[Surgical treatment of metastases to the extremities].
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Adult↗
Biomedical subjects
W Düsel
Publications and source records attributed to W Düsel.
[Prognosis of perforating gastroduodenal ulcer: simple closure or definitive ulcer operation?].
95 patients are reported, who had perforation of a gastroduodenal ulcer. In 47 cases the perforation was oversewn only; primary or secondary high selective vagotomy (HSV) were done in 33 cases and resection in 15 cases. Lethality of the first group was 23.3%; it was 9.1% after primary HSV and resection. No death was recorded in the group of 26 patients, who had secondary HSV or resection. In the group of patients surviving, which had symptoms for more than 3 months prior to surgery, 42.4% had new symptoms of ulcer diseases after surgery and 27.2% actual relapse, if the perforation had been oversewn only. These numbers were 16.2% after HSV and 5.4% after resection respectively. In patients where the ulcer was located intra- or postpylorically symptoms of ulcer disease were observed in 42.1% after simple oversewing, and in 15.4% after HSV or resection, the difference being significant. There was no difference between incidence of postoperative symptoms when ulcers was located prepylorically.
Adult↗
[Results of the surgical treatment of bleeding gastroduodenal ulcers].
Within 11 years 279 operations for acute bleeding from gastroduodenal ulcers were performed at the surgical University Clinic in Würzburg. Of the 279 patients, 140 had to be operated on immediately because of acute severe bleeding. Of the 158 bleeding duodenal ulcers, 104 had a selective proximal vagotomy (SPV), 29 had gastric resection, and in 25 the ulcer was simply closed. The overall mortality after SPV was 8.6%, 62% after gastric resection, and 40% after simple suture ligation. Recurrent bleeding occurred in 8.7% after SPV, 10.3% after gastric resection, and in 24% after suture ligation. Of the 89 bleeding gastric ulcers, 25 had a selective proximal vagotomy, 30 a gastric resection, and 34 excision of the ulcer. The overall mortality after SPV was 16%; after gastric resection it was 23.3% and 41.2% after ulcer excision. Recurrent bleeding was observed in 8% after SPV, in 10% after gastric resection and in 11.7% after ulcer excision.
Female↗
[Cimetidine with suture ligature of ulcers - an alternative in the treatment of severe acute gastroduodenal ulcer hemorrhage].
The results of SPV with suture ligation of the ulcer (n = 60), suture ligation combined with postoperative Cimetidine medication (n = 20) and suture ligation alone (n = 20) for severely bleeding gastroduodenal ulcers were studied retrospectively and compared. No significant difference could be found between suture ligations of the ulcer combined with SPV or Cimetidine concerning recurrent bleeding and specific or overall mortality. Their rate were highest after suture ligation alone as well in bleeding duodenal ulcers as in gastric ulcers.
Acute Disease↗
[Clinical results of Child' and Phillips' mesenteric plication for the prevention and therapy of small intestinal ileus].
Mesenteric plication was performed on 148 patients (99 adults and 49 children) in the Surgical Department of Würzburg University. Recurrent bowel obstruction occurred as an early complication in 6.8%. A relaparatomy was necessary in all cases. 4 out of 10 recurrences were due to complications of the method itself. Recurrent bowel obstruction in the form of a subileus occurred as a late complication in 2.2%. There was a concurrent peritonitis at the time of mesenterial plication in 52 patients. The number of relaparatomies in the presence or absence of peritonitis was 15.4% and 8.3%, respectively. No patient died of complications due to plication. The intestinal transit time was normal 2 to 11 years after the procedure in over 92% of the patients. The typical arrangement of the small bowel mucosa was absent in 81%.
Adult↗
[Two cases of ischemic cerebral damage associated with catheterization of the internal jugular vein (author's transl)].
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Aged↗
[Benign hepatomata while taking oral contraceptives (author's transl)].
In recent years an increase in benign hepatomata during administration of oral contraceptives has been reported many times. A case is reported here of a 38-year-old woman who took such contraceptives for 8 years. The cardinal symptom was a tumor in the right upper quadrant of the abdomen. Laparotomy revealed several nodules in both lobes of the liver which could be almost completely removed by a wedge-shaped incision. Histologically a multicentric, focal nodular hyperplasia was present. Follow-up examinations after 24 months show no enlargement of the remaining tumor residues.
Adenoma↗