[Diagnostic possibilities of multilayer computer tomography in blunt abdominal trauma].

The purpose of our study was to determine MDCT diagnostic possibility in blunt abdominal trauma. Our work was based on MDCT results of 84 blunt abdominal trauma patients with stable hemodynamic status (28 (33.3%) female and 56 (66.6%) male). Age ranges from 17 up to 64 years. The CT scan showed obvious organ and system injuries in 82 poly-trauma patients. Injuries of craniocerebral region, also of facial bones, chest and spine were determined in two patients; in one of which, however, it was not possible to differentiate subcapsular spleen hematoma accurately because of left upper joint metallic holder artifacts. In second patient the liver injury was accurately diagnosed, but there were visualization problems caused by the massive retroperitoneal hematoma from right adrenal gland injury. The investigation showed that sensitivity of CT scan data was 98%, specificity-97% and accuracy rate-98%. All above mentioned clearly states the importance of MDCT in the emergency department. MDCT ensures precise diagnosis in maximally short period of time and thereby helps to choose proper treatment and decreases post-traumatic complications.

[The role and place of helical ct for preporative diagnosis of acute appendicitis].

The goal of our study was to ascertain the role and place of helical CT for preoperative diagnosis of acute appendicitis. Our study relied upon the results of helical CT scans of 60 patients, which were diagnosed probable acute appendicitis based upon clinical signs. Of these 60 patients 49 (81,6%) were female, 11 (18,4%) male. For all patients laboratory studies of blood were made, 31 patients were examined by ultrasonography. Among this group the diagnosis of acute appendicitis was verified by CT scan in 41 patients. In the case of 5 patients the scan was equivocal because of smaller amount of omentum; in this subgroup of 5 patients (5% overall) three were given radiocontrast dye, and two (3,3% overall) were not. In 11 (18,3%) cases the diagnosis of acute appendicitis was not verified, and in three cases the diagnosis was incorrect. According to data of our study and intraoperative data analysis, sensitivity of this method approaches 93% and the specificity - 92%, and overall diagnostic accuracy 93%. Helical CT may be stated as diagnostic method of choice in the diagnosis of acute appendicitis. It is helpful in clinical decision making, and reducing the amount of false appendectomies.

Endovascular treatment of stenosis of autogenous arteriovenous access for hemodialysis.

Retrospectively review of long-term outcome of balloon angioplasty (TBA) in the treatment of native dialysis A-V fistulae stenosis was conducted. From February 2008 to January 2009, seven hemodialysis patients (5 women and 2 men; mean age 46.4 years) were treated for stenosis of the A-V fistula at the venous outflow tract. Angioplasty was performed with the use of high-pressure balloons. Percutaneous transluminal angioplasty was used. There were no any complications during and after procedure. In 4 cases residual stenosis did not exceed 10% and in 3 cases 30%. After 3 month the improvement rate was 85%. Two patients required surgical treatment. None of the patients displayed any major complications from the procedure. This study confirms the efficacy of PTA in the treatment of vascular access stenosis. Elevated dialysis blood line pressure can be the first sign of fistula stenosis. Although our series is small, we have nevertheless demonstrated that the concerted efforts of nephrologists, interventional radiologists, and surgeons are the key to maintaining and prolonging vascular access survival in this group of patients.