Leg oedema and exertional dyspnea due to aortocaval fistula complicating an abdominal aortic aneurysm.

Aortocaval fistula (ACF) represents a rare complication of abdominal aortic aneurysm (AAA) that may lead to hyperdynamic heart failure. We briefly describe a 58-year-old man with an old myocardial infarction, who developed leg oedema and worsening exertional dyspnea due to ACF complicating an AAA. This uncommon case highlights that an appropriate investigation for AAA and ACF should be performed in high-risk patients presenting with a history of worsening leg oedema and dyspnea in the absence of an obvious precipitating factor.

Ultrasonically activated shears in extended lymphadenectomy for gastric cancer.

Gastrectomy, followed by extended lymphadenectomy, is the treatment of choice in some stages of advanced gastric cancer. Lymphorrhea, as a result of the many divided lymphatic vessels, increases the morbidity. Ultrasonically activated coagulated shears (UACS) may divide all small vessels followed by immediate sealing of the coapted vessel walls.