[Traumatic injuries of the distal ureter in pelvic fractures]. / Traumatische Verletzungen des unteren Harnleiters bei Beckenfrakturen.

Ureteral injuries due to external blunt violence are quite rare. Less than 40% of these injuries are diagnosed in the first 24 hours. The authors described 2 cases of traumatic injuries of the lower ureter due to pelvic fractures. In both patients the injuries are caused by a bony spicule of the fractured acetabulum. If acetabular fracture occurs possible ureteral injury should be suspected and excluded by an intravenous urogram.

[The place of adrenal angiography (phlebography and arteriography) in the diagnostic stepwise program in arterial hypertension]. / Der Stellenwert der Nebennierenangiographie (Phlebographie und Arteriographie) im diagnostischen Stufenprogramm bei arterieller Hypertonie

Arteriographical and phlebographical methods are distinctly suited for the diagnostics of the adrenal glands in the stop program of the combat against hypertension. Hypervascular tumours of the adrenal medulla, especially phaeochromocytomata may be established arteriographically relatively certainly. Avascular processes of the adrenal cortex, however, are better to be diagnosed by the selective phlebography of the adrenal glands. The phlebography is also suited for the planimetric determination of the size. The following uncorrected normal values were established: on the left m1 = 10.58 +/- 1.17 cm2, on the right m2 = 6.95 +/- 1.39 cm2. The mean value of normal couples of adrenal glands is M = 18.17 +/- 1.96 cm2. The left adrenal gland is statistically significantly larger than the right one (p greater than 0.001). In 214 patients altogether 44 selective arteriographies and 276 selective phlebographies of the adrenal glands were performed. As angiographical basis examination of all patients was at first performed an abdominal aortography or an angiography of the kidneys. The phlebographical diagnostics was successful on the left in 98.7% and on the right in 90.4% of the cases. 72 patients had pathological processes of the adrenal glands, out of them 20 times a solitary adenoma of the adrenal glands was present. 38 patients had a one- or double-sided hyperplasia, and 4 patients had a phaeochromocytoma. In 10 other cases more infrequent changes were found.

Traumatic injuries of the lower ureter associated with pelvic fractures.

Ureteral injuries following blunt pelvic trauma are extremely rare. Experiences with two cases of lacerations of the lower ureter due to pelvic fractures are presented. In patients with acetabular fractures the likelihood of lower ureteral injuries should be suspected and excluded by an intravenous urogram.

[Results of 189 Visotrast studies in the differential diagnosis of acute intestinal obstruction]. / Ergebnisse bei 189 Visotrastpassagen in der Differentialdiagnose des akuten Darmverschlusses.

In cases of an acute abdomen, bowel obstruction cannot always be excluded. In this case the administration of oral water soluble contrast media (Visotrast) is helpful. On the basis of their experience with 189 patients who underwent gastrointestinal x-ray examination with Visotrast (157 spontaneous mechanical obstruction, 32 postoperative ileus) the authors recommend this diagnostic procedure in difficult situations.