Microsurg~cal operations are costly and technologically demanding. We have therefore developed new conventional flap techniques using state-of-the-art knowledge of skin anatomy and circulation. The V-flap is a combination of the V-Y advancement flap and two Limberg flaps [2]. Sixty patients treated by the new flap technique have shown a low rate of complication. Even when used in difficult regions of the body or in very large defects, the V flap has proven to be very effective.It has been adopted as a standard flap technique in our hospital. The Berlin tulip flap is another very reliable flap. To form the tulip flap, the outer corners of a subcutaneous pedicle flap are curved backwards. When detached, they can be transposed to the healthy tissue on the contralateral side. This completely relieves the midzone, which then can be safely closed in the same manner as a V-Y flap. The Berlin tulip flap is particularly useful for covering trunk defects and managing sacral ulcers in paraplegics.
Splenic artery pseudoaneurysm is a rarely described condition and it is even more rarely considered as a complication of peptic disease. The most common etiologies are pancreatitis, both chronic and acute, and trauma. Diagnosis can be challenging, including ultrasonography, computed tomography scan and angiography, the latter being useful also for therapy (embolization). Given her history of bulimia nervosa and the stress related to hospitalization, our patient was particularly predisposed to peptic ulcer.
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