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Biomedical subjects

M Dürig

Publications and source records attributed to M Dürig.

At least 73 records · Page 4Linked to original sources
PubMed1980

[Diagnosis of intra-abdominal bleeding--comparison of peritoneal lavage and laparoscopy].

By peritoneal lavage, patients with abdominal trauma can be categorizied into: I. strongly positive = frank bleeding into the abdominal cavity; II. negative = no danger of bleeding; III. only small amounts of blood staining the lavage = watching policy by repeating the peritoneal lavage. Out of 132 PL, 33 were not conclusive in the first attempt. During the course, 9 of these had to be operated upon, whereas 24 could be spared a laparotomy by our watching policy. As to accuracy, there is no doubt that peritoneal lavage is outstanding and cannot be outweighed by laparoscopy. The same is true as to rapidity. In a retrospective study concerning 100 patients with blunt abdominal trauma and intraabdominal bleeding, we found that with peritoneal lavage 75% could be diagnosed within two hours following admittance, whereas our laparoscopy team reached the same in only 26% of the patients.

Abdomen↗
PubMed1980

[Antibiotic prophylaxis in colon surgery with Cefazolin].

In a prospective randomized and controlled double-blind trial the effect of prophylactic systemic administration of Cefazolin in elective colorectal surgery on postoperative wound infection was investigated. The incidence of wound infection was significantly reduced (P less than 0.01) from 32% in the control group to 10% in the treated group. Furthermore there was a significant reduction (P less than 0.05) in hospital stay of about 3 days.

Cefazolin↗
PubMed1979

The operative treatment of elbow dislocation in the adult.

Operative treatment of traumatic dislocation of the elbow joint is indicated when there is proved gross instability or osteochondral fractures and loose bodies, or both. We performed a capsule-ligament repair in twenty-eight patients, and no cast was applied postoperatively. Satisfactory results were achieved with an average follow-up of two and one-half months. In all patients postoperative assisted range-of-motion exercise was begun after the operative wound and healed. The functional outcome depended on the osseous lesions involving the articular surface and on the time interval between the accident and the operation.

Adolescent↗
PubMed1978

[Traumatic hemobilia. A case report (author's transl)].

A case of traumatic hemobilia is reported. After ligation of the left hepatic artery and additional dearterialisation a third bleeding period occured due to a porto-hepatic communication, diagnosed by a transumbilical portography. A left hepatic lobectomy was finally necessary to achieve hemostasis. This case demonstrates that a selective artery ligation for the treatment of hemobilia is only successful if a complete dearterialisation is performed at the first operation. Furthermore a porto-hepatic communication may require partial hepatectomy.

Adult↗
PubMed1978

[Antibiotic prophylaxis: definition and documentation].

Controlled, randomized and prospective studies were reviewed to evaluate the value of antibiotic prophylaxis in colonic and biliary tract surgery as well as in the treatment of open fractures. --Colorectal surgery: 7 studies using oral and 3 using parenteral antibiotics in addition to extensive bowel preparation have demonstrated the importance of a short term prophylaxis, instituted before surgery and discontinued soon thereafter. Different antibiotics with aerobic or anaerobic spectra reduced the incidence of wound infections significantly; further improvement could be expected from combinations covering both spectra. --Biliary surgery: cefazolin, gentamycin and rifamycin--used in four controlled studies--were effective in reducing infectious complications. No distinction was made between patients of different infectious risks. In low risk gallbladder surgery the real value of antimicrobial prophylaxis is unknown. Short term prophylaxis is recommendable in all high risk patients undergoing surgery and in the low risk case submitted to extensive interventions. --Open fractures: only three authors have submitted their patients to controlled studies. All protocols suffered from some bias. No definite conclusions can be made. The authors' personal recommendations are: no prophylaxis in first degree injuries; early preoperative administration of penicillinase-resistant drugs in second and third degree lesions.

Administration, Oral↗
PubMed1977

[Intrathecal herniation of a cervical disc. A case report (author's transl)].

1. The literature concerning intrathecal herniation of intervertebral discs is briefly reviewed. 2. A case of an intrathecal herniation of a cervical disc with transitory paraplegia and a following Brown-Sequard-Syndrome is reported. 3. Laminectomy disclosed a rotation of the cord and a sequestrated disc embedded in the anterior substance of the cord. 4. A trauma of the cervical spine 8 years ago seem to be responsible for the progredient protrusion of the cervical disc. 5. Adhaesions between the dura mater and posterior longitudinal ligament in this case are regarded as origin of intrathecal herniation.

Dura Mater↗
PubMed1977

Spontaneous rupture of the gastrocnemius muscle.

Nineteen ruptures of the medial head of the gastrocnemius muslce are described. These were caused by sudden overstretching of the muscle though concomitant ankle dorsiflexion and knee extension. Surgical exploration in 12 patients verified rupture of the musculotendinous junction. A 2-year follow-up showed that the surgical approach with suture of the muscle gave better results than conservative treatment, especially in the younger and athletic patients.

Adult↗
PubMed1977

Rectal bladder with dorsolateral, intrasphincteric submucosal pul through of the sigmoid colon in adult bladder cancer patients. Five years later.

Report on 12 adult bladder tumor patients with cystectomy, rectal bladder and dorsolateral, intrasphincteric pull through of the sigmoid and anal colostomy (Nédélec type). Voluntary control of feces and urine was found satisfactory by most patients although urinary continence at night was not perfect. The long-term prognosis with this form of urinary diversion in patients with bladder cancer was far from satisfactory: 4 patients died of recurrent carcinoma with terminal symptoms of sepsis, but 5 patients died from primary sepsis (and not cancer) from 3 months to 4 years after diversion. It seems that this bad prognosis was due to insufficient separation of urinary and fecal passage in a group of patients, where the upper urinary tract has often already suffered as the result of earlier tumor treatment. Fewer complications might be expected with an intersphincteric pull through and perineal colostomy (Gersuny type).

Aged↗
PubMed1977

[Antibiotic prevention using cephalothin].

A single intravenous dose of Cephalotine, given at the start of operations, significantly reduces the incidence of postoperative wound infections. The concentration of Cephalotine was maintained throughout operation. The occurrence of other infections was also reduced. The results of this study imply that operations on patients with higher infectious risk should be accompanied by antibiotic prophylaxis.

Adolescent↗
PubMed1977

[Capsular arthroplasty of the elbow joint for the treatment of recurrent dislocation. Personal results in comparison with case reports in literature. Indication--methods--after care].

Four cases of recurrent dislocation of the elbow joint are reported. Instability of the postero-lateral ligaments were found in all patients, both clinically and during operation. In one case there was also instability of the medial ligament. Lateral instability is regarded as the primary lesion responsible for recurrent dislocation. Intraarticular pathological lesions such as osteochondral fractures were also diagnosed in our patients. All were treated by a capsuloligamentous repair as proposed by Osborne and Cotterill [8]. Based on follow-ups of 2 to nearly 5 years no recurrences were seen. The patients were free of pain with a nearly full range of motion. Considering the results reported in the literature of cases treated by the same method, the authors are convinced that the operation repairs the essential lesion.

Arm Injuries↗
PubMed1976

[The operative treatment of recurrent and simple traumatic dislocations of the elbow by the method of Osborne and Cotterill (author's transl)].

The essential pathological defect causing dislocation of the elbow is failure of the postero-lateral ligamentous and capsular structures. A pocket of the capsule is created into which the head of the radius is received as it slides off its articulation with the humerus. Damage to the osteochondral surface of the radius and capitulum humeri is often significant in recurrent and also simple traumatic dislocations of the elbow joint. An osteochondral fracture may occur in simple dislocation happening but once and predispose for recurrent dislocation. For treatment of recurrent dislocation we prefer the simple method of Osborne and Cotterill because in our opinion it attacks the essential lesion. More complicated techniques such as bone blocks or tendon transfers, are believed to be less effective and unnecessary. Four patients with recurrent dislocation of the elbow joint were treated successfully by this method, based on an follow-ups of from 2 to 4 years. Encouraged by the results we transferred the method to the treatment of simple traumatic dislocations in 10 patients. A follow-up of these patients has shown that an early operation will give satisfactory functional results. In the meanwhile the method of Osborne and Cotterill has become a standard technique for the treatment of osteochondrosis dissecans too by the authors.

Adolescent↗