Preoperative bowel preparation with meglumine and sodium diatrizoate (Gastrografin): a prospective randomised comparison.

OBJECTIVE: To test the use of meglumine and sodium diatrizoate (Gastrografin) as an agent for preoperative mechanical bowel preparation. DESIGN: Prospective randomised comparison. SETTING: County general hospital, Greece. SUBJECTS: 58 patients listed for elective colorectal operations were randomly divided into 2 groups. The first (n = 30) was given Gastrografin 200 ml orally for 2 consecutive days before operation, and the second (n = 28) was given Ringer's solution through a nasogastric tube. MAIN OUTCOME MEASURES: Tolerability, acceptability, quality of cleansing, and complications. RESULTS: There were no disturbances in electrolyte concentrations, and other laboratory variables also remained unchanged. Two patients treated with Ringer's solution had appreciable increases in arterial blood pressure, but there were no significant overall changes. About half the patients given Ringer's felt nauseated and a third vomited. Such symptoms were uncommon in patients treated with Gastrografin (p < 0.01). 28/30 and 26/28 (93%) had a clean colonic lumen at operation, whereas in the reminder the lumen was evaluated as containing "slight residue". There were no operation-related complications. CONCLUSIONS: Gastrografin can be used successfully as an agent for mechanical bowel preparation before elective colorectal surgery, as it gives equally good cleansing results compared with the established method of whole gut irrigation. It also seems to be better tolerated and accepted by patients.

[Treatment of alkaline gastritis and recurrent ulcer following Roux-en-Y gastrectomy and construction of a Rumpf antireflux valve]. / Therapie der alkalischen Gastritis und des Rezidivulkus nach Roux-en-Y-Gastrektomie und Bildung eines Antirefluxventils nach Rumpf.

Two-third gastrectomy or supplementary gastrectomy was performed on 13 patients, between July 2, 1986 and September 30, 1988. Continuity of the gastro-intestinal tract was restored by end-to-side gastrojejunostomy according to Roux-en-Y. An antireflux valve according to Rumpf was inserted 15 cm below the gastroenteroanastomosis, and end-to-side jejunostomy was performed about six centimetres below the valve. This surgical method was applied to six patients for treatment for alkaline gastritis. The same method was used on another seven patients to prevent development of alkaline gastritis. All the 13 patients were males aged between 42 and 77 years. There were no postoperative problems in any of them. Follow-up checks were made 12 to 36 months after surgery and confirmed the effectiveness of this surgical approach for both healing and prevention of alkaline gastritis.

[Perforation of the urinary bladder with retroperitoneal abscess formation and septic shock following diagnostic curettage]. / Perforation der Harnblase mit retroperitonealer Abszessbildung und septischem Schock nach diagnostischer Abrasio.

A case of perforation of the urinary bladder is presented which occurred occasionally a diagnostic curettage. At admission there was a severe septic shock. After intensive treatment the diagnosis of perforation of urinary bladder was made by intravenous urography and cystography. Laparotomy with closure of the perforation, lavage of abdomen and drainage of the pouch of Douglas made a total recovery.

[Fibrothecoma of the ovary with typical Meigs syndrome and tumorous cachexia]. / Ein Fibrothekom des Ovars mit typischem Meigs-Syndrom und tumoröser Kachexie.

A case of a big fibrothecoma of the right ovary is reported. A women 49 years of age was admitted in a bad general situation with anemia, ascites, hydrothorax and weight loss. On operation the tumor looked like malignant one. Both the ovaries were excised. The pathological examination showed a fibrothecoma of the ovary with no signs of malignancy. The postoperative period was uneventfull and the patient is in a good condition 7 months after operation.