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Biomedical subjects

D Barić

Publications and source records attributed to D Barić.

At least 19 recordsLinked to original sources
PubMed1997

War injuries of the femoral artery and vein: a report on 67 cases.

During the war in Croatia (from May 1991 to December 1995), 67 patients with war injuries of the femoral vein and/or artery were treated at the Surgical Clinic of Split Clinical Hospital. All the wounded were admitted directly from the battlefield or from front-line hospitals. There were five women and 62 men with a median age of 29 (range 15-54) years. There were 70 arterial (28 isolated) and 49 venous injuries (six isolated). Forty-six arterial injuries were repaired by reverse vein graft. Four proximal profound femoral arteries were reconstructed. Major venous injuries were repaired, 11 by compilation autogenous vein graft. No synthetic grafts were used. Repair of veins with large defects using compilation saphenous vein grafts gave good results. Six profound femoral veins and two superficial femoral veins were ligated. Vein ligation should be avoided unless another life-threatening injury demands priority. Twenty-one patients required open prophylactic fasciotomy. Two patients died (3%) and three ultimately underwent amputation (5%). Intermittent hyperbaric oxygen therapy was given to 18 heavily wounded patients with beneficial effect. The results support an immediate and coordinated approach to femoral vascular trauma with repair of arterial and venous injuries.

Adolescent↗
PubMed1995

Advances in diagnostics and successful repair of proximal posttraumatic superior mesenteric arteriovenous fistula.

Posttraumatic arteriovenous fistulas affecting the superior mesenteric artery and vein are extremely rare. Twenty-four cases of posttraumatic superior mesenteric arteriovenous fistulas (SMAVFs) have been reported. We presented two cases of SMAVFs occurring in a young woman and man secondary to a gunshot and a grenade shrapnel wound in the epigastrium, respectively. Nausea, heartburn, emesis, and cramping abdominal pain were the clinical signs of SMAVF. Abdominal pains, particularly after meals, tense and meteoristic abdomen, frequent liquid bowel movements, oliguria, subfebrility, abdominal thrill, and bruit were also present. Abdominal duplex ultrasonic scanning and computed tomograms with a contrast agent were especially useful screening tools. As our results demonstrated, those methods were not only suitable for clinical use, but were also as good as arteriography in defining both the exact location and the extent of the mesenteric vessel involvement. However, the superior mesenteric arteriogram remains mandatory for complete preoperative evaluation. Arteriovenous fistulas were successfully treated by suturing the arterial and venous sides of the fistula in one case, and resectioning the fistula and end-to-end anastomosis in the other case.

Adult↗
PubMed1994

Military injuries to the popliteal vessels in Croatia.

OBJECTIVE: The paper reviews military popliteal vascular injuries in Croatia. SUMMARY BACKGROUND DATA: Popliteal vascular injuries still pose difficult problems for vascular surgeons despite improvements in resuscitation, surgical techniques and wound coverage. Popliteal vascular injuries, both arterial and venous, with a high incidence of associated musculoskeletal injuries are presented in patients with military injuries in South Croatia. METHODS: 26 wounded with popliteal vascular injuries are presented. Explosive injuries are found in 21 and associated fractures in 9 cases. In immediate repair group the time interval between trauma and surgery was 2 to 30 hours (average 9.8 hours). In the delayed repair group the interval between trauma and surgery was 11 days to 24 days. RESULTS: 21 out of 26 patients with popliteal vascular injuries had combined arterial and venous injuries; 4 patients had isolated popliteal arterial injuries, while 8 patients had other vascular injuries along with the popliteal ones; 8 amputations resulted (30.8%). CONCLUSION: Popliteal vascular injuries caused by typical military mechanism during the war in Croatia present large and extensive defects of tissues and bones, are often associated with other injuries and require more extensive surgical therapy. Evacuation of the wounded under very difficult conditions as well as considerable organization and transportation problems are characteristic for this war and greatly affect the success of vascular reconstruction. Hyperbaric oxygen therapy offers a safe noninvasive method of improving wound healing and decreasing edema formation in popliteal vascular injuries.

Adult↗
PubMed1990

[Splenorrhaphy and partial splenectomy as an alternative to splenectomy in trauma--overview].

For many year splenectomy was considered to be the only possible surgical treatment for all laceration of the spleen, whether resulting from abdominal contusion or not. Such factors have led to changes in practical attitudes to splenic lacerations but it would seem that indications for a conservative approach must be based upon the underlaying condition and the precise nature of the lesions. Splenectomy should be done promptly in cases of concomitant splenic and cerebral injury and in patients with injury of multiple organ systems. Present knowledge of the complications of anesplenia has led to new surgical techniques for conservation of splenic tissue. Splenorrhaphy was a frequently used treatment in the non-complicated traumatic lesions. The decision of whether or not to remove an injured spleen is one which must be made intraoperatively by the surgeon. Operative splenic repair and preservation of the spleen often requires considerable experience. We conclude that surgical splenic preservation is a viable and safe procedure, especially in infants and young children.

Humans↗
PubMed1989

[Retroperitoneal hematoma as a consequence of blunt abdominal injury].

In our examination we have used clinical material of 448 cases treated in our clinics for blunt abdominal trauma in period from 1976. to 1988. with special care on the group of 172 patients in who the retroperitoneal haematoma was founded. In the group of 172 patients we have examined the frequency on way to age, sex, and presence of the retroperitoneal haematoma in clinical picture of the blunt abdominal injury, and frequency of the retroperitoneal haematoma in abdominal injury connected with the injuries of the other organs.

Abdominal Injuries↗
PubMed1989

[Injuries of the pancreas].

At the Surgical Clinic of the University Hospital Center "Firule" Split in the period from 1977-1987. years were treated 12 patients with injuries of the pancreas. That is 4% of all abdominal injuries treated in those 11 years. We presented 10 patients after blunt abdominal trauma and 2 after penetrating injuries of abdomen associated with acute pancreatic injury. The most important is early recognizing injury of pancreas and making the time from moment of injury to surgical exploration shorter as much as possible. There is no early specific signs of injury of pancreas and the key to treatment is accurate evaluation of extent of injury.

Adult↗
PubMed1989

[Traumatic arteriovenous fistula].

Three cases of arteriovenous fistulae and one iatrogenic observed in recent years at the University of Split's Surgical Clinic, and of different site and aetiology, are presented. Their clinical signs, diagnosis and vascular surgical access are discussed.

Adult↗
PubMed1977

[Manifestation of echinococcosis in the chest cavity].

In the interim from 1970 to 1974, the authors had occasion to encounter several patients with symptoms of hydatid disease in the chest, particularly with pleural effusion not always easily differentiated from effusions other etiology. This pertains especially to hydatid disease of the liver with a perforation through the diaphragm and clinic and roentgen findings revealing only thoracic signs. All the clinical diagnosis in cases of patients who had undergone an operation, were confirmed by patho-anatomic findings.

Adolescent↗
PubMed1977

[Some interesting cases of pulmonary echinococcosis].

The authors had the opportunity in the interim of the past fifteen years to treat at the hospital in Zadar 277 patients suffering from hydatid disease of different body organs. The most frequently affected was the liver--56.3%, followed by the lungs--24.9% and 18.8% were other organs. Out of the 69 cases of affected lungs, the authors chose several which they considered to be most interesting. These consisted of: 1. A fistula between the cyst in the liver and the right lung. 2. A syndrome of the middle lung lobe caused by the hydatid cyst. 3. The Cumbo's symptom following a perforated lung cyst as a definite sign of hydatid cyst. 4. A hydatid cyst in a two years old child complicated with pneumothorax, peripnemocyst and perforation of the cyst itself in the bronchus. And finally 6. The case of a primary liver cyst which perforated in the vena cava caudalis with secondary dissemination in both lungs.

Adolescent↗