KLIPPEL-TRÉNAUNAY SYNDROME WITH BLEEDING PER RECTUM AS A MAJOR SURGICAL CONCERN.

ABSTRACT : This case of Klippel-Trénaunay syndrome (KTS) is being shared as a clinical experience for future reference regarding the presentation and management of bleeding per rectum in KTS. Bleeding per rectum is a potentially lethal complication due to the colorectal hemangiomas in rare cases of KTS. Decision making regarding the choice of treatment in these patients is subject to many variables and different methods of medical and surgical treatments have been attempted and published in the literature. We are sharing our experience of surgical treatment for bleeding per rectum in KTS with satisfactory early postoperative outcome.

Measurement of mixed venous oxygen saturation (svo2) in high risk cardiac surgery patient

Our study included 112 high risk patients undergoing cardiac surgery in our hospital. Their postoperative hemodynamic parameters were monitored in short intervals using a Swan-Ganz catheter. A ROC curve of SO2 was plotted based on the collected data to evaluate its prognostic performance for patient early postoperative outcome and probability of dying within 30 days after surgery. Results: The best cut-off SO2 value for predicting post-operative complications related to heart failure and the probability of dying within 30 days after surgery in high risk cardiac sugery patients was 55% with a sensitivity of 91.18% and specificity of 31.82%. No death was reported in this study. Conclusions: A SO2value < 55% at the time of admission to ICU indicates poor prognosis for high-risk cardiac surgery patients and more aggressive treatment is required accordingly. This finding is consistent with the results from several studies on patients undergoing surgery for coronary artery disease.