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Biomedical subjects

A Rohner

Publications and source records attributed to A Rohner.

At least 127 records · Page 7Linked to original sources
PubMed1987

Surgery for chronic pancreatitis.

We operated on 102 patients (89 men and 13 women) who had chronic pancreatitis. The mean age at the time of surgery was 45 1/2 years. Of these patients, 77 had resections (57 distal pancreatectomies, 17 duodenopancreatectomies, an three total pancreatectomies) and 25 had diversion procedures (15 Puestow operations and 10 internal drainage of cysts). The indication for surgery was abdominal pain in 88% and the presence of jaundice in 21%. Our patients had severe pancreatic disease: 64% had pseudocysts, 41% had calcifications, and 26% had calculi in the duct of Wirsung. The postoperative mortality rate was low (3%), but morbidity occurred in 18% (mostly after resection procedures). The incidence of diabetes after surgery was high after resection (57%) but it also occurred after diversion procedures (10%). The quality and length of survival was similar after resections and after diversions, although patients with alcoholic pancreatitis had the worst long-term prognosis. Reoperations were performed in 16% of all patients; the incidence was lower after duodenopancreatectomy.

Abdomen↗
PubMed1986

[Treatment of benign tumors of the liver].

Benign hepatic tumors have today acquired an importance they did not have a few years ago. On the one hand, new X-ray techniques detect lesions unrecognized in the past, while on the other oral contraceptives increase the incidence of some and the clinical symptoms of others. Hemangioma, which is common and asymptomatic when small, may produce clinical symptoms or even severe complications when they become larger. The significant technical progress achieved in partial hepatic resection appears to allow even larger prophylactic hepatectomy. Adenoma may rupture and cause death due to intraperitoneal bleeding. In contrast to what has been claimed, interruption of oral contraceptives does not remove this risk. The following three circumstances require surgery for most large tumors: hemorrhagic risk, presence of malignant tumors (transformation? coincidence?) and impossibility and danger of attempting diagnosis by percutaneous puncture. In contrast, focal nodular hyperplasia seldom bleeds and involves no risk of malignancy, and thus surgery can be dispensed with except in the case of voluminous or compressive tumors. Solitary or multiple hepatic cysts call for surgery only when their volume discomfort. Percutaneous puncture with aspiration will gain time and allow cytologic investigation of the drained fluid. In our experience of over 140 hepatectomies in Geneva, only 22 were performed for benign tumors. Overall mortality in this survey was 11%, but there were no deaths among the 55 hepatectomies for benign lesions (including the 22 cases mentioned above).(ABSTRACT TRUNCATED AT 250 WORDS)

Adenoma↗
PubMed1986

Traumatic lesions of the rectum.

Twenty-two patients treated for rectal trauma between 1975 and 1985 were reviewed. There were 13 males and nine females, of mean age 38 years (18-72 years). Causes included gunshot (2), sexual trauma (8), road accident (5), impalement (5), polypectomy (2). Two patients died, giving a treatment mortality of 9%. Cases with peritonitis or sphincter injury were treated by defunctioning colostomy and immediate repair of rectum and sphincter. Of 14 such patients the colostomy had been closed in all but one, who accounted for the only failed sphincter repair out of eight performed. The results show the success of a policy of faecal diversion for intraperitoneal rectal injury and sphincter damage and of local repair without diversion for most cases with extraperitoneal rectal injury.

Adolescent↗
PubMed1986

Can serum and peritoneal amylase and lipase determinations help in the early prognosis of acute pancreatitis?

Serum and peritoneal amylase and lipase levels were determined at an early stage in 73 patients with acute pancreatitis confirmed by computed tomography (CT scan), surgery, and/or postmortem. Each patient was given an enzymatic score (ES), which reflects the predominance of the serum or peritoneal concentration of the two enzymes, as the case may be. This score can thus be either 0, 1, or 2; ES = 0 if neither enzyme is predominant in the peritoneal fluid, ES = 1 if amylase or lipase alone are predominant therein, and ES = 2 if both enzymes are predominant. This enzymatic score appears to be a good indicator of severity of disease, being as it is directly and significantly related to mortality rate, prognostic score as proposed by Ranson, and incidence of extrapancreatic spreads as demonstrated by CT scan. In 38 patients (including two fatalities) with an enzymatic score of 0 or 1, mortality was 5%, whereas in 35 patients (10 fatalities) with ES = 2, mortality was 29% (p less than 0.01).

Acute Disease↗
PubMed1985

[Emergency surgery of complicated gastroduodenal ulcers: risk factors and results].

Between 1972 and 1981, 290 patients underwent emergency surgery in this Department for hemorrhagic (n = 104) or perforated (n = 186) gastric or duodenal ulcer. The introduction of cimetidine in 1977 did not influence the annual number of operations for complicated ulcer. Operative mortality was 15% for haemorrhage and 11% for perforation. Age, associated diseases, total bleeding, and delay between perforation and surgery were the most significant risk factors. In the case of inaugural complication or of brief peptic disease, simple closure, with a recurrence rate of 21%, remains the procedure of choice.

Age Factors↗