Search results for "paro"
showing 10 items of 950 documents
Achalasia
2012
Introduction Many physicians are inadequately familiar with the clinical features of achalasia. Often, it is not diagnosed until years after the symptoms arise. This is unfortunate, because a delay in diagnosis worsens the prognosis.
Obere gastrointestinale Blutung mit hämorrhagischem Schock am Ende einer Urlaubsreise: Präklinische und innerklinische Versorgung eines gastrointesti…
2014
ZusammenfassungNach der Rückkehr aus dem Urlaub wurde ein 55-jähriger Patient mit Teerstuhl und hämorrhagischem Schock im Zugabteil eines InterCity der Deutschen Bahn notfallmedizinisch versorgt und in ein Krankenhaus der Maximalversorgung eingeliefert. Hier erfolgte zunächst die weitere notfallmedizinische Behandlung, in deren Rahmen in der internistischen Notaufnahme in interdisziplinärer Zusammenarbeit eine Stabilisierung der Hämodynamik sowie die Sicherung der Atemwege und Atemfunktion erfolgten. Anschließend wurde eine Notfall-Endoskopie des oberen Gastrointestinaltrakts durchgeführt. Ursächlich für das hämorrhagische Schockgeschehen war eine arteriell spritzende, endoskopisch nicht zu…
Analysis of inter-atrium differences in paroxysmal and persistent atrial fibrillation using principal component analysis
2007
The pathophysiological mechanisms of atrial fibrillation (AF) are not entirely clear yet, and there is no full explanation for the development and evolution of the arrhythmia. The goal of this study is to find inter-atrium differences in electrophysiological behavior between persistent and paroxysmal AF. The database analyzed contains intra-cardiac records from 14 patients with paroxysmal AF and 10 with persistent AF. Dominant frequency and sample entropy measurements showed that in the paroxysmal group there was a left-to-right gradient. These differences were enhanced after the extraction of the main components with principal component analysis. These findings may be interpreted as a poss…
Laparoscopic sentinel lymph node mapping and excision of the rectum using a radioactive tracer — a prospective experimental study
2009
Introduction: Patients with a low risk T1 rectal carcinoma can undergo the therapy of a local excision. In these patients the lymph node status remains unknown. There is a potential risk of up to 7% for nodal metastasis, in high risk cases it can rise up to 35%. To investigate the possibility of using the Sentinel lymph node (SLN) concept, which is anchored in the therapy of malignant melanoma and breast cancer, an experimental study on pigs was undertaken. The objective of the study was to laparoscopically identify and extract SLN’s from the rectum using a radioactive tracer (RT). Material und Methods: The experiment was conducted upon 30 pigs, because sample size calculation indicated tha…
Update in laparoscopic approach to acute mesenteric ischemia
2016
AMI is an uncommon but serious disease often associated with a bad prognosis, associated with occlusion of Superior Mesenteric Artery (SMA) for embolism or thrombosis (67.2 %), mesenteric venous thrombosis (15.7 %), and non-occlusive mesenteric ischemia (15.4 %). Clinical markers are often aspecific and symptoms low suggestive. The gold standard for the diagnosis is multidetector CT Angiography (CTA) with sensibility of 93.3 % and specificity of 95.9 %. Abdominal exploration could be useful to confirm cases of AMI without signs of SMA occlusion at CTA. Few reports have been found on the diagnostic role of Exploratory Laparoscopy. To increase the sensibility of laparoscopy in the diagnosis o…
Adrenal gunshot wound: Laparoscopic approach. Report of a case
2013
introduction: Although there is no debate that patients with peritonitis or hemodynamic instability should undergo urgent laparotomy after penetrating abdominal injury, it is also clear that certain stable patients may be managed without operation. Controversy persists regarding use of laparoscopy. PRESENTATION OF CASE: We report a case of gunshot wounds with bullet in left adrenal gland and perirenal subcapsular hematoma. The patients had no signs of peritonitis but in the observation period we noted a significative blood loss, so we performed an exploratory laparoscopy. DISCUSSION: We found the bullet in adrenal parenchyma. The postoperative period was regular and the patient was discharg…
Chylous ascites after lymphadenectomy for gynecological malignancies
2016
Background and Objectives Chylous ascites, an accumulation of milky-white lymph fluid in the peritoneal cavity, is a rare complication following retroperitoneal lymphadenectomy. This study evaluated the appearance and management of chylous ascites following lymphadenectomy for gynecological malignancies. Methods A total of 931 patients who underwent lymphadenectomy for gynecological malignancies at Erlangen University Hospital between 2002 and 2013 were reviewed retrospectively. Results Chylous ascites occurred postoperatively in 28 of the 931 patients (3.0%). All patients with chylous ascites had undergone combined systematic para-aortic and pelvic lymphadenectomy (SAPL). Patients with chy…
Mirizzi syndrome in a patient with partial gastrectomy with Billroth II anastomosis: A case report
2020
Highlights • Obstructive jaundice may be a challenge for differential diagnosis. • Mirizzi Syndrome may simulate clinical and radiological presentation of common bile duct stones. • ERCP hardly achieves cannulation of biliary duct in altered anatomy, so gastroscope may be a correct choice in these cases. • Surgical treatment is essential in Mirizzi Syndrome.
Small bowel volvulus due to a large intestinal lipoma: A rare case report
2020
Highlights • These are rare, benign, slow-growing mesenchymal tumors originating from adipose tissue in the bowel wall. Lipomas of mesentery, mesocolon, and antimesenteric side of intestine are extremely rare. • We describe a case of small bowel obstruction secondary to volvulus due to an antimesenteric ileal lipoma. • Mesenteric lipomas are rare clinical entity, with less than 50 cases described in English language literature. CT scan is the gold standard imaging modality for diagnosis of mesenteric lipoma and other lipomatous abdominal masses. • It shows homogenous tumor of adipose tissue, gives information about features of the small bowel and if there is evidence of ischemia and can dem…
Unusual giant chromophobe renal cancer totally managed with laparoscopic technique: Report of a case
2020
Highlights • We describe a case report of giant renal cell chromophobe carcinoma totally treated by laparoscopic surgery. • The size of renal lesion represents a critical point in surgical approach because to perform a laparoscopic radical nephrectomy can be challenging even for skilled surgeons in giant renal tumors. • A brief review of literature was performed to identify outcomes and potentially surgical advantages of laparoscopic approach for retroperitoenal liposarcoma. • The possibility of the laparoscopic approach derives from from the preoperative identification of adipose cleavage, from the absence of invasion of major vascular axes, from the absence of distant metastatic lesions.