Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
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Between 1986 and 1988, 999 patients were treated on the emergency scene, then transported with the rescue-helicopter in the Basle area. 687 were victims of a trauma (70.5%) and 287 patients were suffering from an acute internal medicine disease. We performed in-field therapy on the accident scene itself in 53.9% of all the cases. ⋯ Air rescue by helicopter allows fast transportation of patients and immediate high quality intensive care. The low mortality rate during treatment before transport (2.6%) and during the transport itself (0.3%) shows that early beginning of medical treatment on the accident scene is connected to better survival chances.
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61 patients with abdominal abscesses and fluid collections as a postoperative complication underwent percutaneous drainage. 60 abscesses, 11 haematomas, 3 steril seromas and 3 bile collections were drained. The fluid collections were associated with biliary or enteric fistulae in 16 cases. ⋯ The overall mortality rate was 13%. Reasons for drainage failure were infected clots, phlegmonic abscesses and pancreas involvement of the abscesses.
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Case Reports
[Abdominal intercostal nerve pain. A contribution to differential diagnosis of acute abdominal pain].
Intercostal nerves and their vascular supply can be impinged in a fascial gap of the m.rectus abdominalis and cause neural pain simulating visceral symptoms. The diagnosis is based on clinical symptoms and proven by histological demonstration of cicatricial impingement of an intercostal nerve. The disease can be cured by simple resection of the impinged nerve.
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The paper defines indications for amputation, reconstruction and replantation of severely injured extremities of multiple traumatised patients using the trauma score PTS (Hannover Polytrauma Score) and the fracture grading for open and closed fractures.