Traumatic injuries to the mesenteric vessels are rare and often lethal. Visceral vessels, such as the superior mesenteric artery (SMA) and vein (SMV), supply blood to the small and large bowel by a rich system of collaterals. Because fewer than 100 such injuries have been described in the literature, they pose challenges in both diagnosis and management and can unfortunately result in high mortality rates. Prompt diagnosis, surgical intervention, and resuscitation can lead to improved outcomes. Here, we review the literature surrounding traumatic injuries of the SMA/SMV and discuss management strategies.
Visceral vascular injuries are relatively uncommon even in busy urban trauma centers. The inferior vena cava (IVC) is the most frequently injured visceral vein and can be a complex operative challenge. Despite advances in early volume resuscitation, improved transport times, prompt operative intervention, and hemorrhage control, mortality rates have remained largely unchanged. This article conducts an in-depth review of the literature surrounding IVC injuries and a detailed discussion of operative strategies and management as survivability is ultimately dependent on the grade of injury, location, and the presence of hemorrhagic shock.
ChemInform Abstract With Fe complex (III) as electron acceptor the methyl Re complex (I) combined with (II) at -78 rc C reacts on warming to give (IV) and (V) and methane (VI); (IV) disproportionates to ethylene complex (VII) from which ethylene (X) may be liberated by nitrile (VIII). The reaction is studied as well with CH3CN instead of (II) and the mechanism is probed by electrochemical techniques. So the derivative cyclic voltammetry response for the oxidation of (I) in CH3CN/Bu4N+PF6-at a voltage sweep rate of 100 V/s indicates a quasi-reversible charge transfer to produce a relatively long-lived cation radical (I)•+ (rate of its disappearance measured from -24 to 20 rc C).
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