Biomedical subjects

C S Andeweg

Publications and source records attributed to C S Andeweg.

2 recordsLinked to original sources

PubMed2006

[Damage control surgery in polytraumatized patients].

Care for the polytraumatized patient in the pre-hospital phase has improved rapidly in recent years. This has resulted in more patients being alive on arrival at the hospital. The treatment of polytraumatized patients requires a different approach to that of regular trauma patients because they are threatened not only by the injuries themselves but also by the metabolic disruptions that follow. Therefore, the concept of damage control surgery (DCS) has been developed with the primary aim of controlling the life-threatening situation without immediate definitive repair of the sustained injuries. DCS describes a triphasic approach for abdominal and thoracic injuries and for injuries of the pelvic and extremities. The first phase aims at surgical intervention to stop the bleeding and to prevent further contamination. The second phase consists of resuscitation on the Intensive Care Unit and the third phase aims at definitive repair of the sustained injuries. Despite the low level of evidence found in the literature, DCS seems to reduce mortality rates in polytraumatized patients. Therefore, when initiated correctly and at the right moment, it appears to be a promising technique.

Abdominal Injuries↗

PubMed2001

[Two patients with retroperitoneal paragangliomas].

A 35-year-old woman and a 36-year-old man presented with abdominal complaints which, in both cases, appeared to be due to an unusual retroperitoneal tumour, namely a paraganglioma. Three years after radical excision the women had no complaints, while the male patient had developed metastatic disease; he was still alive 6 years after excision. Paragangliomas are sporadic tumours. Although well defined, these tumours are not well known, mainly due to the numerous different names used to describe them in the literature. These neuro-endocrine tumours arise from hyperplastic paraganglionic cells and occur in or near the ganglia of the autonomic nervous system. Paragangliomas may produce catecholamines and, on the basis of this, are classed as either functional or non-functional. In the absence of metastases, there are no definitive clinical, histopathological or molecular-biological parameters to predict whether a tumour is benign or malignant. Macroscopic radical surgical excision is therefore the treatment of choice. Five- and ten-year survival rates of a radically excised paraganglioma are 75% and 45%, respectively. In the case of metastatic disease, half the patients will die within 3 years. If a paraganglioma is found, genetic screening for familial neoplastic syndromes is advised.

Adult↗