Background: Blood vessels injury is one of the most
common causes of medical emergencies that admitted to
hospitals and at the same time it regarded as one of the
most important causes of death. They may represent less
than 15% of all injuries; they deserve special attention
because of their severe complications.
Objective: The aim of the present study is to assess
anatomically the injures of major arteries and veins in the
lower limb with their management.
Methods: The present study extended from April 2006 to
February 2007, in which 65 patients with lower limb
vascular injury were examined in Emergency Department
and Forensic Medicine Department of Tikrit Teaching
Hospital in Salah-Aldin governorate. Diagnosis was made
by clinical diagnosis alone, or in combination with
angiography. Some surgical interferences as vascular
repair was carried out, but if not possible the interposition
graft was used by great saphenous vein for vascular
reconstruction.
Results: The total cases were 65 patients (49 males and 16
females), ranging from 16 years to 67 years with a mean
age of 41.5±6.4 years. Penetrating trauma was the main
cause of injury for 52 patients. Seventeen cases had
bilateral limbs vascular injuries. Arterial injuries were most
common in the femoral arteries, followed by the tibial and
finally the popliteal arteries. Vascular repair were
performed in 16 cases, while in 11 cases great saphenous
vein interposition graft were done. There were 17 cases
associated with venous injury, of which 11 cases had
surgical vascular repair, and 6 had vein graft interposition.
There were concomitant femur fractures in 2 cases, fibula
fractured in 3, tibia fractured in 1 and the foot bones
fractured in 3.
Conclusion: Lower limb vascular injured patient should be
transferred to vascular surgery centers as soon as possible.
After first aid management, anticoagulant treatment may be
started post operatively to prevent the propagation of the
thrombosis. Early fasciotomy is done if there is any
suspicion of occurrence of compartment syndrome.
المقدمة
تتعامل الجهات الضريبية في مختلف دول العالم بأساليب عديدة لجباية الضرائب من المكلفين بغض النظر عن فئات وأصناف هؤلاء المكلفين،وفي العراق تم اعتماد العديد من الأساليب لجباية الضرائب على امتداد المدد الزمنية المتعاقبة،وكان لأسلوب التقدير الذاتي وهو أحد تلك الأساليب مجالاً للتطبيق خلال مدة زمنية معينة،حيث جرى تطبيق هذا الأسلوب على وحدات اقتصادية معينة، وبالرغم من المساوئ التي قد ترافق تطبيق
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