Ischemic injury to the spinal cord or lumbosacral plexus after aorto-iliac reconstruction

Article Abstract:

Arare but severe complication of aortoiliac reconstruction (vascular reconstruction of the major blood vessels of the lower trunk of the body) is paraplegia (paralysis of the lower portion of the body and both legs). This results from ischemic injury (tissue damage due to diminished blood supply) to the spinal cord or nerve roots of the lumbar plexus of the lower spine. This type of injury occurs most often following repair of a ruptured aortic aneurysm (localized thinning and breaking of the aorta wall), but may also occur after elective surgery. A review was undertaken of nine patients who developed ischemic injury to the spine following aortic reconstruction to identify possible causes of injury, and to describe patient symptoms. These patients represented an overall incidence of neurologic injury of 0.3 percent of all (3,320) aortoiliac reconstructions performed at one hospital over a nine-and-a-half-year period. The incidence following elective surgery was 0.1 percent, while after emergency surgery it was 1.4 percent. Eight of the nine patients received bifurcated grafts (forked grafts). Four patients had suffered hypotension (severe low blood pressure) during surgery. In four patients the neurologic deficit was noted immediately after the operation. Two patients (22 percent) died soon after surgery - one from heart attack, the other from septic shock. Long-term outcome was influenced by extent and type of neurologic injury. Patients with injury to the nerve roots of the lumbar plexus had better recovery than those with spinal cord injury. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Surgery, Postoperative complications, Aorta, Abdominal aneurysm, Abdominal aortic aneurysm, Nerves, Spinal, Spinal nerves

---

Abdominal injuries associated with the use of seatbelts

Article Abstract:

The 1977 adoption of a mandatory seatbelt law by the Canadian province of British Columbia provides an opportunity to study the effects of seatbelts on accident victims, particularly with regard to abdominal injuries. The medical records of 562 patients were examined, and documented seatbelt use was found in 126 cases. Thirty-six of these patients, who form the basis of this study, underwent laparotomy (surgical opening of the abdomen).These patients had a higher incidence (67 percent) of injuries to the stomach and intestines when compared with previous blunt abdominal injury figures. Nineteen percent of the patients also had injuries to the lower back. The risk of spinal injury was greater for individuals wearing only a lap belt than for those wearing a lap-and-shoulder-harness combination. Trauma center physicians should be aware of the types of injuries specifically associated with seatbelt use.

Automobiles, Traffic accidents, Seat belts, Abdominal injuries

---

Diagnostic laparoscopy

Article Abstract:

The effectiveness of inserting a flexible viewing tube into the abdomen (laparoscopy) for diagnosing problems of the internal organs was evaluated. In thirty-one patients with acute abdominal pain, diagnosis was confirmed by laparoscopy in 90 percent of cases and opening the abdominal cavity (laparotomy) was avoided in 55 percent. Assignment of chronic abdominal pain with laparoscopy yielded a diagnosis in 82 of the patients, avoiding laparotomy in 64 percent. In 11 patients with abdominal trauma, diagnostic accuracy was 91 percent with laparoscopy; further surgery was not required in 54 percent. In 21 patients with cancer within the abdomen, 67 percent were diagnosed and additional surgery was avoided in 38 percent. Laparoscopy is shown to be a valuable diagnostic aid in abdominal surgery.

Testing, Laparoscopy, Endoscopy, Diagnosis, Surgical, Surgical diagnosis

Similar abstracts:

• Abstracts: Win with team safety. Build a safer construction site
• Abstracts: Local gentamicin application for perineal wound healing following abdominoperineal rectum excision. Synchronous carcinoma of the colon and rectum: prognostic and therapeutic implications
• Abstracts: Multivariate analysis of recurrence after anterior resection for colorectal carcinoma
• Abstracts: Squamous carcinoma of the nasal cavity and paranasal sinuses
• Abstracts: Function and quality of life results after ileal pouch surgery for chronic ulcerative colitis and familial polyposis

This website is not affiliated with document authors or copyright owners. This page is provided for informational purposes only. Unintentional errors are possible.