[Primary spontaneous hematoma of the mesosigmoid].
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This article describes the gastric bypass as performed by the author and his associate since 1979. The Roux-en-Y gastric bypass by this technique has been used in more than 1000 patients. The author uses the additional 3-0 prolene suture on the gastrojejunostomy, but his associate does not. Additionally the author has discontinued the nasogastric tube in the postoperative period, whereas his associate uses it for 24 hours postoperatively.
The common methods used to stabilize a loop colostomy can be fraught with patient dissatisfaction. Presented is an effective and convenient means of securing a loop colostomy by use of a skin bridge fixed by a single heavy suture.
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Transmesocolic omentoplasty is a simple technique for covering prosthetic aortic grafts and preventing aortoenteric fistulas. It is especially valuable in repeat aortic procedures when mobilization of periaortic tissues and graft coverage may be impossible.
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The subserous layer of the colon has, like the small intestine, a rich vascular network. The subserous arteries arise from the straight arteries and are directed towards the taeniae, the surface and free margin of the colon. They terminate at various levels and, by their collateral and terminal branches, form an anastomotic network of vessels whose morphology varies at the level of surface, taenia and the free margin of the colon. From this subserous arterial network arise branches destined to vascularise the muscularis, the fat of the colon and the greater omentum. The subserous venous network copies closely the morphology of the arterial network and is connected by large perforating veins to the submucous venous network.
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The first anlages of the mesenteric lymph nodes in the human transverse and sygmoid colons have been stated by means of common histological methods to appear on the 14th week of the intrauterine development. The lymph node anlages in the colon mesentery are appearing during the whole period of embryogenesis. The lymph nodes are formed as a result of condensation of mesenchymal cells near the external surface of the dilated lymph vessel wall or between two or several vessels.
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Between May 1975 and December 1991, a total of 208 patients were operated upon for severe acute necrotic pancreatitis. The decision whether to operate on patients with clinical and biologic aggravation despite particularly sustained intensive care was taken after evaluation of ultrasound and CT scan images. Combining pancreatic body resections and necrotic tissue excision with laparostomy and staged lavage drainage reduced global mortality rate from 49.2 to 16.4 p. cent. The criteria used for determining the indication for surgical intervention, and the technical and tactical operative procedures applied allowing this improvement, are described and discussed.