[Diarrhea after vascular reconstruction of an abdominal aortic aneurysm]. / Durchfälle nach Gefässrekonstruktion einer aneurysmatischen Bauchaorta.

HISTORY AND CLINICAL FINDINGS: A 60-year-old man had a dacron aortofemoral bypass graft inserted to replace a ruptured infrarenal aortic aneurysm rupture. He subsequently had tachyarrhythmic atrial fibrillation with heart failure, NYHA class IV, and diffuse abdominal pain associated with watery diarrhea. INVESTIGATIONS: Stool tests merely demonstrated Candida albicans. Abdominal ultrasound revealed intestinal loops with thickened walls and decreased peristalsis. Coloscopy demonstrated a retroperitoneal intestinal perforation with abscess formation resulting from ulcerative necrotizing rectosigmoid colitis which had also uncovered the vascular prosthesis near the abscess cavity. DIAGNOSIS: Ischemic transmural necrotizing rectosigmoiditis with retroperitoneal intestinal perforation. TREATMENT AND COURSE: The rectosigmoid colon was resected and an end-colostomy made with closure of the rectal stump (Hartmann's operation). The uncovered right limb of the vascular graft was covered completely and was discharged, being now mobile using a walking frame. There was no evidence of infection in the dacron prosthesis. CONCLUSION: A transmural progression of an ischemic colitis should be considered as a late sequela after emergency vascular reconstruction of the abdominal aorta. Even if symptoms are mild, early postoperative sigmoidoscopy is indicated.

[Total laryngo-tracheo-esophageal cleft with situs inversus totalis, aplasia of the right diaphragm and hypoplasia of the lung on the right side]. / Totale laryngo-tracheo-oesophageale Spalte in Kombination mit Situs inversus totalis, Zwerchfellaplasie rechts und Hypoplasie der rechtsseitigen Lunge.

A report is presented on a newborn with congenital malformations of the respiratory and gastrointestinal tract associated with total laryngo-tracheo-oesophageal cleft (type III). The history, the clinical course with respiratory distress after birth, the intra vitam diagnostic procedures with x-ray and laryngoscopy and the autopsy are reported. Additionally a situs inversus totalis, an aplasia of the right diaphragm and a hypoplasia of the lung on the right side were found. To the best of our knowledge this type of association has not been previously reported.