[Ogilvie's syndrome: a rare cause of the acute abdomen]. / Das Ogilvie-Syndrom: eine seltene Ursache des akuten Abdomens.

Ogilvie's syndrome (acute colonic pseudo-obstruction) is a rare clinical disease characterized by segmental distension of the proximal colon caused by a paralysis without mechanic obstruction. It may be a sequel of underlying neurological, medical or surgical disease. Risk factors are respiratory decompensation, electrolyte disturbances and different drugs. A special kind is the primary idiopathic pseudoobstruction with a high risk of perforation or necrosis. Especially elderly patients (> 70 years) with cardiovascular or neurologic diseases and accordant drugs are concerned. Clinical symptoms are progressive abdominal distension and abdominal pain like an acute abdomen. The differential diagnosis of a mechanic ileus is important for further treatment. This case report should draw attention to this rare disease.

[Gastric pacing. A new method in obesity surgery]. / Gastric pacing. Eine neue Methode in der Adipositaschirurgie.

Obesity is a severe health problem in Europe and in the USA. There are many different methods to reduce patients' weight. We report a new method: gastric pacing. Gastric pacing is intended to induce early satiety through electrical stimulation of the gastric wall. We report the operative technique and the complications.

Immunomodulation by perioperative administration of n-3 fatty acids.

It has been increasingly reported that administration of n-3 fatty acids is beneficial in patients with inflammatory processes. This effect is most likely caused by different biological characteristics, including an immunomodulating effect of the products derived from n-3 fatty acids through eicosanoid metabolism. The aim of this study was to investigate the effect of perioperative administration of n-3 fatty acids on inflammatory and immune responses as well as on the postoperative course of patients with extended surgical interventions of the abdomen. In particular, the effect of n-3 fatty acids on interleukin-6 release and on granulocyte/monocyte function (HLA-DR expression) was studied. There was a downregulation of the inflammatory response, and, simultaneously, a smaller postoperative immune suppression in the n-3 fatty acid group. In addition, we observed shorter postoperative periods in the intensive care unit and on the regular medical wards as well as lower rates of severe infections. The results suggest that perioperative administration of n-3 fatty acids may have a favourable effect on outcome in patients with severe surgical interventions by lowering the magnitude of inflammatory response and by modulating the immune response.