Search results for "abdominal"
showing 10 items of 886 documents
Darmkontrastierung bei der abdominellen Computertomographie: Wasser oder Kontrastmittel?
1991
The suitability of water as an oral or rectal contrast medium for abdominal CT was studied in 56 patients and compared with an iodine-containing water-soluble contrast medium (ioxital amino acid). In some cases it was impossible to differentiate gastrointestinal structures from extraluminal fluid collections (cystic tumours, ascites, abscesses) and there was poor filling of distal small bowel and colon. The routine use of water can, therefore, not be recommended. In some cases, however, water can result in improved image quality by reducing artifacts and improving the demonstration of the mucosa.
Die direkte perkutane radiologische Jejunostomie (PRJ) und Duodenostomie: eine retrospektive Auswertung
2005
Purpose: To present our experience with direct percutaneous radiologic duodenostomy and jejunostomy (PRJ) for alimentation. Materials and Methods: A retrospective study identified 24 patients who had undergone percutaneous jejunostomy or duodenostomy guided by CT and fluoroscopy over a period of 9 years. Whenever possible, the jejunum was inflated with a 5 French diagnostic catheter and jejunopexy was performed using Cope anchors (T-fasteners). A 12 to 14 French locking pigtail drain was inserted for alimentation. In 8 patients, percutaneous direct jejunostomy was performed using only fluoroscopy. In 9 patients, both CT and fluoroscopy were used to guide the jejunostomy. In all 7 patients w…
Is preoperative radiographic localization of islet cell tumors in patients with insulinoma necessary?
1993
Preoperative localization tests [sonography, computed tomography, angiography, percutaneous transhepatic portal venous sampling for insulin radioimmunoassay (PTP)] have a sensitivity of 60% to 90% in cases of organic hyperinsulinism. In all publications, however, the sensitivity of intraoperative localization, 75% to 100%, is distinctly higher. With the exception of PTP, all tumors that can be identified by preoperative localization can also be detected using palpation or intraoperative sonography. Preoperative localization diagnosis is therefore not absolutely necessary prior to primary operation in the case of organic hyperinsulinism. It is requested by many surgeons because: (1) only a f…
Biomechanical and histological evaluation of abdominal wall compliance with intraperitoneal onlay mesh implants in rabbits: A comparison of six diffe…
2012
Abstract Background An ideal prosthetic mesh for incisional hernia repair should mimic the anisotropic compliance of the abdominal wall, and at lower loads should exhibit higher distensibility without impairment of safety at higher loads. This study evaluated the biomechanical properties of six meshes in a rabbit model. Methods New Zealand white rabbits were used for this study. Two meshes of the same brand (Ethicon Physiomesh™, Bard Composix ® L/P, Gore Dualmesh ® , Bard Sepramesh ® , Ethicon Proceed ® or Parietex™ Composite) were implanted into each animal for assessment of intra-abdominal hernia repair, with a total of ten meshes per group. Twelve weeks after implantation, the abdominal …
Non-invasive ventilation in postoperative patients: A systematic review
2010
Background: Postoperative pulmonary complications, generally defined as any pulmonary abnormality occurring in the postoperative period, are still a significant issue in clinical practice increasing hospital length of stay, morbidity and mortality. Non-invasive ventilation (NIV), primarily applied in cardiogenic pulmonary edema, decompensated COPD and hypoxemic pulmonary failure, is nowadays also used in perioperative settings. Objective: Investigate the application and results of preventive and therapeutic NIV in postsurgical patients. Design: A systematic review. Data sources: Medical literature databases were searched for articles about "clinical trials," "randomized controlled trials" a…
Treatment of congenital abdominal wall defects —a 25-year review of 132 patients
2013
The outcome data of 132 patients treated at the Department of Pediatric Surgery in Mainz during the last 25 years were reviewed. Prenatal diagnosis of abdominal wall defects (AWDs) and associated malformations led to increasing selection of the patient population. The aim of primary closure of the abdominal wall can be achieved more frequently in gastroschisis (GS) than omphalocele (OC), while the postoperative course is more complicated and of longer duration in GS. Delayed or secondary closure extended the hospitalization period but had no negative effects on the outcome. Reoperations or planned secondary operations were performed in 23 patients with GS and 14 with OC. Early mortality was…
Surgical treatment of chronic thromboembolic pulmonary hypertension
1999
Background: Chronic thromboembolic pulmonary artery obstruction from unresolved pulmonary emboli is characterized by persistent elevation of pulmonary vascular resistance and progressive right heart dysfunction and failure. The diagnosis of chronic thromboembolic pulmonary hypertension is difficult and often missed. Medical therapy is ineffective in these patients. The prognosis is poor and depends on the degree of pulmonary hypertension. Pulmonary thromboendarterectomy has proven to be an effective and potentially curative surgical therapy for this clinical entity although less than 1000 cases have been reported in the surgical literature. Methods: The current principles of diagnosis, pati…
Goals of Care in Emergency Abdominal Surgery in the Elderly and Frail Patient
2021
Elderly and frail patients are often those at highest risk during surgical procedures both in terms of intraoperative complications and postoperative outcome. It is clear that the best therapeutic result in the elderly and frail patient can be obtained through multidisciplinary management of the problem. In the management of elderly and frail patients undergoing to emergency surgery, we can make a series of considerations that guide our decision-making process. First, correct diagnosis can be difficult because of the impaired cognitive and physical status of the patient or other clinical conditions and medications that mask signs and symptoms. Second, the choice of the treatment to be carri…
Gastrointestinal perforation: ultrasonographic diagnosis.
2013
Abstract Gastrointestinal tract perforations can occur for various causes such as peptic ulcer, inflammatory disease, blunt or penetrating trauma, iatrogenic factors, foreign body or a neoplasm that require an early recognition and, often, a surgical treatment. Ultrasonography could be useful as an initial diagnostic test to determine, in various cases the presence and, sometimes, the cause of the pneumoperitoneum. The main sonographic sign of perforation is free intraperitoneal air, resulting in an increased echogenicity of a peritoneal stripe associated with multiple reflection artifacts and characteristic comet-tail appearance. It is best detected using linear probes in the right upper q…
Classification of Chimney EVAR-Related Endoleaks: Insights from the PERICLES Registry
2017
Juxtarenal aortic aneurysms (JAAs) pose significant challenges for endovascular aneurysm repair (EVAR). A short or absent infrarenal neck typically excludes standard EVAR as a viable or reasonable treatment option. In this context, the use of chimney grafts (chEVAR) is gaining in popularity and applicability. These grafts are designed to course in the aortic lumen outside the main stent-graft to maintain normal perfusion to the involved target branches. As such, they may represent a promising and less resource-intensive option for management of JAAs. However, this technical strategy is not without challenges of its own, particularly the inevitable creation of “gutters” that result from the …