[Richter hernia in trocar site after laparoscopic herniotomy]. / Richter-hernie i trokarsted efter laparoskopisk herniotomi.

A case of an incarcerated Richter's hernia in a 12-mm trocar site is presented. A 72 year old man underwent laparoscopic herniorrhapy because of a recurrent inguinal hernia. On the sixth postoperative day he developed abdominal pain, nausea, vomiting and abdominal distension. Plain abdominal X-ray showed bowel obstruction. Computed tomography with oral contrast showed herniation of small bowel above the fascia. The patient was immediately reoperated, the intestine was reduced, and the fascial defect at the trocar site closed. Three days later he underwent surgery again due to a small perforation of the small bowel and a persistent fascial defect. The patient had an uneventful postoperative course. Herniation through a trocar site is a rare complication-incarceration extremely rare. We recommend that all fascial defects of 10 mm or more are closed sufficiently.

[Magnetic resonance imaging compared to myelography and CT. Diagnostic value in patients with suspected medullary spinal compression syndrome]. / Magnetisk resonans-billeddannelse sammenlignet med myelografi og CT. Diagnostisk vaerdi hos patienter mistoenkt for medulloert tvoersnitssyndrom.

Comparison between myelography (MY) and magnetic resonance imaging (MRI) was carried out in 36 patients with clinical suspicion of spinal cord or root compression due to metastatic disease in the spinal canal. In three patients metastatic lesions were visualized on MY but not on MRI, while there were no cases with a negative MY and a positive MRI. In 44% of the cases MY alone or combined with postmyelographic CT (pm-CT) showed a larger tumour extension than did MRI, while the opposite occurred in 25%. As for detection of bony metastases and tumour masses localized outside the spine there was no difference between MRI and MY + pm-CT. The results indicate that the choice between MRI and MY + pm-CT still can be based on the availability and quality of the procedure at a given institution.

Magnetic resonance imaging in the evaluation of sequelae after tibial plateau fractures.

Nine knees with persistent radiographic depression of the articular surface after tibial plateau fractures treated by traction and early knee motion were examined using magnetic resonance imaging (MRI). The MRI examinations demonstrated that the radiographic bone defects were filled up with different tissues, which we interpreted as cartilage, fibrous tissue and synovial plica. The type of tissue in the bone defect did not seem to affect the functional capabilities of the knee. However, a demonstrable thin cover of tissue, with the signal-intensity of cartilage, over the defect, seemed to be associated with an excellent functional result.

[Air cysts of the colon]. / Luftcyster i colon.

Air cysts in the colon may cause problems in differential diagnosis. This is illustrated by a case report. The etiology and diagnosis are briefly discussed.

[Knee replacement with a St. Georg prosthesis]. / Knaealloplastik med St. Georg protesen.

Fifty-six St. Georg prostheses (23 unicompartmental and 33 bicompartmental) were introduced and 34 of these patients were followed-up with a mean period of observation of 4.6 years (2.1-8.9). The results were assessed according to the New York Hospital for Special Surgery Knee Rating Scale. Out of the unicompartmental replacements, 15 out of 19 obtained excellent or good results in contrast to 14 out of the 28 bicompartmental replacements. The St. Georg prostheses may be recommended for treatment of unicompartmental arthrosis. This review suggest that bicompartmental St. Georg prostheses provide unsatisfactory results compared with the results obtained with total condyle prostheses.