[Diagnostic and therapeutic problems in amebic liver abscess]. / Diagnostische und therapeutische Probleme beim Amöbenabscess der Leber.

Abscesses of the liver represent the most common complications of amebiasis. In general they are treated non-surgically by the aid of Metronidazol. Complications, however, such as perforations, development of fistulas or septicemia may occur and necessitate surgical intervention. The role of CT in diagnostic problems and therapeutic management is discussed in three different cases with respect to other diagnostic techniques.

Coping with a stoma - a comparative study of patients with rectal carcinoma of inflammatory bowel diseases.

409 patients who had either an implantation of a stoma or a bowel resection for either colorectal carcinoma of colitis/ileitis answered a 200-item questionnaire. A discriminant analysis revealed a higher degree of pre- and postoperative depression and a decrease of social activities for stoma patients who also more often lived in rural areas in comparison with patients with the same diagnosis who only had a resection. A comparison of operated cancer patients with patients operated for ulcerative colitis or Crohn's disease showed less depression before and after surgery in cancer patients. Cancer patients also frequently ceased sexual activities after the operation, and they came from much more remote rural areas than the comparison group, irrespective of the type of operation performed.

[Analysis of postoperative deaths in colon and rectal cancer (author's transl)]. / Analyse der postoperativen Todesfälle beim Colon- und Rectumcarcinom

Analysis of the clinical and autopsy reports of 200 deaths following surgery for colorectal cancer from 1956 to 1974, at the Dept. of Surgery, University of Heidelberg, revealed that pneumonia (24.5%) was the most common cause of death followed by peritonitis (22%), pulmonary embolism (15.5%), advanced tumor disease (14%), cardiac failure (9.5%), ileus (5.5%), and others (9%). The explanation for the postoperative mortality rate of 12% (cancer of colon) and 13.2% (cancer of rectum) lies in the fact that 82.5% of those who died postoperatively were beyond the age of 60, and 40.5% beyond 70 years at the time of surgery. Moreover, in 50.5% advanced tumors with regional and/or distant metastases were found. In 55.5% severe preoperative complications (ileus: 38%, peritonitis: 11%, abscess formation or hemorrhage: 6.5%) required an emergency operation. Only 38.5% of the procedures were considered for cure. Besides the need for early recognition of the cancer, intensification of pre- and postoper treatment appears to be the predominant task in the effort to decrease postoperative mortality.

[The postoperative atonic bladder (author's transl)]. / Die sogenannte "Postoperative Blasenatonie"

Urodynamic investigations in 96 patients with carcinoma of rectum showed that the term "postoperative atony" does not describe the measurable alterations following excision of the rectum. Postoperative mechanical disorders of micturition and neurogenic lesions were analysed under the aspect of future therapy.

Results of psychosocial adjustment to long-term colostomy.

114 patients with permanent colostomy for carcinoma of the rectum were compared by questionnaire and interview with 110 cancer patients, having undergone colonic resection but not bearing a colostomy. The patients' own assessment of their health was for the colostomy group even better than for the controls. The emotional state before and after surgery showed significant degrees of hopelessness, depressions and fear especially for young women awaiting colostomy. Social contacts were considered as far as visits of friends or cinema, theatre are concerned. Sexual activity decreased significantly for 75% of colostomized men. In 40% organic lesions led to impotence. The Giessen test revealed significant rates of social impotence, negative social resonance and depression for men with colostoma.