Spontaneous isolated dissection of the abdominal aorta.

Isolated spontaneous dissection of the abdominal aorta is such a rare entity and there are only a few cases reported in literature up to date. A 42-year old male was admitted to the hospital with mild pain in the lower abdomen and back that had began seven days prior to admission together with the sudden onset of the ischemic symptoms of the left leg (ischemic ulcers of the calf gangrenous toe and pallor foot). Patient denied any trauma, hypertension history was negative, while he was active cigarette smoker. MSCT and digital subtracted angiography have shown a dissection of the abdominal aorta approximately two centimeters below the origin of the inferior mesenteric artery extending in the left common iliac artery, with no sign of the aneurysmatic dilatation of the abdominal aorta. Emergent surgery was performed with aorto-biiliacal bypass graft interposition, amputation of the left toe and necrectomy of the left calf Postoperative follow up and local vascular condition were satisfied. Even though is rare entity, isolated abdominal aorta dissection accounts for approximately 2-4% of all aortic dissection. Nowadays therapeutic regimen includes endovascular, open surgery or conservative treatment.

[Endoscopically assisted lipectomy]. / Endoskopski asistirana sukcija lipoma.

The aim of the study was to compare lipectomy and endoscopically assisted lipectomy. In a group of 32 patients with cytologically verified lipoma, 16 patients underwent classic lipectomy and endoscopically assisted lipectomy each. At 12-month follow up, there was no difference in the number of lipoma recurrences between the two techniques. Endoscopically assisted lipectomy proved to be a safe method with excellent cosmetic result and shorter recovery period for patients at the same risk of recurrent lipomas.

[Surgical and radiotherapy in treatment of postauricular keloids--case report]. / Kirurska i iradijacijska terapija u lijecenju postaurikularnih keloida.

Treatment of keloid remains a great challenge for clinicians, in spite of numerous therapeutic regimens reported in the literature to date. Earlobe or postauricular regions are predominant locations for postoperative keloids due to the treatment of lop ears. There are several treatments that include intralesional steroid injections, surgical excision, cryotherapy, laser therapy, radiotherapy and pharmacotherapy. A case is presented with fourth recurrence of keloids after surgical treatment of lop ears with final satisfactory outcome after combined therapy that included surgical excision, skin flap transposition and radiotherapy. It is concluded that interdisciplinary approach that includes a combination of surgery and radiotherapy results in a satisfactory outcome of keloid treatment.

[Importance of medical treatment in second echelon during war in Croatia, example--war surgical hospital in Garesnica]. / Znacenje bolnica II. Esalona u sanitetskom zbrinjavanju u domovinskom ratu na primjeru ratne kirurske bolnice u garesnici.

At beginning of 1991, the increasing necessity of emergency surgical treatment of wounded persons in Croatia led to the formation of mobile surgical teams. However, this system was abandoned due to many problems and echelon health division was formed. One of the war surgical hospitals (second echelon) was the War Surgical Hospital Garesnica. In this study, materials of the Croatian War Veterans Ministry, Ministry of Defense, Garesnica War Surgical Hospital and Garesnica Defense Office archive were used. We analyzed the number and localization of wounds, and describe the organization, work and results of the War Surgical Hospital in Garesnica. During the work of the War Surgical Hospital in Garesnica, 909 surgical examinations were performed, 521 wounded were surgically treated (45% civilians and 55% soldiers), 331 wounded were operated on, 5 lethal outcomes were recorded, 68% of wounds were localized on the extremities, 19% on the thorax and abdomen, and 13% on the head end neck. In this article the organization and work of the War Surgical Hospital in Garesnica is described, which had a major role in providing emergency medical care to people wounded in west Slavonia.