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Biomedical subjects

A Furtschegger

Publications and source records attributed to A Furtschegger.

18 recordsLinked to original sources
PubMed1996

Laparoscopic repair of recurrent inguinal hernias.

BACKGROUND: Repair of recurrent inguinal hernias is associated with recurrence rates as high as 30% and complication rates higher than for primary hernias. PATIENTS AND METHODS: In a prospective study, results were evaluated after laparoscopic transabdominal preperitoneal hernia repair in 192 patients with 200 recurrent inguinal hernias. A total of 132 hernia repairs followed one previous repair, 41 followed two repairs, 17 followed three repairs, 6 followed four, 3 followed five, and 1 followed six previous repairs. The surgical technique is described. RESULTS: Follow-up ranged from 9 to 31 months (mean 18.4). Twelve patients (6%) had groin seromas or hematomas; 3 (1.5%) had transient thigh numbness. One patient (0.5%) underwent laparoscopy a second time because of a large hematoma. In 1 patient (0.5%), a staple on the n. cutaneus femoris lateralis was removed laparoscopically. Patients described postoperative pain as being much less severe compared with their previous operation. Of the total group, 76% of patients were able to return to work within 2 weeks of surgery. One recurrence (0.5%) occurred after 6 months because of too small a prosthetic mesh. CONCLUSIONS: This laparoscopic technique can be applied to recurrent hernias, even in difficult cases, with low morbidity rates. Recurrence rates as low as for laparoscopic repair of primary hernias can be expected.

Adult↗
PubMed1995

Sonography in the postoperative evaluation of laparoscopic inguinal hernia repair.

We evaluated the use of sonography as a means of assessing hernial occlusion and possible postoperative changes such as hematomas or seromas in the inguinal and scrotal regions after 1139 laparoscopic repairs of hernias between August 1992 and November 1994. Changes after laparoscopic hernia repair were found in 307 patients (27%). Hematomas or seromas were seen in 132 patients, protrusion of the prosthetic mesh in 17, mesh infection in two, and small bowel entrapment in an insufficient peritoneal suture in two. Recurrences were diagnosed correctly in six patients, mobile preperitoneal lipomas in five. Sonography is useful in the evaluation of complications after laparoscopic hernia repair, including recurrent hernia. In the absence of symptoms, sonography is not indicated.

Adolescent↗
PubMed1994

[Laparoscopic surgery of inguinal hernia by transperitoneal implantation of an artificial mesh. Technique and early results].

We report on 250 patients with 342 inguinal hernias operated laparoscopically by pre-peritoneal implantation of a prosthetic mesh. 167 hernias were indirect, 175 direct, including 92 bilateral, 71 recurrent and 4 femoral hernias. There were four major complications: two lesions of the urinary bladder, treated in one case by laparotomy and two foreign body reactions against the mesh, which had to be removed. Two recurrences (0.6%) occurred during a 2-12 months follow-up. The mean hospital stay was 4 (3-10) days. Return to full activity was possible after one week.

Adult↗
PubMed1992

[The value of nuclear magnetic resonance tomography in diagnosing invasive trophoblast disease].

13 patients between 19 and 35 years, 12 of them with histologically verified trophoblastic disease, were examined by MRI, to prove the diagnostic value of this method. In line with the excellent results of MRI described in the literature with respect to the differentiation of tissue characterisation, vascularisation and localisation of tumours, the response to chemotherapy was evaluated comparatively to HCG-titres (5 patients). The results showed, that a decrease of HCG-titres correlated with significant tumour reduction. MRI was performed with 1.5 Tesla machines. Axial, sagittal and coronal images of pelvis and abdomen in T1, proton density and T1 sequences, one after administration of Gd-DTPA, were carried out. Except for one case with decreasing titres, GTP was proven by MRI. The tumour showed a remarkable lack of homogeneity and signal increase in 7 cases in T2-weighted images. In one case, the tumour showed a marked signal enhancement after applying Gd-DTPA, compared with the normal myometrium. In 5 cases, destruction of the zonal anatomy of the uterus and dilatation of subserosal uterine and pelvis veins were found. The uterus was larger in size than expected for the duration of gravidity. In correlation with the clinical examination and HCG titres, MRI has the potential of multiplanar imaging and signal characterisation of tissue, and is therefore useful to evaluate the tumour extent and to detect residuals. Gradient echo-technique and the use of contrast media will reduce the duration of examination, but more experience is required.

Adult↗
PubMed1991

[A two-stage kidney rupture following an intrarenal kidney cystic lesion].

Five days after a blunt trauma with intrarenal rupture of a renal cyst, whereby temporarily a calyceal communication had formed, there was a spontaneous second rupture of the cyst with excessive retroperitoneal haemorrhage. Surgical treatment was necessary and could be accomplished without nephrectomy. Both an arterial bleeding at the bottom of the cyst and a several days' old renal infarction at the edge of the cyst seemed to be relevant for the two-stage rupture. The sonographic, urographic and surgical findings are reported.

Adult↗
PubMed1990

[The value of sonography in scrotal trauma].

65 patients with penetrating or blunt scrotal trauma underwent scrotal ultrasound. High-resolution real-time sonography was able to differentiate testicular from extratesticular lesions in all cases. Lesions of the epididymis were diagnosed in 14 cases. In epididymal haematoma sonography revealed an hyperechoic enlarged epididymis whereas posttraumatic epididymitis was demonstrable as hypoechoic swelling. 14 testicular ruptures and 6 testicular haematomas without disruption of the tunica albuginea were correctly diagnosed. Diagnosis could be confirmed at operation in 12 cases and by clinical and sonographic follow-up in 8 cases. A heterogeneous parenchymal pattern, contour abnormalities, poorly defined margins and obvious fragmentation of the testicle strongly suggest testicular rupture.

Adolescent↗
PubMed1990

[The effect of sonography on the therapeutic outcome in posttraumatic, postoperative and inflammatory soft tissue lesions].

A total of 135 patients with a suspected diagnosis of post-traumatic, postoperative or inflammatory soft-tissue lesions were examined by ultrasound. The majority of patients (n = 48) showed post-traumatic soft-tissue hematomas with or without muscle rupture. Post-operative hematomas were found in 23 and hematomas after anticoagulation therapy in 4 patients. Inflammatory soft-tissue lesions were diagnosed in 14 patients and inflammatory tendon lesions in 16. The ultrasonographic diagnoses and therapeutic consequences were compared retrospectively. Therapeutic management was based upon the clinical signs and sonographic findings. Ultrasonically guided needle aspiration is of diagnostic value and is performed as a therapeutic modality as well.

Adolescent↗
PubMed1990

[Computerized tomography diagnosis of cavernous thymus hemangioma and differentiation from other mediastinal hemangiomas].

A case of cavernous haemangioma of the thymus is reported, including the findings of conventional X-ray imaging, computed tomography, surgery and histology. In addition, the literature of thymic angiomatous mesenchymomas as well as of mediastinal haemangiomas is reviewed. The tumour of a 29-year old and asymptomatic woman was located in the anterior mediastinal compartment at the site of the left thymic lobe. The tumour contained phleboliths and was surrounded by a small capsule of fat. After bolus infusion of contrast agent a delay of enhancement could be detected by CT, which led to the diagnosis. Due to the fact that the status of thymic tumours must assessed with special care, operation and histologic investigation were required. Thymic haemangiomas in contrast to other mediastinal haemangiomas are most amenable to surgical treatment. One year after surgery the patient is still in good health without evidence of tumour regrowth.

Adult↗
PubMed1989

[The value of seminal vesicle sonography in transrectal ultrasonic examination of the prostate].

During the course of four and a half years, transrectal sonography was performed in 724 men; in each case the seminal vesicles and prostate were evaluated. In 149 examinations, changes were found in the seminal vesicles and in 143 of these, the sonographic finding suggested that the changes were due to prostatic disease. In 95 histologically proven prostatic carcinomas, infiltration of the seminal vesicles could be demonstrated. In three patients there was an empyema and in three others a malformation of the seminal vesicles. Prostatic sonography is essential for accurate diagnosis of the basic abnormality.

Adult↗
PubMed1989

[Injuries of the intracranial arteries in the angiogram].

Damage to intracranial arteries was demonstrated angiographically in 24 patients with severe trauma to the skull and brain. The most common abnormalities were damage to the intima and traumatic carotid-cavernous fistulae (nine cases each). In addition, there were six traumatic aneurysms of the internal carotid artery, two extravasates from ruptured intracranial branches and one traumatic A-V fistula between the middle meningeal artery and the spheno-parietal sinus. The arterial damage was diagnosed either during the acute stage or after a latent period of days and weeks, if there were signs of intracranial bleeding or other evidence of vascular damage. Cerebral angiography in two or more projections is the method of choice for demonstrating even minor vascular lesions.

Adolescent↗
PubMed1988

The value of sonography in the diagnosis and follow-up of patients with blunt renal trauma.

Eighty-eight patients with blunt renal trauma were examined sonographically. Rupture of the kidney was diagnosed in 41 patients and contusion of the kidney in 45. The correlation between operative findings, sonography and urography showed positive sonographic findings to be correct in all patients with rupture of the kidney. In 4 patients with normal sonograms, the diagnosis of a contusion was based on the urographic results. Three patients underwent angiography. An intimal lesion was seen in 2 and a tear of the renal artery in 1. The results of our investigation suggest that sonography should be applied in the first place in the evaluation of blunt renal trauma. It is the investigation of choice during follow-up after surgical as well as conservative therapy.

Adolescent↗
PubMed1988

Value of ultrasonography in preoperative diagnosis of rotator cuff tears and postoperative follow-up.

Four hundred and six patients presenting with shoulder pain underwent bilateral shoulder ultrasonography. Rotator cuff lesions were diagnosed in 197 patients. In 155 of the 308 patients who had additional arthrographic examinations, the arthrogram documented rotator cuff tears. Sixty-eight patients underwent surgery. There was good correlation between the ultrasonographic and arthrographic findings as well as the surgical results, with a sensitivity of 91% for each examination technique. Thirty-six postoperative patients were studied ultrasonographically; a minor to marked increase in rotator cuff echogenicity was demonstrated in them all. Its high predictive value makes ultrasonography the method of choice in diagnosing rotator cuff tears. Based on the evaluation of particular criteria, rotator cuff tears (greater than 1 cm) are commonly documented by ultrasonography. Only in patients with indeterminate or negative ultrasonograms in whom there is a high index of clinical suspicion, should arthrography be performed as a complementary imaging test. In postoperative follow-up the degree of scar formation at the reinsertion of the tendon is adequately documented by ultrasonography.

Adult↗
PubMed1987

Ultrasound in patients with blunt renal trauma managed by surgery.

We investigated 24 patients with blunt renal trauma by excretory urography plus nephrotomography and ultrasound. The results of these investigations were correlated with the operative findings. The ultrasound diagnosis was correct in 16 of 18 patients with parenchymal injuries. Injuries to the renal pelvis, ureter and renal pedicle were suspected only in connection with excretory urography. Ultrasound provides an excellent inexpensive noninvasive diagnostic tool for the initial diagnostic study of patients with blunt renal trauma.

Adult↗
PubMed1987

Clinical significance of sonography of the ureter.

The relevance of sonography compared with conventional methods is demonstrated by means of 103 patients investigated with obstruction of the ureter. The knowledge of the exact topographic anatomy of the ureter in all sections enables the experienced investigator to demonstrate cause and position of ureteral obstruction by sonography in up to 75% of cases. Ultrasound is not sufficiently accurate to be used as the primary modality, but could be the initial modality in specific circumstances such as pregnancy, children or patients with a history of reaction to contrast media.

Adolescent↗
PubMed1986

[Sonographic monitoring in blunt abdominal injuries in children].

Sonography is nowadays the most important examination in diagnosing lesions of the parenchymatous organs after blunt abdominal trauma. Also for monitoring this method is recommended. Under the premises of 1. no clinical deterioration, 2. the possibility for repeated ultrasound investigations, and 3. readiness to operate at any moment it is possible to treat traumatized parenchymatous organs conservatively. This is of utmost importance in paediatric surgery because of the risk of overwhelming postsplenectomy infection after splenectomy especially for young children. Examples for conservative treatment for trauma to spleen, liver and kidney are discussed.

Abdominal Injuries↗
PubMed1986

[Sonography as a new diagnostic procedure for resolving shoulder problems].

Eighty-one sonographic examinations of patients with complaints relating to the shoulder joint have shown that this is the method next in value to radiological examination. So far, lesions of the rotator cuff and of the long head of the biceps could only be demonstrated by invasive procedures such as arthrography or arthroscopy. In these situations, sonography attains a similar accuracy. Diffuse lesions can also be diagnosed correctly, making arthrography and arthroscopy unnecessary. In addition, sonography can demonstrate inflammatory and degenerative changes and incomplete sub-acromial and intermediary tears of the rotator cuff, unlike conventional diagnostic methods. In future, arthrography and arthroscopy will only be necessary as additional diagnostic methods if sonography remains inconclusive.

Adult↗
PubMed1986

[Sonographic diagnosis of an aneurysm of the superior mesenteric artery].

This is a report on a patient with a mycotic aneurysm of the superior mesenteric artery proved by histology. Because of a marked intolerance of contrast media we abstained from angiography. It is shown that real-time sonography gives a definite diagnosis, if the multiple vascular structures of the upper abdomen are precisely identified.

Aneurysm, Infected↗