Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
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We report about a severe retroperitoneal bleeding of a ruptured angiomyolipoma of kidney. Despite of maximal diagnostic effort including CT and angiography it was not possible to find the exact diagnosis preoperative. The extensive bleeding did not allow to resect only the tumor, nephrectomy was necessary.
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In a 28-year-old woman right-sided pneumothorax developed during a laparoscopic cholecystectomy. The authors believe that the pneumothorax was caused by in the inflow of carbon dioxide into the thoracic cavity without injury to the diaphragm. So far, only a few reports of this complication exist, but in the future it will probably occur more frequently, since the number of laparoscopic operations is increasing. The symptoms are alterations in capnography, subcutaneous emphysema and diminished respiratory sounds.
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After the first successful laparoscopic closure of a perforated peptic ulcer in 1990, 13 consecutive patients with laparoscopic closure were compared to 8 previous patients with conventional surgery. The endpoints adverse advents (complications), pain intensity, fever, leucocytosis and hospital stay showed no clinically relevant differences. ⋯ Laparoscopic closure of perforated peptic ulcer is technically feasible. The safety of the method and the benefit for the patient need proof by a randomized controlled trial.