[Use of fibrin glue in prevention and therapy of intra-abdominal adhesions]. / Die Anwendung des Fibrinklebers zur Prophylaxe und Therapie intraabdomineller Adhäsionen.

In prevention of the recurrent intestinal obstruction we performed at the Department of Pediatric Surgery of the University of Mannheim a sutureless plication of the small bowel with fibrin glue only over the last 7-year period. The postoperative course was uncomplicated in all patients. The clinical and experimental experiences suggest that the high concentrated human fibrinogen is able to start healing of the lesions of the serosa to prevent intraabdominal adhesions prospectively. Furthermore the time saving and easy procedure is to be stressed. First of all the high risk of tissue necrosis or intestinal perforation due to ischemia by sutures and stitches like in the traditional technique of plication is not present.

[Abnormalities of the common bile duct and Vater's papilla in various forms of duodenal atresia]. / Fehlbildungen des Ductus choledochus und der Papilla Vateri bei den verschiedenen Formen der Duodenalatresie.

Associated anomalies are often found in newborn with duodenal obstruction. Anomalies of the biliary tract are of special interest. Malformations of the terminal common bile duct and the papilla of Vater are the most common ones. The recognition of the possible anatomical variations is most important to avoid inadvertent injuries in the correction of duodenal obstruction.

[Myositis ossificans progressiva (M.o.p.)--a morphological and biochemical study (author's transl)]. / Myositis ossificans progressive (M.o.p.). Eine morphologische und biochemische Studie.

In a two-year-old girl suffering from myositis ossificans progressiva a biopsy specimen from a soft tissue tumor was examined by electron microscopy and by collagen electrophoresis (SDS-Polyacrylamide Gel Electrophoresis). Electron microscopic findings of the biopsy specimen showed that the collagen appeared to be similar to type II collagen which can be found for example in hyaline cartilage however collagen electrophoresis revealed neither any certain signs of type II collagen nor any different proportion of type I and type III collagen compared to a healthy child.

Coincidence of congenital cystic adenomatoid malformation and extralobar sequestration of the lung in a newborn.

We present a rare case of coincidence of an extralobar sequestration with a congenital cystic adenomatoid malformation of the lung in a newborn. The symptoms, diagnostic features, and therapy are described and the etiology and classification are briefly discussed.

[Imaging procedures and follow-up in pediatric surgical diseases]. / Bildgebende Verfahren und Verlaufskontrollen kinderchirurgischer Erkrankungen.

The most important modern imaging diagnostics are the ultrasound, scintigraphy, computed tomography and recently the nuclear magnetic resonance (NMR). The diagnostic tools should be used one after another, always starting with the easiest to perform, with low risk and no harm to the patient, at low costs. In routine diagnostic procedures (e.g. blunt abdominal trauma) this will be the sonography. The result of the ultrasound may give rise to other, but more invasive methods. Computed tomography, e.g. may give more detailed information about position, size and operability of a tumor whereas scintigraphy has its strong point in disclosing functional organ disorders (e.g. kidney, liver and especially in splenic transplants).

[High frequency oscillatory ventilation of infants with severe respiratory disorders: possibilities, risks and limits]. / Hochfrequenzoszillationsbeatmung bei Säuglingen mit schwersten Atemstörungen: Möglichkeiten, Risiken und Grenzen.

By pediatricians the high frequency oscillatory ventilation (HFOV) is used almost only in the neonatal period. We report on the administration of HFOV in infants with pulmonary insufficiency after failure of conventional ventilatory support. 6 infants (aged 2-7 months, all former preterm babies) were referred to our hospital due to severe pneumonia after unsuccessful conservative management. Indications for HFOV were hypoxia (mean paO2 41.8 mm Hg with FiO2 = 0.95 and mean airway pressure = 16.6 cm H2O) and/or air leak syndrome. In all cases a sufficient oxygenation could be achieved by HFOV, followed then by stepwise reduction of FiO2 and MAP. The air leaks receded. After 12-178 h on HFOV a successful switchback to conventional ventilatory support (at FiO2 = 0.48 and MAP < 12 cm H2O) was possible, all infants were extubated 6-15 days later. Possible risks of HFOV are air leaks, a necrotizing tracheobronchitis and hemodynamic changes due to compression of the heart and great vessels. With the at the moment in Germany available oscillatory ventilators HFOV as a rescue therapy must be limited for infants with a body weight below 5-6 kg.

[Congenital pulmonary fibrosarcoma. Differential diagnosis of infantile pulmonary spindle cell tumors]. / Kongenitales pulmonales Fibrosarkom. Differenzialdiagnose infantiler pulmonaler spindelzelliger Tumoren.

Primary pulmonary mesenchymal tumors are rare causes of intrathoracic lesions in newborns. We describe a case of pulmonary spindle-cell tumor with features of infantile fibrosarcoma and discuss the differential diagnosis of spindle-cell lesions in this location. In view of further case reports of the literature, this neoplasia can best be categorized in a spectrum of fibroblastic/myofibroblastic differentiated spindle-cell tumors, with excellent prognosis. Especially in congenital lesions a favorable clinical course is to be expected after complete surgical resection. Additional radio- and/or chemotherapy is not recommended.