[Post-traumatic space-occupying trauma].
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Biomedical subjects
Publications and source records attributed to H D Strube.
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The results of the study presented in this paper are based on a comparison of two equally large groups of 33 children each with chronic appendicitis on whom appendectomy had been performed, as well as 33 children with inguinal hernia and relevant surgery. The preoperative and postoperative signs and symptoms were compared in both groups. It was found that reduction of symptoms was significantly greater following appendectomy than after herniotomy. Hence, the question whether after diagnosis based on a more liberal interpretation of the indication for appendectomy in chronic appendicitis in children, the overall well-being of the children can be improve significantly, should be given an affirmative answer.
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The diagnosis and treatment of tumors of the skeleton of the hand are reviewed. Benign enchondromas were found to be the most common. Primary osteogenetic sarcoma was rare as was malignant degeneration in initially benign tumors and in the bony manifestations of systemic disease such as neurofibromatosis or hyperparathyroidism. Tumors were more common in phalanges and metacarpals than in the carpus and showed their highest incidence in the 4th decade. Diagnosis was aided by angiography and bone-scanning. Some difficulties were encountered in pathological examination. Treatment involved curettage and cancellous grafting in small tumors, en bloc resection followed by osteosynthetic stabilisation in larger instances and radical ablation followed by chemotherapy in malignancy.
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18 patients were admitted from 1969 to 1973 to the Surgical and Urological University Clinic in Mainz with ruptured infrarenal aortic aneurysms. Three patients died immediately following the operation and three during surgery from internal hemorrhage. Eight patients died later following prolonged shock. Four patients survived surgery. The classical symptoms of shock, abdominal pain and pulsating tumor was only present in three patients. The diagnosis was only made in seven patients at admission, from the clinical findings. Urological symptoms were also prominent such as unilateral flank pain, colic, dysuria, anuria and tenderness over the kidney. There is no typical clinical picture of ruptured aortic aneurysm. Acute urological symptomatology in cases of acute abdomen with unclear etiology and in connection with shock could indicate a ruptured aortic aneurysm. There is absolute indication for immediate operative intervention. The aneurysm is removed and replaced by a vascular prosthesis. Early diagnosis is important since prolonged shock and anuria will result in a poor postoperative prognosis. Abdominal exploration is therefore also indicated when a ruptured aortic aneurysm is only suspected.
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