Rupture of the aortic wall with compression of bronchial arteries.

A case of closed traumatic rupture of the aortic wall with compression of the bronchial arteries is described. No comparable case has been reported in the literature so far. The effect on pulmonary perfusion and gas exchange is demonstrated. The compression, displacement and transportation of the bronchial arteries (vasa privata) is shown is postmortem angiography.

[Pancreatic duct occlusion following duodeno-pancreatectomy in cancer surgery]. / Pankreasgangocclusion nach partieller Duodenopankreatektomie in der Carcinomchirurgie.

In 19 patients with a carcinoma of the pancreas an intraoperative occlusion of the pancreatic duct was performed with a partial duodenopancreatectomy by instillation of Ethibloc. In 13 cases a carcinoma of the papilla and in 6 cases a carcinoma of the head of pancreas were found. In two cases the duct was primarily closed by suture, which was followed by a pancreatic fistula that disappeared after 2 weeks. Therefore, a pancreaticojejunal anastomosis was performed in the other patients. One patient died owing to a total necrosis of the remaining pancreas, but no other local complications were seen at the time of pancreatic anastomosis. Lethality was approximately 5% and was therefore significantly lower than in other reports.

[Experience with the surgical treatment of peripheral arterial occlusions]. / Erfahrungen mit der chirurgischen Behandlung akuter peripherer Arterienverschlüsse.

A total of 293 patients were treated 320 times for acute peripheral vascular occlusion. Arterial embolism was most frequent followed by arterial thrombosis and traumatic vascular occlusion. For differential diagnosis other causes had to be considered. The method of choice is extraction of the thrombus by Fogarty catheter or ringstripper. The results depend on the time between occurrence and operative treatment of the occlusion. Angiography is not necessary in a clear case of embolism, but essential when exact preoperative classification of the vascular occlusion is not possible.

[The effect of intraductal duct occlusion with a fast hardening amino acid solution in acute animal experimental pancreatitis]. / Die Wirkung der intraductalen Gangocclusion mit einer schnell härtenden Aminosäure-Lösung bei der akuten tierexperimentellen Pankreatitis.

The effect of the occlusion of the pancreatic duct system by Ethibloc was studied in cases of acute pancreatitis in animal experiments. Application of 4,5 ml Ethibloc leads to high significant reduction of amylase increase. The favourable effect is markedly reduced after application of 9 ml Ethibloc. A partial excretory function could be demonstrated also after disintegration of Ethibloc. Histological follow-up shows a progredient fibrotic atrophy of pancreas parenchyma.

[The Caroli syndrome]. / Das Caroli-Syndrom.

Caroli's disease is characterized by congenital pseudocystic dilatation of the biliary tree. Inflammation and stone formation lead to clinical manifestation in the second decade. ERC and computed tomography are main diagnostic procedures. In cases, where the alterations are limited partial hepatectomy has been recommended. If dilatations are diffuse, the aim of surgical treatment is the performance of a choledochojejunostomy to realize drainage and prevent recurrent ascending cholangitis.

[Thrombosis and embolism as causes of the acute peripheral ischemia syndrome--differential diagnosis and differential therapy]. / Thrombose und Embolie als Ursache des akuten, peripheren Ischämiesyndromes--Differentialdiagnose und Differentialtherapie.

A total of 572 patients were treated 628 times for acute peripheral vascular occlusion. Arterial embolism was most frequent with 65% followed by arterial thrombosis and traumatic vascular occlusion. For differential diagnosis other causes had to be considered. The method of choice is extraction of the thrombus by Fogarty catheter or ring stripper. The results depend on the time between occurrence and operative treatment of the occlusion. Angiography is not necessary in a clear case of embolism, but essential when exact preoperative classification of the vascular occlusion is not possible.

[Benign and semimalignant soft tissue tumours (author's transl)]. / Benigne und semimaligne Tumoren der Weichteile.

1033 cases of benign and semimalignant tumours of the soft somatic tissue are examined. Tumours of the fatty tissue and those of blood vessels do not cause any difficulties in diagnostics and therapy. Concerning semimalignant tumours there is a high risk of recidivation but no metastasising. Likewise there is a high risk of recidivation in tumours of the fibrillar and embryomorphous tissue. Patients suffering from these tumours are included in the aftercare programme corresponding to the postoperative treatment of patients with malignant tumours.

[Somatostatin in pancreas and small intestine fistulas]. / Somatostatin bei Pankreas- und Dünndarmfisteln.

Infusing 6 mg of somatostatin continuously for 24 hours will lead to a reduction of pancreatic secretion and perfusion of the splanchnic area. Due to this mechanism, secretion is significantly reduced in case of pancreatic or small intestine fistulae. Somatostatin was applied continuously in 39 patients for a period of 7 days. This led to a healing of pancreatic fistulae in 85.7% and small intestine fistulae in 63.6% of cases.

[Meckel's diverticulum (author's transl)]. / Das Meckelsche Divertikel.

Complications (inflammation, bleeding, perforation) occurred in 20 of 38 patients with Meckel's diverticulum. Complications were disproportionately common in children up to ten years of age. Because of the high mortality rate in the presence of complications (20%) it is recommended to search actively for Meckel's diverticulum during every upper-abdomen laparotomy, as long as the underlying disease and the operative procedure allow it.

[Experimentally induced pancreatitis (author's transl)]. / Experimentelle Untersuchungen zur Pankreatitisentstehung.

Pancreatitis was produced in 29 mini-pigs by partial occlusion of the pancreatic duct; occlusion was performed by implanting a T-drain into the duct. Inflammatory changes were induced additionally by applying radiopaque material in excess. Acute and chronic pancreatitic lesions could be diagnosed by X-ray examination, evaluation of blood chemistry and by histology.

[Acute pancreatitis in animal experiments - a new method]. / Die akute Pankreatitis im Tierexperiment - eine neue Methodik.

Acute pancreatitis was induced in 30 minipigs (Göttingen) by implantation of a T-drain into the Ductus Wirsungianus. The distal part of the T-drain, which led into the duodenum was stenosed to 1/3 of the original diameter. The inflammation was caused by stenosis of the Ductus Wirsungianus additionally by application of contrast medium. The course of the inflammation was demonstrated by biochemical, roentgenological and histological examinations.

[Asymmetrical macrodactyly]. / Asymmetrische Makrodaktylie.

A case of asymmetrical macrodactyly is reported with special regard to the conservation of the remaining function. It is shown that partial resection of the metacarpal bones, performed for functional reasons, leads to a satisfying result, while the amputation of the fingers, proposed for cosmetic reasons, is not recommended.

[Xeroangiographic findings in patients with haemodialysis fistulas in the arm (author's transl)]. / Xeroangiographische Befunde bei Patienten mit Hämodialysefisteln am Arm.

The authors report on a simple and accurate method for xeroangiographic visualisation of haemodialysis shunts in the arm which has been performed so far in 98 patients without complications. By this method, approx. 45 ml metrizamide (80 mg iodine/ml) are injected into the venous limb during short-term hypersystolic congestion. Single xeroradiography performed subsequently shows both the arterial and the venous vessels. The pathological findings established during the examinations (stenoses, pseudoaneurysms, venous thromboses) were confirmed by subsequent surgery.

[Somatostatin in the treatment of acute experimental pancreatitis (author's transl)]. / Somatostatin in der Behandlung der experimentellen akuten Pankreatitis.

An acute pancreatitis was induced in 20 Göttinger mini pigs by implantation of a T-tube and application of contrast medium. This process was demonstrated by laboratory and microscopic findings. Continuous infusion (n=11) of 2500 mcg somatostatin (GHIF) over 10 h showed a significant reduction of amylase and blood glucose level corresponding to the microscopic findings. The group of animals treated with somatostatin (GHIF) showed a ratio of 1:5 between necrotic and unaffected parenchymal tissues. By contrast, the histologic findings of the untreated group showed a ratio of 1:1. The investigations of blood glucose, gastrin and glucagon levels showed a rebound effect after ending the treatment with somatostatin.

[Surgical management of incontinence in rectal constipation (author's transl)]. / Chirurgische Behandlung der Uberlaufinkontinenz bei rektaler Obstipation.

In rectal constipation chronic filling of the rectum with feces will cause continuous rectal dilatation, a permanent stimulus for defecation and finally rectal incontinence. Reduction of rectal volume and perfect continence may be achieved in these cases by surgical removal of part of the elongated colon; thus surgery may have its place as an alternative to medical treatment of this disease. Patients with rectal constipation do not have an aganglionic segment of the colon, as is the case in Hirschsprung's disease; the dilated part of the colon is characterized on the contrary by hypertrophic intestinal wall.