PubMed Health⌕ Search

Biomedical subjects

D Kirndörfer

Publications and source records attributed to D Kirndörfer.

9 recordsLinked to original sources
PubMed1981

[Therapeutic principles and priorities of polytrauma in general surgery (author's transl)].

The absolutely prior task in patients with multiple injuries is to maintain the cardiac and pulmonary functions. Furthermore a quick decision is needed regarding additional life-saving operations. Apart from a careful clinical investigation simple diagnostic procedures are necessary (chest x-ray, peritoneal lavage). The life of the injured person is endangered through hemorrhages. The most effective therapy is to recognize and to stop these bleedings. The surgical repair of intestinal ruptures, injuries to the pancreas, ruptures of the diaphragm and other problems can be postponed. The same applies to most of the thoracic injuries, except to the tension pneumothorax. Mediastinal injuries require the use of the heart-lung-machine, if the heart and the big vessels are involved. The extent of an operation and the intraoperative procedure are determined by the injury.

Abdominal Injuries↗
PubMed1980

[Thorax trauma].

263 patients with severe thoracic trauma were treated between 1961 and 1977. In 219 cases, most of them being traffic accidents, the injury was caused by blunt trauma. 80% were thoracic emergencies. Injuries of the mediastinal organs were observed in 26 cases. Even the slightest suspicion of injuries of the airways demands bronchoscopy. In case of rupture early surgical intervention gives the best results. 3 of 7 patients with tracheo-bronchial rupture were saved. Complete rupture of the large vessels of the myocardium leads to fatal bleeding. Partial rupture can be survived. Angiography gives proof of dissecting aneurysm. 2 of our patients with traumatic aneurysms of the aorta have survived after resection of the aneurysm and interposition of a prosthesis. Massive bleeding into the pericardium causes shock and high venous pressure in most cases. In 2 cases of traumatic valve insufficiency a Björk-Shiley-valve could be implanted sucessfuly. Perforating thoracic injuries have been observed in 44 of our patients; 7 died. Besides surgical wound care and intravenous fluids, Bülau's drainage is often the only treatment necessary. While intraabdominal lesions require immediate laparotomy, lesions of the lung generally do not demand thoracotomy. However, whenever there is suspicion of injury to the mediastinal organs immediate surgery has to be performed.

Adolescent↗
PubMed1979

[Surgical aspects of open and closed chest injuries (author's transl)].

263 persons with chest injuries were treated over a period of 16 years. 47 had performating chest injuries, in the remaining cases it was a blunt trauma. Prompt recognition of a life-endangering situation (cardiac tamponade, tension pneumothorax, mediastinal emphysema, massive haemothorax) is essential; radiological and laboratory diagnostic methods play a secondary role. The most effective emergency treatment is intercostal continuous suction; in many cases it is the only one needed. A haemothorax must be evacuated completely because of the risk of complications and fibrin formation. Thoracotomy is rarely, and surgical removal of lung tissue hardly ever, indicated. 30 persons needed emergency thoracotomy. Accompanying intraabdominal injuries, mostly rupture of the diaphragm and spleen, were observed in 45 patients. Late sequels were lung abscesses, posttraumatic cysts, pleural empyema and adhesions, atelectases. Decortication, if indicated, should be performed at an early stage.

Cardiac Tamponade↗
PubMed1979

[Tracheal and bronchial ruptures (author's transl)].

Rupture of the major airways is rare. Open injuries usually involve the trachea; injuries to the airways in closed chest trauma are in 80-90% of the cases located at the bifurcation or the main bronchus. Rupture of the bronchial system may cause an immediate threat to life, but may also produce few symptoms. The possibility of such an injury should always be taken into consideration, even if at first the clinical signs only point to damage of the lung parenchyma. Intubation and continuous suction drainage are life-saving emergency measures to be followed as soon as possible by bronchoscopy to establish the diagnosis. Treatment is by prompt suture or anastomosis. Failure to diagnose rupture of a bronchus results very soon in stenosis and, later on, in damage to the lungs and jeopardizes the success of subsequent reconstructive surgery. The repair of extended stenoses presents particularly difficult technical problems. Alloplastic grafts may be the answer. During 1961-1978 7 persons with injuries to the trachea and bronchi were treated at the Department of Surgery, Giessen. 3 persons were saved by immediately performing an anastomosis.

Bronchi↗
PubMed1979

[Injury to the mediastinal organs in chest trauma (author's transl)].

10% of chest traumata are accompanied by injuries to the mediastinal organs. Since rupture of a bronchus may be masked by additional intrathoracic injuries any suspicion of such lesion must be verified by bronchoscopy. Symptoms of a shock condition after traumatization of the precordial region point to damage to the heart the extent of which may range from a slight disturbance of cardiac function (commotio cordis) to laceration of cardiac tissue and rupture of the myocardium. Enlargement of the mediastinum after a sufficiently forceful chest trauma should be examined by visualization of the aortic arch to elucidate its aetiology and exclude an aortic aneurysm. The mortality of chest trauma involving the mediastinal structures is 35%. This fairly high figure is partly attributable to severe accompanying injuries.

Adult↗
PubMed1976

Effect of 13-Nle-motilin in postoperative ileus patients: a double-blind trial.

In this study, the effect of 13-norleucine motilin (13-Nle-M) on post-cholecystectomy ileus was assessed in 6 female patients. 13-Nle-M given by continuous i.v. infusion (0.4 mug/kg-h) on the second and third day following surgery did not influence the manifestation and duration of intestinal paralysis in comparison to 6 control patients treated with 0.9% saline. Bowel sounds, however, were more pronounced in the 13-Nle-M-group. Blood pressure and pulse rate were not influenced by the polypeptide, and no other side effects were seen, either.

Adult↗