Rozhledy v chirurgii : měsíčník Československé chirurgické společnosti
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The finding of acute inflammation of the terminal ileus frequently leads to differential diagnostic reflections whether it is the first stage of Crohn's disease or acute ileitis with a different aetiology. At the Surgical Clinic of the Third Medical Faculty in Prague 10 in 1981-1992 21 patients with this condition were hospitalized and operated. ⋯ The mean age of these patients at the time of operation was 30.4 years, the mean length of the gut affection was 9.7 cm, the mean follow up period is 6.4 years. The author analyzes possible causes of these cases of ileitis and discusses the relationship with Crohn's disease.
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The authors give an account of their experience with the treatment of punctures and gunshot injuries of the chest and abdomen in 43 patients hospitalized at the Surgical Clinic of the Third Medical Faculty, Charles University Prague 10 between 1989 and 1992. Injuries of the chest were recorded 15 times, abdominal injuries in 25 patients and concurrent injuries of the chest and abdomen in three patients. ⋯ Based on analysis of their own results and data in the literature, the authors recommend in casualties with penetrating chest injuries and abdominal injuries early indicated surgical revision which alone ensures adequate treatment with minimal diagnostic errors. They also draw attention to the necessity to ensure effective first aid and rapid transport of casualties to prevent the development of irreversible changes as a result of haemorrhage, as observed in a single patient who died after a piercing heart injury.
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The authors monitored in children with craniocerebral injuries hospitalized in their department in the course of the more than one-year existence of the child ARO ward in addition to other vital parameters also changes of the haemocoagulation system. They describe the majority of commonly observed abnormalities as "latent consumption coagulopathy", where laboratory findings are not associated with clinical signs of coagulopathy. On the other end of the spectrum of coagulopathies after head injuries is the unit of disseminated consumption coagulopathy which is generally evaluated as a secondary phenomenon or as an intermediary mechanism of the disease which complicates various pathological conditions incl. craniocerebral injuries. The authors discuss the pathophysiology, diagnostic possibilities and their experience with the treatment of the mentioned disorders.
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The authors give an account of the incidence and prognosis of the mentioned injuries treated during the past five years (1987-1991) at the surgical department of a district hospital in the centre of Prague. During the past two years a marked increase of these injuries was recorder. ⋯ During the same period 24 patients with abdominal injuries and 6 patients with chest injuries were hospitalized as well as four patients with combined abdominal and chest injuries. Nineteen ambulatory patients and 34 hospitalized patients during the five-year period are an ever increasing group of casualties who suffered injuries usually when drunk or due to violence.
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The condition of the main pancreatic duct determines very probably in a decisive way the fate of posttraumatic pancreatic pseudocysts and acute pancreatic injuries. Endoscopic retrograde cholangiopancreatography is the only diagnostic method which makes possible to evaluate the condition of this duct. ⋯ In the discussion the authors summarize data from the literature regarding the use of ERCP in the preoperative diagnosis of posttraumatic pancreatic pseudocysts and acute pancreatic injuries. The authors consider ERCP a method which renders the diagnosis of posttraumatic pancreatic pseudocysts and acute pancreatic injuries more accurate.