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An aneurysm has been defined as a permanent local dilatation of the diameter of an artery by at least 50% of its normal value. A splenic artery aneurysm is most frequently a visceral artery aneurysm and clinically it is usually asymptomatic but potentially life-threatening at the same time, with the incidence of its rupturing being 2-10% and then the mortality rate ranges from 20 to 36%. A 51-year-old female patient was admitted to the Department of Vascular and Transplantation Surgery in Novi Sad having been found to have a big splenic artery aneurysm during the ultrasound examination of her abdomen after cholecystectomy. The additional diagnostic procedure--computerized tomography of the abdomen with i.v. contrast subtraction angiography--confirmed the splenic artery aneurysm to have the diameter of 5 cm and therefore the elective surgical treatment was indicated after the preoperative preparation and risk assessment. The aneurysm was exposed through Chevron incision, and the detailed surgical exploration was done after the omental bursa had been opened. The aneurysmectomy and the reconstruction of the splenic artery by the termino-terminal anastomosis were performed after the weakening of the wall had been verified. The biopsies of the liver and the aneurysmal sac were done during the surgery. The pathohistological finding confirmed the atherosclerotic etiology of the aneurysm. Since the postoperative course was normal, the patient was discharged on the eighth postoperative day.

Introduction: True aneurysms of the extracranial internal carotid artery are rare lesions. Surgical treatment is considered to be the best therapeutic option. However, the use of the intraluminal shunt remains controversial., Case Report: We reported a case of a giant extracranial internal carotid artery aneurysm treated by reconstructive surgery. A 76-year-old woman was referred with a pulsatile mass inside her mouth, associated with dizziness and dysarthria. There was no history of cerebrovascular symptoms, neck pain, or cervical trauma. A magnetic resonance scan showed a 45 mm aneurysm of the internal carotid artery (ICA), and kinking of ICA. Angiography demonstrated a saccular ICA aneurysm, with a lengthening and tortuosity of the ICA. The aneurysm and the carotid artery branches were easily exposed through a standard anterior cervical incision. After resection of the aneurysm, a Javid shunt was inserted between the common and internal carotid arteries, and end-to-end repair of ICA was easily performed due to ICA redundancy. The aneurysm was of atherosclerotic origin. Four months after the operation, the patient showed a complete recovery from peripheral neurological deficit., Discussion: Our results show that surgical reconstruction is a satisfactory therapeutic choice in the management of extracranial carotid artery aneurysms in order to avoid rupture, thromboembolism and cerebrovascular insufficiency. To date, there has been little experience with endoluminal exclusion techniques and the long-term effectiveness is still uncertain.

Aortoenteric fistula represents a communication between aortic and duodenal lumen. It is a very rare complication of aortic aneurysmal disease as well as aortic prosthetic surgery. There are only few surgeons who have seen more than one case of aortoenteric fistula. At the Institute of Surgery one case of aortoenteric fistula was treated. It was well diagnosed at the Institute for Internal Medicine, and then presented to the vascular surgeon who operated immediately. The whole diagnostic and therapeutic procedure was well done, but stenosing carcinoma of ascendent colon was found during the operation. Resection were done leading to the dehiscence of bowel anastomosis and fatal outcome for the patient. This case is instructive in a diagnostic and surgical manner.

This paper analyzes results of 5-year surgical treatment of patients with ruptured abdominal aorta aneurysms (1991.-1995.) at the Clinic for Vascular and Transplantation Surgery of the Institute of Surgery in Novi Sad. 105 patients with abdominal aorta aneurysm underwent surgery, whereas in 31 patients there was a suspicion of rupture and it was confirmed by US and CT examination. One of basic factors to decrease mortality in these patients is early diagnosis and surgery before hemorrhagic shock occurs. Results in hemodynamic stabile patients with blood pressure over 100 mmHg and regular diuresis are much better with mortality of 20%. In order to estimate the correlation of hemodynamic state and outcome of the operation, patients were divided into three groups--hemodynamic stable with blood pressure over 100 mmHg and regular diuresis at admission: hemodynamic unstable patients with signs of mild or moderate shock and blood pressure under 100 mmHg and without initial diuresis which was regulated at the beginning of therapy and hemodynamic unstable patients in severe shock and unmeasurable blood pressure. The highest survival rate (10% mortality) and the least complications occurred in the first group of patients. The total mortality of patients after surgery was 48.48%. Timely diagnosis, suspicion of rupture and adequate first and with urgent transfer to a competent surgical institution are key factors in treatment of this disease and its outcome.

From 1988 to 1993 thirty liver resections were performed in thirty patients. Eight were operated for suffering from hepatocellular carcinoma, four from metastasis of colon's adenocarcinoma, five for great hemangiomas and the rest for focal liver changes. Right lobectomy was performed in six cases, as well as two trisegmentectomies and two left lobectomies while segmentectomies in the rest. Periopretive mortality occurred in two cases as two patients died because of postoperative thrombosis of vena portae and massive gastrointestinal bleeding. Recidive of malignant tumors was established in five patients after year and in other five till the second year. Benign tumors are without recidives. Later resection is a safe procedure with a considerable selection of patients, with use of latest technical conveniences, application of grafts on branches of vena portae and with routine application of intraoperative ultrasonography. The paper contains diagnostical postulates, surgical techniques and anatomic and morphologic types of resection.

We reviewed a complex nuclear medical method's application for investigating venous circulation of lower extremities--radionuclide venography (RVG) in explaining a case of suspective ileofemoral thrombosis. Suffering from pain and swelling of the right leg, patient T.J. wanted a checkup. After the physical examination, vascular surgeon suspected phlebothrombosis of the right ileofemoral region and immediately sent her to have a radionuclide venography (RVG) (because by Doppler-ultrasonography certain data confirming presence of thrombus in the pelvic region couldn't be gained). On the basis of gathered results vascular surgeon can make a final diagnosis (phlebothrombosis of the right vein femoralis), so that in this case flebography was not necessary. Although performing RVG is complex and requires engagement of experts of different profiles, gathered data are valuable because they cover the shortage of existing diagnostic methods which are most often used in routine work (Doppler-ultrasonography and phlebography). Applying RVG phlebography can be avoided in all patients who are not expected to have operative treatment, and in cases where thrombosis is suspected in deep veins of pelvis, RVG can be performed right away, without Doppler ultrasonography.

Hatha Yoga's effects on the posture of 15 ten year-old children and also its effects on the psychophysical condition of 15 grown-ups was studied. As symptoms, during the first examination, 12 of the 15 children had head protrusion, 14 had shortened back extensors, all 15 had bent shoulders, relaxation of the frontal abdominal wall and shortened flexors of both the calf and thigh. The condition of all the children was remarkably better after six months of practice, some of the symptoms having completely disappeared (head protrusion, asymmetry of the shoulders, mamillas and hips, shortening of the pectoralis and back extensors), 9 children still had slight to medium relaxation of the frontal abdominal wall, 8 children still had bent shoulders, and 1 child still had shortened calf and thigh extensors. The adults were in a weak or very weak psychophysical condition, they tired easily, they complained of sleep disturbances, fluctuation of emotional state and irritability. After 3 months of practice, the vital capacity of 8 of the adults tested (53.3%) had increased by 435 ml. The time duration of apnoea had lengthened for all of the practicing adults, but with a truly large variation among them (a median of 14%). The deep waist-bend length of all the practicing adults had lengthened by an average of 9.5 cm, and the average length increase for the 3-minute running test was 42 m. All those who practiced, had experienced an alleviation of psychic difficulties.