Biomedical subjects
Publications and source records attributed to S Uranüs.
We describe a case of hemorrhage into the pancreatic duct, secondary to a bleeding aneurysm of the splenic artery. The problem of the diagnosis of this rare cause of upper gastrointestinal hemorrhage and therapeutic possibilities with their recurrency and mortality rates under short review of literature are discussed.
A case of retroperitoneal fibromatosis in a 28-year-old white male is presented. The soft tissue tumor, with a weight of 8000 g, was resected by laparotomy. Because of adhesions to the ascending colon and the right ureter, a hemicolectomy and partial resection of the right ureter had to be performed additionally. Intraabdominal fibromatoses are very infrequent tumorous lesions of the connective tissue, occurring retroperitoneally only in isolated cases. Their etiology is presumed to be a hereditary or gene-associated defect in the regulation of connective tissue growth. In addition, trauma and hormonal influences often appear as inductive cofactors.
Cysts are rare lesions of the spleen, and may be divided into parasitic and non-parasitic types. After the parasitic cysts, the second most frequent group is the (secondary) posttraumatic form of non-parasitic cysts. The primary form (congenital and neoplastic) of the latter is the least frequent. Whereas splenectomy was the treatment of choice for lienal cysts until a few years ago, a change has occurred in the techniques of splenic salvage. Against the background of a case report of a primary epidermoid cyst the etiology, diagnostic measures, and the recent developments in conserving spleen surgery are discussed.
We studied two new techniques for orthotopic preservation of the spleen in an animal model with respect to their technical feasibility and their hemostatic efficacy. This study was performed in two stages. In the first, the treatment of central bursting ruptures by splenorrhaphy using a resorbable compressive mesh was tested. 20 sheep have been used for this part of the study. They were divided into four groups (A: control, B: sham operation, C: splenectomy, D: mesh splenorrhaphy). Following completion of this stage, two animals from group A and two from group B were used to test a second experimental setting. Experimental trauma corresponding to isolated third degree polar rupture of the spleen was induced. This was then treated by a polar resection using stapling instruments. All animals from each stage were subjected to spleen scanning three months postoperatively, followed by splenectomy. The spleens were then examined histologically. Both macroscopically and microscopically normal splenic tissue was found. No difference between the different groups could be detected by laboratory investigations. Gamma-globulins and total serum proteins were within normal ranges after five weeks. Splenic scan revealed an excellent function of the pulp. Both techniques are distinguished by their facility and rapidity, as well as reliable hemostasis and minimal technical prerequisites.
During a period of 19 months, 22 organ preserving splenic operations were performed. Eleven of these, were severe third degree traumatic bursting ruptures, which were treated using a resorbable compressive mesh. An intralienal pancreatic cyst, a case of splenomegaly suspicious for lymphoma, one traumatic and two accidental polar lesions were treated by partial splenic resection using stapler. In two patients with traumatic and four with accidental first and second degree lienal lesions, collagen tampon and fibrin adhesive were employed. None of these patients required a second laparotomy. Aside from an edematous tail pancreatitis, no complications arose. Two patients succumbed to their severe cranial injuries. In the same period, four posttraumatic splenectomies were performed. Thus, excluding incidental and technical splenectomies, the application of the described methods resulted in orthotopic splenic preservation in 78% of traumatic splenic ruptures.
Tuberculosis of the intestine and peritoneum has become a rare disease. This is the result of a general decrease in pulmonary and extrapulmonary tuberculosis, rigorous BCG vaccination programs, and the eradication of tuberculosis in cattle. A case of tuberculosis in this frequent location, which was discovered unexpectedly during an emergency laparotomy, is reportet.
Splenic cysts are uncommon. Primary (true, epithelial) and secondary (false, non-epithelial) forms may be distinguished, the latter being more usual. Organ-preserving resection of a primary mesothelial splenic cyst, using a TA-stapler, is described and alternative techniques of splenic preservation are discussed.
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In an experimental animal study (Sus scrofa domesticus) we investigated the effects of the new technique of laser needle stimulation (wavelength: 685 nm; energy density: 4.6 kJ/cm2 per point; application duration: 20 min). The results revealed changes in microcirculatory parameters of the skin resulting in an increase in blood flow. However, the quality and intensity of the laser light did not induce micromorphological alterations in the skin.