Serious complications following gynecologic laparoscopy are rare. We report a case of a 24-year-old woman who had a common iliac artery and vein injured by the trocar, resulting in deep shock. The arterial lesion was repaired with an allograft and the vein sutured. The patient recovered with light sequelae. The literature was reviewed and we found 15 cases described in varying detail. In most cases the injury was caused by the pneumoperitoneum-needle and in only 2 by the trocar. Characteristically the terminal aorta and its major branches were injured. All the patients had a large retroperitoneal hematoma and only minimal free blood in the peritoneum. Signs of bleeding were nearly always acute. Most lesions could be treated by simple suture. Recovery is the rule, but 2 of the 15 died. Examiner's experience and correct technique are important to prevent this potentially lethal complication which is also probably underreported.
The aim of this study was to examine whether it was possible by a reaction time (RT) test to predict if a patient was to complain of sequelae after a cerebral concussion. 55 patients had an RT test performed 1-5 days after concussion. The test showed a significant (P less than 0.02) prolongated RT in patients having postconcussional sequelae (median 186 ms) after 1 month (27 patients, 49%) compared to the patients without sequelae (median 168 ms). Patients with sequelae after 3 months (12 patients, 22%) also had a prolongation of RT (median 183 ms) although non-significant. These results supports a structural organic etiology for postconcussional sequelae.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.