Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
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Following amniotic embolism a severe ARDS developed in a 21 year-old women. After two months of respirator therapy a giant tracheoesophageal fistula arose. ⋯ Our two step surgical management consisted of esophageal diversion and reconstruction of the intestinal passage by retrosternal gastric tube. The advantages and disadvantages of esophageal diversion in giant tracheoesophageal fistulas are discussed.
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The rectus sheath hematoma is a generally rare disease, however the frequency of occurrence has increased with introduction of anticoagulant therapy. It almost always mimics the symptoms of acute abdomen. In 7 out of 14 cases, which we observed, an anticoagulant therapy was administered. ⋯ In 6 patients a laparotomy was performed, because rectus sheath hematoma was not considered. The correct diagnosis was found intraoperatively as a surprising assessment. By inclusion of rectus sheath hematoma in the differential diagnosis of acute abdomen and the verification by sonography an emergency laparotomy because of a false diagnosis in the often severe ill patients can be avoided in favour of a minor and more appropriate procedure.