[Urologic complications after implantation of aortofemoral blood vessel prosthesis]. / Urologische Komplikationen nach aortofemoraler Gefässprothesenimplantation.

After implantation of aorto-femoral grafts, primary ureteral lesions and secondary ureteral obstructions are the most important urological complications. Surgical repair carried out as quickly as possible, including reanastomosis without tension and covering with a peritoneal patch or omentum interposition, seems the best means of preventing secondary complications. In the case of secondary obstructions, the interval between implantation of the graft and the diagnosis of obstruction has to be considered. A wait-and-see strategy is justified in the case of early obstruction without symptoms during the 1st year because of the high rate of spontaneous remission. Obstructions that appear more than 1 year after operation or symptomatic obstructions have to be treated immediately (i.e. duodenojejunal stent, percutaneous nephrostomy). If repeated obstructions after removal of stents or nephrostomies are noted, surgical repair seems to be indicated. Stents or nephrostomies as definitive procedures are appropriate only in patients in whom surgical revision is not possible or desirable.

[Late surgical treatment of traumatic rupture of the oesophagus (author's transl)]. / Spätversorgung einer traumatischen Osophagusruptur.

The article reports on a 21-year old patient admitted on an in-patient basis after compressed air injury with a severe open craniocerebral lesion, and in whom the diagnosis of rupture of the oesophagus was made two weeks later only. Late surgical management by means of oesophagus suture and sealing of the diaphragm, was successful. The article discusses the symptoms and possibilities of treatment of traumatic rupture of the oesophagus, basing on the present case, and surgical treatment is advocated even if the 48-hour limit has been exceeded.

[Spontaneous intestinal biliodigestive fistula and its treatment (author's transl)]. / Die spontane innere biliodigestive Fistel und ihre Behandlung.

The current clinical and therapeutic status of spontaneous intestinal biliodigestive fistulae in 14 of the author's own cases is presented. Two groups are distinguished: those "short-circuit" connections to the gastro-intestinal tract due to biliary disease--the biliodigestive fistula in the narrower sense as well as enterobiliary fistulae caused by gastro-intestinal disease. Differences in etiology, clinical presentation, therapy and operative lethality make it seem advisable to form two categories, A and B, and to compare the one with the others.

[Symptomatology and treatment of malformations of the inferior vena cava (author's transl)]. / Klinik und Therapie der kongenitalen Vena cava inferior-Missbildungen.

A review of the embryology, pathophysiology semiotics and surgical treatment of malformations of the inferior vena cava is given based on 3 clinical histories. The cases consisted of a typical membrane occlusion, an atresia of the infrarenal segment and of a hitherto not described combination of several malformations of the inferior vena cava: membrane occlusion, aplasia of the infrarenal segment of the vena cava inferior and multiple aneurysms of the iliac vein. The symptomatology of malformations of the vena cava inferior depends on the compensation by the collateral or the persisting embryonic veins, respectively, and on the localization and the degree of the obliteration. The varying hemodynamic reactions are described. The following surgical methods for the treatment of inferior vena cava occlusions in the hepatic segment are available: The so called conservative interventions for the creation of collaterals, the direct or indirect recanalization and the bypass operation. Congenital infrarenal atresias of the vena cava are corrected by homologous or prosthetic interposition. The venous replacement with a bovine heterograft presented here, has not yet been described in the literature.