[Pharyngeal hemorrhaging due to iatrogenic false aneurysm. Complication after cannulation of the internal jugular vein]. / Pharynxblutung bei iatrogenem Aneurysma spurium: Komplikation nach V.-jugularis-interna-Punktion.

Catheterization of the internal jugular vein is used for temporary access to the central vein in patients with acute or chronic renal failure. The most frequent problem is the arterial puncture and accidental placement of the large catheter in an artery. This case report describes a rare secondary complication by accidental catheterization of the right common carotid artery after intended dual lumen catheter insertion into the right internal jugular vein. A false aneurysm with pharyngeal hemorrhaging developed 2 weeks after the puncture. The diagnosis was made using colour-Doppler ultrasound and the aneurysm was treated with vascular surgery.

[Glomus tumor--a rare stomach tumor]. / Der Glomustumor--ein seltener Magentumor.

We report on a 72 year old woman with a large glomus tumor of the stomach is given. The difficulty of preoperative diagnostics is described, and the importance of immediate section of microscopic examination during surgery in order to minimize the extent of resection is shown. Gastric glomus tumors are rare, benign, and normally solitary lesions in the antrum or pyloric region. When the exact intraoperative diagnosis is possible, a local excision is seen as a sufficient treatment.

[Prolapsed malignant polyp of the stomach causing acute pancreatitis]. / Akute Pankreatitis durch einen in das Duodenum prolabierten malignen Magenpolypen.

Polyps of the stomach are rare lesions with an incidence between 1.7% and 3.9%. Until now, most cases were asymptomatic and found during endoscopic examination. Only three cases of prolapsing gastric polyps causing acute pancreatitis have been reported. Prolapsed polyps of the stomach should be included in the differential diagnosis of secondary pancreatitis. If endoscopic polypectomy is impossible, surgical treatment is necessary. In case early gastric cancer of the mucosa is detected in a polyp, limited surgery is possible. Otherwise, gastrectomy with lymphadenectomy of the D2 compartment is required

[Waiting for the EuGH verdict to be put into practice or "Introduction of the four-day week on full pay"]. / Warten auf die Umsetzung des EuGH-Urteils oder "Einführung der Viertagewoche bei vollem Lohnausgleich"

The submitted model of working time transposes and interprets german industrial law. The result of this interpretation is a high level of acceptance of the employees, a fast education that is high qualified with costs that are still affordable. The advantage of this model compared with the shift-model that runs after the EuGH-decision is obvious if you look at the reality of our health care system. This is why it is important to have an efficient interpretation of the existing law. Of course it will be a necessity also in the future to create new models of working time and to adapt these models in a way that it fits into the structure of a hospital. It would be the wrong way to force a juridical and political decision, how it was done by the german government that gave a deadline to put the EuGH decision into operation, without the possibility of an interpretation that fulfils the demand of the hospital.

[Roentgen studies of the skull in head injuries--a multicenter study]. / Röntgenuntersuchungen des Schädels bei Kopfverletzungen--eine Multicenterstudie.

The multi-center study presented reveals that 76% of the conventionally performed X-ray investigations of the skull can be avoided without any relevance concerning the non-diagnosis of severe injuries. Only in 3.2% of all patients investigated a skull X-ray had instantaneous therapeutically consequences. Thus routinely performed skull X-rays are no longer acceptable in the light of cost reduction and radiation load. The clinical-neurological investigations however are inevitable to perform the state of the art treatment of patients with head injuries today, leading to computerized tomography if necessary. A check-list of clinical findings is presented to get the indications for conventional X-rays of the skull and to manage an effective use of such investigations in appropriate clinical situations.