0000000000347507
AUTHOR
E. Lang
Die Perforation bei Morbus Crohn als Komplikation in der Schwangerschaft
The manifestation of Crohn's disease with perforation in pregnancy has been described in one case only. In our case, a 25-year-old woman in the 28th week of pregnancy was admitted to our hospital with signs of an acute abdomen. Due to deterioration of the maternal and foetal situation, the child was delivered by a Caesarean section. Subsequently, exploration of the abdomen showed an ileum perforation with diffuse fibrinous peritonitis. In this case, the definitive diagnosis could not be made prior to laparotomy. The aim of surgical therapy in such cases should be the limited resection with end to end anastomosis. In diffuse peritonitis, discontinuous resection and secondary reconstruction a…
SARS-CoV-2 vaccination modelling for safe surgery to save lives: data from an international prospective cohort study
Abstract Background Preoperative SARS-CoV-2 vaccination could support safer elective surgery. Vaccine numbers are limited so this study aimed to inform their prioritization by modelling. Methods The primary outcome was the number needed to vaccinate (NNV) to prevent one COVID-19-related death in 1 year. NNVs were based on postoperative SARS-CoV-2 rates and mortality in an international cohort study (surgical patients), and community SARS-CoV-2 incidence and case fatality data (general population). NNV estimates were stratified by age (18–49, 50–69, 70 or more years) and type of surgery. Best- and worst-case scenarios were used to describe uncertainty. Results NNVs were more favourable in su…
Der Aussagewert der endorektalen Sonographie beim präoperativen Tumorstaging und der postoperativen Tumornachsorge
Fortgeschrittene Rektumkarzinome werden kontinenzerhaltend reseziert bzw. abdominoperineal exstirpiert. Fruhe Stadien des Rektumkarzinoms konnen dagegen moghcherweise durch die lokale Exzision als ausreichend therapiert angesehen werden. Entscheidend fur die Selektion der Patienten zur lokalen Exzision ist eine moghchst exakte praoperative Beurteilung der Tumorinfiltration. Die Treffsicherheit der rektal-digitalen Untersuchung bei der Beurteilung fruher Stadien des Rektumkarzinoms hegt bei etwa nur 70% [4]. Die Endosonographie eroffnet hier neue Moglichkeiten. Wie verschiedene Autoren zeigen konnten, ist endosonographisch eine zuverlassige Beurteilung des T-Stadiums in knapp 90% der Falle m…