[Experiences during office hours about venous problems].
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Biomedical subjects
Publications and source records attributed to B Stegemann.
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Between 1964 and 1978 twenty patients suffering from acute mesenteric vascular occlusion were treated in the surgical department (University of Münster). The average duration of the anamnesis until their hospitalization was 3.1 days and the actual operation was performed 11.35 hours later on the average. In only 15% of the cases had a correct preoperative diagnosis been given. As regards the frequency of causation, 60% of the mesenteric vascular occlusions were caused by a mesenteric arterioembolism, 20% by a mesenteric venous embolism, 10% by a mesenteric arterial thrombosis and 10% by a non-obstructive occlusion. In a post cardiac infarction condition was the predisposing factor in 50% of all cases, valvular defect in 33.5% and tachyarrhythmia in 16.6%. The causes found for the mesenteric venous tbrombosis were insufficiency of the right heart, absolute bradyarrhythmia, recurrent venous thrombosis of the leg, and myeloproliferative syndromes.
Sarcoidosis (Morbus Boeck) is a frequently found disease of the reticulohistiocytic system. Etiology and pathogenesis were mostly unknown until today. Histologic study of sarcoidosis shown granuloma with epitheloid cells similar to tuberculosis, often with hyalinization but without cheesy necrosis. The disease mostly starts with a mediastinal and cervical lymphadenopathy. Radiographically, the disease shows three typical stages when spreading to the lungs. Bone involvement in lymphomas, especially vertebral involvement, is found to be rare. A case with an additional retroperitoneal fibrosis is reported from our own hospital.
The Doppler ultrasound is a proper method to diagnose pathologic venous flow in the pelvic and and femoral regions. It is possible to differentiate deep vein thrombosis and chronic venous insufficiency of the typical kind of disturbance. This method permits only functional but not morphological findings; it offers the chance of preselection to other invasive methods.
Tumorous amyloid deposits in the neck region of a 31-year-old man caused difficulties in the preoperative differential diagnosis of a tumorous process of the thyroid gland. Several tumorous amyloid deposits compressing and eroding the left nevus vagus and having no connection to the trachea or thyroid gland were removed. Such isolated tumorous amyloid deposits in the neck region have not been described before. Histologically no thyroid tissue was found. A medullar cancer of the thyorid gland that has to be excluded in such cases was not found.