RESUMO
From 1986-1992, more than 6250 patients were admitted to a Level I Trauma Center, with 175 patients requiring hepatorraphy. Eleven patients (6%) developed either a biloma (1), biliary fistula (2), or both (8 patients). Patients' ages ranged from 15-40 years with a mean Injury Severity Score of 23. Seven patients (64%) suffered penetrating injury and four (36%) were victims of blunt trauma. The right lobe was injured in 10 patients (91%), with one patient (9%) sustaining left lobe injury. All liver injuries were either grade 3 (seven patients, 64%) or grade 4 (four patients, 36%). No patient sustained extrahepatic biliary tract injury. Bilomas and fistulas were diagnosed 14-30 days post injury (mean 24 days) by CT and HIDA scans. All were managed by CT-guided percutaneous drainage. One patient also required percutaneous transhepatic cholangiography with biliary stent placement due to bile ascites. Fistulas persisted from 5-120 days (mean 44 days). No patient required further operative intervention and all fistulas closed spontaneously without complication.
Assuntos
Bile , Fístula Biliar/etiologia , Fígado/lesões , Complicações Pós-Operatórias , Ferimentos não Penetrantes/cirurgia , Ferimentos Penetrantes/cirurgia , Adolescente , Adulto , Fístula Biliar/terapia , Drenagem , Feminino , Humanos , Incidência , Escala de Gravidade do Ferimento , Masculino , Complicações Pós-Operatórias/terapiaRESUMO
Occurring rarely after aortic surgery, post-operative pancreatitis is often complicated and carries a high mortality rate. We have reported a case of pancreatic pseudocyst involving a polytef aortic prosthesis used to repair a ruptured abdominal aortic aneurysm. The pseudocyst was treated successfully by repeated percutaneous aspiration, and removal of the aortic prosthesis was not required. Although less successful than operative drainage, percutaneous approaches to pancreatic pseudocysts are an important option for patients who are poor surgical candidates.
Assuntos
Ruptura Aórtica/cirurgia , Cisto Pancreático/etiologia , Pseudocisto Pancreático/etiologia , Complicações Pós-Operatórias , Sucção/métodos , Aorta Abdominal , Prótese Vascular , Humanos , Masculino , Pessoa de Meia-Idade , Pseudocisto Pancreático/terapiaRESUMO
A mobile screen of plate glass for use in special procedures is described. The screen offers protection for the head and neck of physicians, allows for full visibility, is easily maneuvered, and attenuates at least 86% of incident photons.