Maciej Stryga and Piotr Szopiński
Eliza Pleban and Piotr Szopiński
Extracranial Carotid Aneurysms
Piotr Szopiński, Mateusz Terlecki and Eliza Pleban
Endovascular Treatment of Upper Gastrointestinal Bleeding Detected with the Use of CT Angiography
The authors present a case of a patient with a history of open repair of abdominal aortic aneurysm with a tube graft three years previously presenting with gastrointestinal bleeding as a sign of aortoduodenal fistula. The diagnosis of the fistula was established on the basis of computed tomography angiography, with no source of bleeding found in endoscopy. Endovascular treatment was undertaken due to high operative risk (ASA class IV). A tube stentgraft was implanted covering both anastomoses of the previously implanted prosthesis. In 2-year observation no recurrent gastrointestinal bleeding was noticed.
Maciej Stryga, Marcin Janas and Piotr Szopiński
Melanoma Metastases to the Small Intestine Mesentery, Greater Omentum and Parietal Peritoneum - Case Report
We present a case of 58-year old female patient that underwent surgery at Department of General and Vascular Surgery, Voivodeship Hospital of Traumatic Surgery in Warsaw for abdominal pain and nausea and palpable mass located in the left mesogastric region. During the surgical procedure, numerous, large nodules of the small intestine mesentery and the greater omentum were found. Histopathological examination demonstrated that they were melanoma metastases. When we confronted the reported case with available literature, we found only few similar reports.
Piotr Szopiński, Maciej Stryga and Mateusz Terlecki
Hybrid Operation of Posttraumatic Dissecting Aneurysm of Descending Aorta - Case Report
A case is presented of a 48-year old patient, hospitalized in 1st Clinic of General and Vascular Surgery, 2nd Medical Faculty, Warsaw Medical University. The patient underwent successful hybrid treatment for a dissecting aneurysm of the descending aorta. The dissection was repaired using a bimodular stent-graft Zenith TX-2 Zenith, Cook, covering origins of the left subclavian artery and left common carotid artery. Blood flow in the neck was restored using non-anatomical anastomoses: the left common carotid artery was connected with the right common carotid artery and left subclavian artery.
Bartłomiej Noszczyk, Joanna Jutkiewicz, Józef Jethon, Mirosław Wróbel and Piotr Szopiński
Results of Surgical and Postoperative Treatment of Syndactyly in Epidermolysis Bullosa
Use of small autologous skin grafts or leaving the defects and waiting for their spontaneous reepidermization are one of the methods of wound management after surgical treatment of hand contractures in Epidermolysis bullosa. This techniques are believed to allow quick wound healing, however this does not seem universally possible.
The aim of the study was to assess healing rate and incidence of early recurrence after using of both techniques.
Material and methods. Eleven operations of hand contracture were performed, including two recurrent cases after previous surgeries. Skin grafts were used in eight cases. Kirshner wires were not used and the fingers were stabilized in an extended position only with a supportive dressing. In the early postoperative period, dressings were made in the operation room and patients were admitted for 24-hour hospitalizations no more than once a week.
Results. Complete healing before day 35 was achieved only in five cases. In the remaining cases, dressings in the operating room were abandoned between day 35 and 40 and the patients were referred to further treatment in the outpatient setting. Outpatient dressings were done without anesthesia which in the event of unhealed spaces between the fingers, seemed to impair their separation and facilitate early recurrences of syndactyly. Two cases of early recurrence (18%), during the first year after the operation, were noted in one patient
Conclusions. Our results indicate that the postoperative wound healing does not depend on the use of skin grafts and can be much longer than some previous studies suggested. This shortens the period of full efficiency between the recurrences. Clinical observations also indicate that this affects the risk of early recurrences. Despite that, their number is similar to the value considered good in the literature.
Eliza Pleban, Piotr Szopiński, Grzegorz Górski, Jacek Michalak, Bartłomiej Noszczyk and Piotr Ciostek
The Use of Liposomal Heparin Spray-Gel in the Treatment of Superficial Thrombophlebitis: A Multicenter Clinical Investigation Analysis
The aim of the study was to evaluate the efficacy and safety of liposomal heparin spray-gel in the treatment of superficial thrombophlebitis.
Material and methods. The presented study is an analysis of two clinical investigations performed during the period between March 1999 and May 2002, which evaluate the efficacy and safety of liposomal heparin spray-gel (Lipohep) in the treatment of superficial thrombophlebitis, as well as a comparison with results obtained following subcutaneous enoxaparin injections. The study group comprised 88 patients, including 43 on Lipohep treatment and 45 on low molecular weight heparin.
Results. Two patients withdrew from the investigation before the control visit. After seven days, therapy was stopped in the case of 16 Lipohep patients and 18 low molecular weight heparin patients. After 14 days, therapy was stopped in 21 and 25 patients, respectively. One low molecular weight heparin and five Lipohep patients did not finish the investigation. This was connected with a lack of clinical improvement and development of side-effects. A statistically significant reduction of pain and the appearance of erythema was observed in both patient groups during the initial seven days of treatment. One patient on low molecular weight heparin was diagnosed with superficial thrombophlebitis recurrence. Ten patients developed complications, with deep venous thrombosis being most significant (two patients were treated with Lipohep and one with enoxaparin). One patient on Lipohep treatment developed superficial thrombophlebitis of the upper extremity.
Conclusions. Liposomal heparin spray-gel is safe and effective in the treatment of local superficial thrombophlebitis symptoms. The initial results considering the use of Lipohep are promising and should be confirmed in a larger group of patients.