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Publikacije (18)

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Nenad Lalović, M. Mališ, M. Korica, Radovan Cvijanović, Milan Simatović, M. Ilić

AIM To determine the pattern of origin of medial circumflex femoral artery (MCFA), its origin distance from the midpoint of the inguinal ligament and the topographical relations of the origin, which have great significance in clinical work. METHODS Dissections on the autopsy group of 42 thighs were performed, and anatomical relationships of MCFA was analyzed. All data were entered into a scheme of the protocol which was designed for this research containing the case number, age and sex, side, topographical-anatomical relations of MCFA, artery dimensions and variations, and the distance between the place of origin of MCFA and the midpoint of the inguinal ligament. RESULTS Commonly, in 25 (59.5%) limbs MCFA originated from the deep femoral artery. In 14 (33.3%) limbs MCFA arose from the femoral artery (FA), in one case (2.4%) a common source of deep femoral artery (DFA) and MCFA was identified, and in two limbs MCFA was not noticed. The distance between the level of origin of MCFA and the central point of the inguinal ligament was 44.2 mm, in average, when it was emerging from FA, and 57.9 mm, in average, in cases where MCFA originated from DFA. CONCLUSION Surgeons and radiologists should be familiar with the variations of clinically important MCFA, which is commonly involved in peripheral occlusive arterial diseases, to improve effectiveness of diagnosis and treatment of various pathological conditions in the femoral region.

Nenad Lalović, Nikolina Dukić Vladicić, R. Marić, M. Čuk, Milan Simatović, D. Jokanović

INTRODUCTION Acute bleeding from the upper gastrointestinal system is a medical emergency which is followed by high mortality rate, ranging from 6 to 15% in spite of modern diagnostic methods and treatment. Bleeding from the upper gastrointestinal system may be caused by gastrointestinal stromal tumors of the stomach, which are mainly characterized by occult bleeding, while profuse bleeding rarely occurs accompanied by hemorrhagic shock. Gastrointestinal stromal tumors of stomach are the most common mesenchimal tumors of the gastrointestinal tract. CASE REPORT In our study we showed a 60-year-old female patient with profuse bleeding from the stomach and the clinical picture of severe hemorrhagic shock, caused by gastrointestinal stromal tumor. An ovoid junction, raised towards the lumen, covered with ulcerated mucosa in several places and followed by massive arterial bleeding was found intraoperatively, after the performed gastrotomy. Histopathological examination with immunohistochemical analysis confirmed that this was a gastrointestinal stromal tumor of the stomach. DISCUSSION Acute bleeding from the digestive system is a sudden and serious condition of the body. Urgent esophagogastroduodenoscopy is a sensitive and specific diagnostic and therapeutic method of choice. Massive bleeding from the upper gastrointestinal tract is very rarely caused by gastrointestinal stromal tumors, whose clinical picture is very heterogeneous and depends on tumor size and location. Abundant bleeding from the tumor is an indication for urgent surgical intervention. CONCLUSION According to the literature massive hemorrhage of the upper digestive system can rarely be caused by gastrointestinal stromal tumor of the stomach. It is shown that abundant hemorrhage of the upper digestive tract can be caused with gastric gastrointestinal stromal tumor. Surgical resection is the main form of treatment of gastrointestinal stromal tumors of the digestive system and bleeding from these tumors caused by failure of endoscopic hemostasis.

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