Chylothorax as a rare complication of acute pancreatitis in a 25-year-old woman after cesarean section.

The paper presents the case of a 25-year-old woman who underwent cesarean section for gynecological indications in the 37(th) week of her second pregnancy. The perioperative course was uncomplicated, but one day later the general condition of the patient suddenly deteriorated: she developed respiratory disorders requiring intubation and treatment in an intensive care unit. On the 6(th) day after the surgery, the patient was diagnosed with acute pancreatitis. Appropriate conservative treatment was instituted, resulting in a gradual improvement of her condition. On the 13(th) postoperative day, a cardiac arrest in asystole occurred, with no response to the undertaken resuscitation procedures. An autopsy performed in the Department of Forensic Medicine in Lódz revealed, among other findings, acute pancreatitis with enzymatic necrosis of the adipose tissue, a significant accumulation of lymph in both pleural cavities, and pulmonary atelectasis. As demonstrated by the analysis of the case, chylothorax had most probably developed in the course of acute pancreatitis which was a complication of the cesarean section. Consequently, the prosecutor opened an investigation into the case under Article 155 of the Polish Penal Code to assess the appropriateness of medical management. The medico-legal opinion was issued by experts from outside the Department of Forensic Medicine in Lódz. In their view, the medical management of the patient was correct.

[Diagnosis of the upper thoracic outlet syndrome]. / Diagnostyka zespolu górnego otworu klatki piersiowej.

Basing on a review of literature and own experience the authors present the aetiology and various diagnostic methods of thoracic outlet syndrome (t.o.s.), especially electrodiagnostic and Doppler studies. Provocative tests like Wright, Adson or hyperabduction manouvers are discussed and their role in modern diagnosis of t.o.s. is presented.

[The effect of degenerative cervical spine lesions and blood flow velocity in vertebrobasilar system in Doppler measurement]. / Wplyw zmian zwyrodnieniowych odcinka szyjnego kregoslupa na predkosc przeplywu krwi badanego metoda dopplerowska w ukladzie tetniczym kregowo-podstawnym.

The purpose of the study was to establish the effect of degenerative lesions of cervical vertebrae on blood flow velocity in the vertebrobasilar system measured by means of Doppler phenomenon using Transpect--TCD device according to generally accepted principles. The study was carried out in 20 healthy controls and 40 individuals with these lesions (aged 16-60 years). It was found that blood flow velocity in this arterial system is highly variable individually. In patients with degenerative changes pathological reduction of this velocity was found in this system which is an unquestionable evidence of the influence of these lesions on blood flow in vertebral arteries.

[Administration of the cervical torsion test by the examination of Doppler's blood flows in vertebral arteries and basilar artery in patients with degenerative cervical spine changes]. / Zastosowanie testu skretu szyi przy badaniu predkosci przeplywu krwi metoda doplerowska w ukladzie tetnic kregowych i podstawnej u osób ze zmianami zwyrodnieniowymi odcinka szyjnego kregoslupa.

Using the neck rotation test during examination of Doppler's blood flows in vertebral arteries and basilar artery, the authors examined 60 subjects aged 16-60 years, including 20 healthy ones and 40 with cervical spondylarthrosis. The Transpect-TCD was used. Half the patients with cervical spine changes had also receptive hearing damage of low degree. The study demonstrated that neck rotation affected of patological Doppler's blood flows in one or in both vertebral arteries at 50% patients with cervical spondylarthrosis, but without clinical symptoms, and at 70% patients with cervical spondylarthrosis and clinical symptoms. The neck rotation test can have diagnostic significance by examination of sufficiency in vertebrobasilar system, or qualitative significance to microsurgical treatment.