Abstract: AIM: Aim of the study was to prove possibilities of laparoscopic diagnostics of an acute bowel ischemia when using fluorescein dye and the ultra-violet (UV) light. MATERIAL AND METHODS: There were five animals (domestic pigs) included into the experiment in the year 2005. The endoluminal embolization of the peripheral branch of superior mesenteric artery (SMA) was made. Optical filters were placed to laparoscopic set to produce UV light. Fluorescein was administered intravenously and bowel inspection and applying the clips on the border of ischemia visualized by fluorescein was performed. RESULTS: In all cases, the combination of laparoscopy, UV light and fluorescein dye distinguished ischemic part of bowel from the viable remnant. CONCLUSION: Combination of the UV light and fluorescein dye is able to reliable differentiate the viable segments of the bowel from the ischemic ones.
Abstract: Clostridial sepsis is a rare complication after intraabdominal operations, mostly fatal. According to our knowledge only two papers describing clostridial sepsis as postoperative complication in 4 patients were published in the Czech literature, only one of them survived. Authors present a case report of patient operated on for cholecystolithiasis and obstructive icterus where within 48 hours after cholecystectomy the clostridial sepsis and gas gangrene of the abdominal wall developed and that were successfuly managed.
Abstract: PURPOSE: The aim of this prospective randomized study was to investigate the necessity of suturing subcutaneous fat tissue in elective abdominal surgery. METHODS: 415 patients undergoing elective abdominal surgery were admitted to the trial. The patients were divided into two basic groups according to wound contamination: clean operations (n = 201) and clean-contaminated operation (n = 214). Subcutaneous suturing of the subcutaneous fat tissue was performed in half of the patients in each group, determined using the envelope method ('Suture Yes' or 'Suture No'). Wounds were checked on postoperative days 3, 7, 14, and 30. Infectious and non-infectious wound complications were charted in the records. Data were statistically analyzed. The percentages of complications in groups with and without subcutaneous suturing were statistically compared using Yates' corrected chi(2) two-tailed test. RESULTS: There were no statistically significant group differences in infectious and non-infectious wound complications. CONCLUSION: These results suggest that omission of subcutaneous fat tissue suturing does not increase the occurrence of infectious or non-infectious wound complications.
Abstract: Exogenous foreign particles in the appendix rarely case appendicitis. Their prevalence is reported to be 0.0005%. This fact makes both lay and medical community underestimate possible complications related to the presence of foreign particles in the appendix lumen. Our case review documents risks related with swallowing a sharp foreign particle. The particle concerned was a tooth root--on prosthesis with an acrylic crown, which caused acute appendicitis with the appendical wall perforation by the above mentioned foreign body.
