[Atopic stomach polyp as the cause of invagination of Meckel's diverticulum]. / Dystoper Magenpolyp als Ursache der Invagination eines Meckel'schen Divertikels.

We report a 16 year old boy with suspected appendicitis. Besides leucocytosis a roll was palpable in the right lower quadrant. The enema with water soluble contrast medium revealed an invagination. Intraoperatively, reduction was possible. The cause was an inverted Meckel's diverticulum. In this diverticulum we found a large perpendicular hyperplasiogenic gastric polyp as the cause of inversion and invagination.

[Ileus of the large intestine as a late sequela of direct diaphragmatic rupture]. / Der Dickdarmileus als Spätfolge einer direkten Zwerchfellruptur.

We report two patients who were administered to our hospital with an obstruction of the colon. 4 months ago one of the patients had suffered a penetrating wound with a knife in the upper left abdomen. The other patient was wounded by gunshot in the left thorax 50 years ago. The x-ray of the lung showed the ruptured diaphragm as a sharp line in the left thorax and the enema with contrast fluid revealed a stop at the left colonic flecture. In both cases the rupture of the diaphragm was closed via an abdominal approach, the inspection of the colon did not discover any defect. The postoperative course was uneventful. In contrast to other authors we believe that the delayed rupture of the diaphragm in connection with a colonic obstruction should be repaired by an abdominal access.

[Mesh reinforced cutis-plasty]. / Die netzverstärkte Kutisplastik.

We report on 27 patients in whom a total of 28 augmented cutis plasties were performed to correct large hernias of the abdominal wall. After closure of the defect by cutis plasty an absorbable mesh is sutured at the fascia 2-3 cm away from the edge of the fascial defect. Postoperatively, 2 subcutaneous seromas had to be punctured. No wound infections were observed. After a first procedure (n = 14) the recurrence rate was 7%, while after correction of recurrent hernias (n = 14) there were 2 failures (14%). Augmentation by the mesh means that high initial stability of the abdominal wall is achieved, allowing transformation of the cutis into a strong fibrous tissue.

[Results of therapy following lumbar sympathectomy. A retrospective study over the course of 10 years]. / Therapieergebnisse nach lumbaler Sympathektomie. Eine retrospektive Studie über einen Zeitraum von 10 Jahren.

In a retrospective study we report about 142 patients who had 159 lumbar sympathectomies from 1975-1985. The angiological status was evaluated with a clinical examination or a questionnaire. In 96% we saw the clinical stages III and IV. The clinic lethality was 3.5%. Besides the sympathectomies 62 reconstructive procedures were necessary which were performed mostly before the sympathectomy. The higher the occlusion resp. stenosis the worse the prognosis after sympathectomy. A postoperative abstinence of smoking improves the prognosis. The amputation rate was 35.8% including minor amputations (n = 20) and loss of the extremity (n = 37). The high number of minor amputations shows that the sympathectomy is an appropriate procedure to shift the amputation to the periphery. The older the patient the higher the amputation rate. The analysis of the clinical examination or the questionnaire shows that a third of the patients has a long-term profit from the sympathectomy.

[Metachronous double carcinoma of the large intestine]. / Das metachrone Doppelkarzinom des Dickdarmes.

Seven patients developed two separate carcinomas of the colon over an average interval between the two of 8.5 years. Five of the second tumours were discovered during routine endoscopic follow-up of the first. Ten of the 14 tumours were located in the left colon. These seven cases represent an incidence of metachronous double carcinoma of the colon of 0.9% among a total of 762 patients with carcinoma of the colon seen during the same period. Two patients died of the malignancy seven and 24 months, respectively, after the operation. The others have so far remained clinically free of tumour.

[The mobile-cecum--a contribution to the independence of this disease and to its surgical treatment]. / Das Coecum mobile-Ein Bein Beitrag zur Eigenständigkeit dieses Krankheitsbildes und zur operativen Versorgung.

A mobile caecum can certainly exist perpetually without symptoms. The operation is indicated after a barium enema and upper gastro-intestinal x-ray examination if the symptoms-especially colicky abdominal pain-have been lasting for a long period. Caecum and ascending colon are fixed at the lateral abdominal wall as a "coecocolofixatio lateralis" (Klose 1909). 93.7% of our 35 patients had no postoperative complaints. The operation is not indicated as prophylaxis for volvulus or invagination.

[Inguinal herniation of a tubular duplication of the ascending colon (author's transl)]. / Inguinale Herniation einer tubulären Duplikatur des Colon ascendens.

A 6-year-old boy is reported who was operated upon with a pre-operative diagnosis of a recurrent right incarcerated inguinal hernia. As green-brown fluid appeared from the suspected hernial sac, a laparotomy was performed which showed a duplication of the ascending colon with a prolongation into the inguinal canal. The duplication and the relative intestinal segment were excised (right-sided) and because of the close relationship between the intestinal wall and the wall of the cyst, and the shared blood supply, an organ procedure was technically not possible.

[Relaparotomy after appendicectomy in childhood (author's transl)]. / Die Problematik der re-laparotomien nach Appendektiomien im Kindesalter.

In 591 appendectomies a repeat laparotomy was necessary in 19 children (3.2%). 12 of these children had had perforated appendicitis. After a so-called "chronic appendicitis" we have never seen an indication for a second operation. The most important indications requiring relaparotomy were the post-operative ileus and the septic complications. We found intra-abdominal infections mainly after perforated appendicitis, the re-laparotomy was never carried out before the eighth post-operative day.