ABSTRACT
Vertebral hemangiomas are relatively common, but those causing spinal cord compression are rare. A 19-year-old male presented with thoracic back pain. The neurologic examination was normal and radiological examinations demonstrated an aggressive vertebral hemangioma centered within the T11 vertebral body. Damaged vertebral bone and soft tissue components of the mass were observed in the epidural space. Surgery was performed using a new technique involving radiofrequency ablation, injection of a hemostatic agent (FLOSEAL, Baxter, USA), and bone autograft placement in the affected vertebral body. There were no complications intra- or postoperatively, and the patient's back pain resolved completely during the postsurgical period. Bleeding is a serious issue in cases of aggressive vertebral hemangioma. This new technique provides improved bleeding control and strengthens the affected vertebra through autograft placement.
Subject(s)
Decompression, Surgical/methods , Hemangioma/surgery , Radiofrequency Ablation/methods , Spinal Neoplasms/surgery , Thoracic Vertebrae/surgery , Vertebroplasty/methods , Back Pain/etiology , Bone Screws , Bone Transplantation , Gelatin Sponge, Absorbable , Hemangioma/complications , Hemangioma/diagnostic imaging , Hemostasis, Surgical/methods , Humans , Laminectomy , Magnetic Resonance Imaging , Male , Radiography, Interventional , Spinal Cord Compression/etiology , Spinal Cord Compression/surgery , Spinal Neoplasms/complications , Spinal Neoplasms/diagnostic imaging , Thoracic Vertebrae/diagnostic imaging , Transplantation, Autologous , Young AdultABSTRACT
BACKGROUND: Splenic involvement secondary to blunt abdominal trauma is often treated by performing a splenectomy. The severity of the post-splenectomy syndrome is currently well known (blood loss, sepsis), so there is an increasing tendency to preserve the spleen. The case is presented of splenic preservation after blunt abdominal trauma with hilum involvement, emphasising the role of Floseal as a haemostatic agent, as well as the use of resorbable meshes to preserve the spleen. CLINICAL CASE: A 22-year-old woman presenting with a grade IV splenic lesion secondary to a blunt abdominal trauma after a traffic accident. Partial splenic resection was performed and bleeding was controlled with Floseal and use of a reinforcing polyglycolic acid mesh. No postoperative complications occurred, being discharged on day 5. The long-term follow-up has been uneventful. CONCLUSION: The use of haemostatic agents such as thrombin and the gelatine gel (FloSeal) and the use of polyglycolic acid meshes enable spleen-preserving surgery, making it a feasible and reproducible procedure and an alternative to classical splenectomy.
Subject(s)
Abdominal Injuries/surgery , Organ Sparing Treatments/methods , Spleen/surgery , Splenectomy/methods , Wounds, Nonpenetrating/surgery , Accidents, Traffic , Electrocoagulation , Emergencies , Female , Gelatin Sponge, Absorbable , Hemorrhage/etiology , Hemorrhage/surgery , Hemostasis, Surgical , Hemostatic Techniques , Humans , Lacerations/surgery , Polyglycolic Acid , Spleen/injuries , Surgical Mesh , Young AdultABSTRACT
Neste artigo, o autor propõe o uso na cirurgia BucoMaxiloFacialde um novo agente hemostático,o qual é amplamente empregado nas cirurgiasvasculares de órgãos internos, tais como cardiovascular,pulmonar, hepática e renal. É oferecidade forma imparcial uma opinião sobre o produtoquando aplicado na mentoplastia óssea.
In this article, the author considers the applicationin Oral and Maxillofacial Surgery of a newhemostatic agent which is widely used for vascularsurgery of internal organs such as cardiovascular,pulmonary, hepatic, and kidney surgeries.An unbiased opinion about the product isoffered when it is utilized for bone genioplasty.
