Browsing by Author "Maricic, Bojana (57907785500)"

Amyand's hernia is a condition where the vermiform appendix is contained within an inguinal hernia sac. An inguinal hernia with an appendix in the hernia sac is extremely rare and almost exclusively occurs on the right side. The mechanism of developing appendicitis with hernia is most likely the compression of the appendix at the level of the neck of the sac or due to impaired vascular supply leading to infection. Despite technological advances in radiology modalities, the preoperative diagnosis of and hernia is challenging: the role of abdominal ultrasound and computed tomography is very important and is essential in planning surgical management and approaches. In our case, we made a rare preoperative diagnosis of Amyand's hernia using ultrasound showing a typical appearance only without wall hyperemia probably due to vascular compression of the inguinal ring, which was confirmed by CT. CT is more sensitive to the detection of radiological signs of appendiceal inflammation and perforation in the hernia sac and is most often used in the case of an inconclusive ultrasound findings. Due to the prompt radiological diagnosis of acute appendicitis in the hernia sac provided by ultrasound, our patient underwent laparoscopic appendectomy. © 2024 Australasian Sonographers Association.

Background: Spontaneous retroperitoneal hematoma is a severe and potentially fatal complication that appears in the course of anticoagulation therapy. Therapeutic doses of low molecular weight heparin (LMWH) are used for the prevention of thrombosis in patients seriously ill with Covid-19. Methods: We describe 27 (0.14%) patients with retroperitoneal hematomas who required emergency surgery out of 19108 patients with Covid-19 who were hospitalized in Batajnica COVID Hospital between March 2021 and March 2022. All the patients were on therapeutic doses of LMWH. The existence of retroperitoneal hematoma was confirmed by abdominal ultrasound and computed tomography scans. Result: Open surgery was performed on 27 patients with spontaneous retroperitoneal hematomas (12 female and 15 male). The mean age of the study population was 71.6±11.9 years. D-dimer was significantly elevated two days before the surgery in comparison with the values on the day of surgery (p=0.011). Six patients (22.23%) survived, while 21 (77.77%) patients died. Conclusion: Bleeding in Covid-19 patients treated by LMWH is associated with an increased risk of developing retroperitoneal hematoma. Open surgery for retroperitoneal hematoma in Covid-19 patients on anticoagulation therapy is a procedure associated with a high rate of mortality. © Celsius.