A case of avulsion injury to the renal pedicle caused by blunt trauma in a 22-year-old man is reported. Mild peritoneal irritation, microscopic hematuria, a nonsecreting left kidney on intravenous pyelography, and an intimal tear of the left renal artery were demonstrated on renal angiography and suggested an injury to the pedicle of the left kidney. Explorative laparotomy revealed minor lacerations of the ileal mesentery and an intimal tear of the renal artery with complete transection of the renal pelvis in its intrarenal portion. The combined vascular and ureteral injuries were repaired by the ex vivo "bench" technique. The kidney was reimplanted into the left iliac fossa. Intravenous pyelography performed one month postoperatively revealed an immediate secretion of the left kidney. One year later the patient was normotensive, with good function of the reimplanted kidney. This is the first reported application of the ex vivo "bench" technique and autotransplantation of the kidney to the iliac fossa in a trauma case.

Adult↗

PubMedDate not supplied

Surgical aspects of multifocal involvement of the gastrointestinal tract in progressive systemic sclerosis.

An operative approach to the problem of progressive systemic scleroderma, affecting both the esophagus and duodenum, is demonstrated in the case of a 38-year-old woman severely incapacitated by protracted vomiting. Nissen's fundoplication, antrectomy and Billroth II gastroenterostomy were performed. The need for a comprehensive balanced surgical therapeutic approach in patients suffering from scleroderma is emphasized.

Adult↗

PubMedDate not supplied

Partial splenectomy in staging laparotomy for Hodgkin's disease.

Partial splenectomy with resection of the lower third of the spleen was performed in three children as part of a standard staging laparotomy for Hodgkin's disease. The technique proved to be simple and safe with no post-operative complications. The ability to preserve splenic tissue and to prevent post-splenectomy sepsis in children is weighed against the probably low risk of missing solitary splenic lesions with partial splenectomy. This procedure should play a major role in the surgery of various splenic disorders in children, including Hodgkin's disease.

Child↗

PubMedDate not supplied

Early experience with balloon catheter angioplasty.

Percutaneous transluminal angioplasty with the Gruntzig balloon catheter was undertaken in 12 patients with chronic lower limb ischemia. As judged by postdilatation angiography, the procedure was successful in 11 patients (91.6%). Nine patients were either free of symptoms or very significantly improved at follow-up, one to five months after angioplasty. Indications for angioplasty and the technique are described and discussed.

Adult↗