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Biomedical subjects

F P Pfingsten

Publications and source records attributed to F P Pfingsten.

4 recordsLinked to original sources

Computed tomographic cholangiography using spiral scanning and 3D image processing.

Volumetric computed tomography (CT) scans ("spiral CT") were performed after intravenous (i.v.) cholangiography followed by additional 3D surface reconstructions of gallbladder and biliary ducts. 34 patients were investigated prior to cholecystectomy. No allergic adverse reactions were observed. The scan time was 24 s. Contrast enhancement in the extrahepatic bile duct and gallbladder were measured. All CT image series were reviewed independently by four experienced physicians (two radiologists, two surgeons) and compared for quality with conventional cholangiography on a three-point scale. The average rating for the demonstration of the biliary tract was significantly better for spiral CT than for conventional cholangiography (p < 0.01). In all cases sufficient contrast was found in the common bile duct (mean 315 HU). 3D imaging was considered to be helpful for intraoperative orientation during laparoscopic surgery.

Adult

[Value of sonography in diagnosis of uncertain lesions of the abdominal wall and inguinal region].

In a prospective trial we investigated the value of ultrasound in 134 patients with clinical doubtful findings of the abdominal wall and inguinal region. Ultrasound diagnosis was made by predefined criteria. In 105 patients a definite diagnosis was made by means of operative findings, CT, NMR, or puncture. In 40 patients a hernia was found. The sensitivity of ultrasound was 85%, the specifity 93.8%, the positive predictive value as 89.5% and the negative predictive value was 91%. Separating the findings to localisation of the hernia results in highest sensitivity for epigastric hernia (100%) and lowest for crural hernia (72.7%). The specifity for all hernias was more than 96%. Liquid tumors (hematom, serom, abscess) could be differentiated from solid tumors (lymphom, metastatic nodule, lipom). The most frequent course of wrong diagnosis was mixing the different liquid or solid tumors among themselves because of similar sonomorphologic properties. The sensitivity for hematom, serom, abscess, lymphom and metastatic nodule was 87.5%, 100%, 66.6%, 77% and 85.7% respectively. The corresponding specifity was 97.8%, 97.8%, 100%, 96.7% and 98%. Ultrasound was found to be of value for the diagnosis of clinical indeterminal findings of the abdominal wall and inguinal region.

Abdominal Muscles

[Surgical therapy of chronic constipation].

Results of the surgical treatment for conservative intractable constipation in 70 adult patients are reviewed. 49 patients with severe symptoms have been treated by partial colectomy as sigmoid colectomy (n = 23) or left hemicolectomy (n = 26). 33 patients underwent colectomy with cecorectal anastomosis (n = 25) or ileorectal anastomosis (n = 8). Out of these patients with colectomy seven had undergone previous segmental colonic resection or internal sphincterotomy. Of those patients with cecorectal anastomosis who were dissatisfied, three underwent ileorectal anastomosis. Overall, a mortality rate of 3.3% and morbidity rate of 22.5 resp. 54.5% for partial and total colectomy were observed. The most frequent occurring complication after colectomy was small bowel obstruction in 30% requiring laparotomy in 40%. Of 45 patients who underwent partial colectomy, 34 (75%) had normal bowel function or were markedly improved. In 28 of 32 patients (87.5%) treated by colectomy a successful result has been achieved. The operation of sigmoid colectomy or left hemicolectomy may be recommended as a treatment for constipation only in patients with less severe symptoms or patients with recurrent sigmoid volvulus. For those patients with severe constipation, at present, colectomy with ileorectal anastomosis seems to be the surgical procedure that offers the greatest probability of improvement. However, the significant morbidity claimed the need for a careful patient selection.

Adolescent

[Repair of recurrent inguinal hernia. Tactics, technic and results].

Based on 301 surgical repairs of recurrent groin hernias perioperative management and recommended techniques for preparation and repair of various kinds of recurrent hernias are presented. Follow-up examinations could be performed on 175 patients, representing 88.8% of 197 patients who underwent surgery for recurrent hernias. Shouldice's technique for hernia repair proved to be the treatment of choice for recurrent groin hernias with a recurrence rate of 2.9% (5/175). Early postoperative complications occurred up to the 14th day following surgery. Frequently they could not be documented due to an average postoperative hospitalization period of 6.2 days only. The rates of postoperative complications were 8.1% prior dismission and 12.6% within two weeks after the operation respectively.

Adolescent