ABSTRACT
Thoracic manifestations of internal pancreatic fistulas are rare. During the last 8 yr, we have treated one patient with a mediastinal pseudocyst, three patients with pancreaticopleural fistulas, and one patient with a pancreaticobronchial fistula. Recurrent pleural effusions represent one of the main clinical features in this entity, and can often lead to false diagnoses. Determination of pancreatic enzyme activity, as well as the combination of ultrasonography, computerized tomography, and endoscopic retrograde cholangiopancreatography (ERCP), enable the establishment of the diagnosis. A complete pancreatic evaluation is the rationale for an adequate and efficient therapy which should always aim at a focal assentation.
Subject(s)
Bronchial Diseases/diagnosis , Fistula/diagnosis , Pancreatic Cyst/diagnosis , Pancreatic Fistula/diagnosis , Pancreatic Pseudocyst/diagnosis , Pleural Diseases/diagnosis , Adult , Cholangiopancreatography, Endoscopic Retrograde , Chronic Disease , Humans , Male , Mediastinal Diseases/diagnosis , Middle Aged , Pleural Effusion/diagnosis , Tomography, X-Ray Computed , UltrasonographySubject(s)
Bezoars/etiology , Esophageal Stenosis/therapy , Adult , Bezoars/surgery , Deglutition , Dilatation/adverse effects , Dilatation/instrumentation , Humans , MaleSubject(s)
Ampulla of Vater/surgery , Cholelithiasis/therapy , Dilatation/methods , Aged , Female , Gastrectomy , Humans , Pancreatic Neoplasms/surgerySubject(s)
Abdomen/surgery , Aging , Anesthesia/methods , Anti-Bacterial Agents/therapeutic use , Cholecystectomy , Esophageal Neoplasms/surgery , Gastrectomy , Humans , Intestinal Obstruction/surgery , Intubation, Intratracheal , Postoperative Complications/prevention & control , Respiration, Artificial , SplenectomyABSTRACT
Surgery of the gallbladder and biliary tract has undergone a few technical changes and widening of possibilities in the last 10 years. Opinions of the surgeons on the one hand and the rest of the medical profession on the other hand differ, often markedly, on the indications for operation in the gallbladder and biliary tract area particularly. For this reason it seems appropriate to present the current position of gallbladder and biliary tract surgery and its indications.
Subject(s)
Bile Duct Diseases/surgery , Gallbladder Diseases/surgery , Biliary Fistula/surgery , Cholangitis/etiology , Cholecystectomy/methods , Cholelithiasis/etiology , Cholestasis/surgery , Endoscopy , Gallbladder Neoplasms/complications , Humans , RiskSubject(s)
Health Education , Surgical Procedures, Operative , Female , Germany, West , Humans , Informed Consent , Male , Postoperative Complications , RiskSubject(s)
Hernia, Ventral/etiology , Postoperative Complications/surgery , Adult , Aged , Female , Hernia, Inguinal/etiology , Hernia, Inguinal/surgery , Hernia, Ventral/surgery , Humans , Male , Methods , Middle Aged , RecurrenceSubject(s)
Endarterectomy , Insurance, Health , Malpractice , Adult , Amputation, Surgical , Aorta/surgery , Diagnostic Errors , Embolism/etiology , Expert Testimony , Female , Femoral Artery/injuries , Femoral Vein/injuries , Humans , Iliac Artery/injuries , Leg/surgery , Ligation , Male , Middle Aged , Postoperative Complications , Thromboembolism/surgery , Thrombophlebitis/complications , Varicose Veins/surgerySubject(s)
Cystadenoma , Pancreatic Neoplasms , Aged , Cystadenoma/surgery , Diabetes Complications , Female , Humans , Palliative Care , Pancreatic Neoplasms/surgeryABSTRACT
Every doctor--and above all every surgeon--must have fundamental knowledge of diagnosis and treatment of surgical angiological diseases. It is no longer sufficient for specialists alone to have such knowledge. Confrontation with surgical angiological problems is possible at any time. Cases are described here in which serious consequences arose for the patient concerned because of a doctor's error. Claims for damages were the result.
Subject(s)
Diagnostic Errors , Femoral Artery/injuries , Accidents, Traffic , Adolescent , Adult , Amputation, Surgical , Expert Testimony , Femoral Fractures/therapy , Fracture Fixation , Humans , Iliac Artery/injuries , Leg/surgery , Male , RuptureABSTRACT
Different kinds of mucosal prolapse at the rectum are differentiated. True and prolapse with protrusion of considerable portions of the rectum principally occur in later life. For younger patients several rather complicated operative procedures for the elimination of anal prolapse come into consideration, but usually they cannot be reasonably accepted by older patients. For this reason a simple method is recommended which carries little risk and yet promises satisfactory result--such as the insertion of a Thiersch ring. Whereas with this technique, if correctly carried out, improvement of the condition is almost certain to be expected, the longterm result over several years is limited, as a followup examination showed. Insertion of a Thiersch ring can, howeever, be repeated without difficulty. This procedure will retain its indication because of its simplicity.
Subject(s)
Rectal Prolapse/surgery , Anesthesia, Local/methods , Anesthesia, Spinal/methods , Humans , Methods , Postoperative Complications , Rectal Prolapse/classification , Recurrence , Suture Techniques , Time FactorsABSTRACT
Avulsion of the extensor tendon of the terminal phalanx of the finger is the most frequent form of all subcutaneous tendon ruptures. The rupture may occur in the tendinous part or cause a fracture of the bone in the region of the insertion. Healing requires at least 5-6 weeks conservative therapy with a Stack's splint being attempted first. Surgical fixation of the terminal joint with Kirschner wire should only be carried out in exceptional cases because of the risk of infection and damage to the joint. Operative union of the ends of the tendon is only immediately indicated with open tendon severance and in old injuries in which complete severing of the tendon can be recognized. If tendon regeneration is unsatisfactory, the Georg method of purse-string suture with temporary arthrodesis is recommended later.
Subject(s)
Finger Injuries/therapy , Tendon Injuries/therapy , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Male , Middle Aged , Splints , Suture Techniques , Tendon Injuries/surgeryABSTRACT
The danger of pressure damage due to bandages is considerable. Plaster casts are incorrect immediately after accidents, repositioning of and operations on limbs. Complaints of circulatory disturbances and pains are to be taken very seriously. Pressure damage may occur not only after plaster casts, but also with elastic bandages. The urgent need to pay attention to undisturbed blood flow to the extremities after accidents and operations is emphasized with reference to 11 cases of various kinds.
Subject(s)
Casts, Surgical/adverse effects , Adolescent , Adult , Calcium Sulfate , Child , Contusions/therapy , Expert Testimony , Extremities , Female , Fractures, Bone/therapy , Humans , Iatrogenic Disease , Male , Middle Aged , Necrosis , Pain , Pressure , Regional Blood Flow , Vascular Diseases/etiologyABSTRACT
A retrospective study was made of 34 cases of recurrent ulcer following gastric resection. Males, especially above the age of 40, were shown to be particularly susceptible. The intact vagus apparently plays the most important role in the pathogenesis. Radiological examination and endoscopy are of the greatest diagnostic importance. Truncal vagotomy must be regarded as the treatment of choice in uncomplicated recurrent ulcer. Resection procedures are indicated in perforating ulcer, gastrojejunocolic fistula, antral residues and ZES.
Subject(s)
Peptic Ulcer/etiology , Postgastrectomy Syndromes , Adult , Age Factors , Gastroscopy , Humans , Middle Aged , Peptic Ulcer/surgery , Postgastrectomy Syndromes/diagnosis , Postgastrectomy Syndromes/diagnostic imaging , Postgastrectomy Syndromes/mortality , Radiography , Recurrence , Time Factors , VagotomyABSTRACT
A retrospective study was made of 34 cases of recurrent ulcer following gastric resection. Males, especially above the age of 40, were shown to be particularly susceptible. The intact vagus apparently plays the most important role in the pathogenesis. Radiological examination and endoscopy are of the greatest diagnostic importance. Truncal vagotomy must be regarded as the treatment of choice in uncomplicated recurrent ulcer. Resection procedures are indicated in perforating ulcer, gastrojejunocolic fistula, antral remains and Zollinger-Ellison syndrome.
