (BCS) successfully treated with recombinant Tissue Plasminogen Activator (rTPA). They briefly outline the etiology and symptomatology of this disease as well as the various surgical procedures used for treatment. Medical therapy has been so far poorly effective in treatment BCS, but recently various reports seem to indicate that rTPA may have a role. The authors suggest that rTPA may be used as the only therapy in selected cases, or in treating patients that are not candidates for surgical intervention, or as a temporizing measure to improve symptoms in patients awaiting surgery.
Subject(s)
Budd-Chiari Syndrome/drug therapy , Tissue Plasminogen Activator/therapeutic use , Acute Disease , Humans , Male , Middle Aged , Recombinant Proteins/therapeutic useABSTRACT
In a series of 954 laparotomies performed for suspected acute appendicitis 5 (0.5%) cecal carcinomas were encountered. When considering patients over 50 years of age only, the incidence of right sided colon carcinomas raised to 5%. The authors review the therapeutic options in order to optimize patients' survival.