[Therapy of pilonidal sinus with the Limberg transposition flap]. / Die Therapie des Sinus pilonidalis mit dem Transpositionslappen nach Limberg.

Pilonidal sinus can not be mentioned as a minor surgery procedure because of high recurrence rate, high morbidity and long disability period. In our clinic between the years of 1988-1991, 92 pilonidal sinus cases were treated primarily with Limberg's flap technique. Only in two cases, late wound healing was detected, no other complications and no recurrences were seen. Compared with other primary treatment methods, Limberg's flap technique was observed to be much more convenient for pilonidal sinus cases.

[Fournier gangrene]. / Fournier-Gangrän.

Fournier's gangrene is a relatively rare, mixed aerobic and anaerobic soft tissue infection in the perineoscrotal area. Although it is convenient to give it a separate name, it is really either necrotizing fasciitis or nonclostridial myonecrosis of the scrotal and perineal areas. The condition frequently develops from perineal diseases, including perianal abscess, and fistulas, inflamed haemorrhoids and indwelling urethral catheter. In patients with Fournier's gangrene morbidity is extreme and mortality high. This article is based on a retrospective study of 15 cases of Fournier's gangrene, 13 in male and 2 in female patients. A combination of surgery and antibiotics was used to treat 9 patients. The last 6 cases were treated with a combination of surgery, antibiotics and hyperbaric oxygen. In 13 cases, the diagnosis was made on the basis of the fulminating progression of the infection to a scrotal gangrene, identification of multiple underlying pathogenic organisms and toxaemia. In the 2 female patients, a similar infection developed in the labia majora and perineum and extended to the buttocks and the anterior abdominal wall.

[Syndrome of solitary rectal ulcer--a rare cause of recurrent rectal hemorrhage]. / Das Syndrom des solitären Ulcus recti--eine seltene Ursache der rezidivierenden rectalen Blutung.

While the clinical symptoms and signs of SRUS are quite obvious, etiology and treatment of the disease remain to be obscure. Although the lesion is usually not solitary this name has been used for the disease. According to other authors, we also find this term inappropriate. During the last 5 years 6 cases of SRUS have been diagnosed, treated and prospectively assessed in the surgical clinic of Cerrahpasa Medical Faculty (Istanbul). Three patients were treated successfully by conservative means, transanal excision was performed and defects were sutured primarily in the other three. In one patient recurrence was seen 8 days after the transanal excision; transabdominal rectopexy was performed 6 months later. All patients have been followed up with no complaints.

[Treatment of venous thrombosis]. / Die Behandlung der venösen Thrombose.

In the treatment of deep vein thrombosis (DVT), a rapid clinical diagnosis supported by the appropriate equipment, the age of the patient, and the extent of the thrombosis are the major determinants of successful therapy. Active and conservative treatment should be aimed at the prevention of pulmonary embolisms, rethrombosis and elimination of the thrombus, while preserving venous valvular function, which in turn is essential to avoid the development of post-thrombotic syndrome. The treatment of acute DVT remains controversial. For this reason the indication, treatment, and recently published results of thrombectomy, thrombolysis, and the possibilities for preventing DVT are discussed.