Penetrating intracranial trauma of two minors treated with endovascular technique with the use of temporary balloon occlusion for proximal arterial control.

We present two children treated with endovascular techniques to gain proximal arterial control of the internal carotid and vertebral artery prior to removal of penetrating objects from the skull base. Both siblings (8-month-old and 22-month-old boys) were injured by different sharp objects (knife and scissor) by a guardian. They were transported to the emergency room where vascular control, including coil embolisation and internal carotid balloon occlusion, was performed in the neuroendovascular suite for safe removal of penetrating objects.

Duration of spinal anesthesia in infants less than one year of age. Comparison of three hyperbaric techniques.

Background And Objectives: Although numerous reports of the use of spinal anesthesia have appeared in recent literature, little information is available on the duration of anesthesia provided by standard doses of the commonly used drugs: lidocaine with epinephrine, tetracaine, or tetracaine with epinephrine. The authors evaluated the duration of spinal anesthesia using standard doses of local anesthetics and an objective endpoint of motor recovery in infants less than 1 year of age.

Methods: After reviewing historic literature to select doses, the duration of hyperbaric spinal anesthesia in 100 infants from 1-month to 12-months of age undergoing surgery below the diaphragm was evaluated.

An inexpensive and effective retractor for transanal surgery.

An extremely effective retractor for use in transanal surgery can be produced by removing the polyethylene bag from a standard colostomy appliance and cutting notches in the outer circumference. The resultant pliable ring serves as a frame to which heavy silk sutures can be attached after placement tangentially at the dentate line. This creates a retractor that conforms to the contour of the buttocks, frees the hands of the assistants, and definitively marks the dentate line.

Anal lesions. When to suspect carcinoma.

Anal carcinoma appears in a variety of forms and may be easily confused with a benign disorder. Diagnosis must be confirmed by biopsy. All anal lesions require careful evaluation and follow-up to ensure resolution of benign disease or proper treatment of malignancy.

Obstructing left-sided colon carcinoma. Appraisal of surgical options.

This study is a retrospective analysis over a 10-year period of 37 patients who presented with a large bowel obstruction secondary to a left-sided colon cancer. Our patients were confined to those with clinical evidence of acute obstruction with lesions located from the mid-transverse colon to the rectum. Thirty-eight per cent of these lesions occurred at the sigmoid level.