Zentralblatt für Chirurgie
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Gastroscopy after surgery of the stomach gives exact information about functional and morphological alterations. The aim of gastroscopy is to detect complications of the early postoperative period as well as of the later phase. Early diagnosis of gastric carcinoma after partial gastrectomy for benign lesions is only possible by routine gastroscopy.
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Fractures of the pelvis impair the statics of the body and the dynamics of trunk and leg movement. Concomitant injuries obtain vital importance for the digestive tract, the urogenital system and the greater blood vessels. ⋯ The late results concerning prevention of arthrosis, however, are not convincing. Posterior marginal fractures of the acetabulum, such as those to be found after posterior luxation of the hip joint, should be fixed by operation.
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Postoperatively patients are particularly endangered by the development of respiratory failure. All parts of the gas-exchange between the atmospharic air and the metabolizing cell are to be considered as a unit. ⋯ Early diagnosis of impaired gas-exchange and an adequate treatment are emphasized. CPAP and intermittent mandatory ventilation are therapeutic methods, well approved in clinical practice.
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The authors performed 2000 laparoscopies in females with chronic and acute pelvic pain. In 399 cases an appendectomy had been done before. Among 478 patients with acute pelvic pain an acute appendicitis was found in 26 women by laparoscopy.
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A total of 51 patients with gunshot injuries of the chest and the abdominal cavity were treated at the Emergency Aid Institute "Pirogov" in Sofia from 1967 to 1976. The series included 45 men and 6 women, with a letality rate amounting to 21.5 per cent (11 patients). In 41 per cent it was a matter of abdominal injury where the letality was the highest (33 per cent). ⋯ Traumatic-hemorrhagic shock and acute respiraotyr insufficiency prevailed. The operative tacties resorted to was strictly individual. In combined lesions of treatment of respiratory insufficiency, parenchymatous organs and major blood vessels has priority over the treatment of hollow organs.