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M Lausen

Publications and source records attributed to M Lausen.

At least 37 records · Page 2Linked to original sources
PubMed1990

[Is advanced age by itself a risk factor in large abdominal surgical interventions].

A logistic regression analysis was performed retrospectively in 237 patients over 70 years of age (group 1) who underwent surgery for diseases of the biliary tract, stomach, and colon and rectum. The data were compared with those of 273 patients with identical operations under the age of 60 years (group 2). The results of our analysis differed according to the cohort of patients. Age was shown to be a significant risk factor for perioperative mortality according to the analysis of young and old patients (group 1 and 2). Analysis of group 1 showed that the urgency of the operation and the sum of coexisting morbidities were significant. The combination of age and urgency is a significant risk factor following colorectal but not gastric and biliary surgery.

Aged↗
PubMed1990

[Diagnosis and treatment of intra-abdominal abscesses].

Intraabdominal abscesses are life threatening complications of inflammatory processes or major surgery. Ultrasonography, computed tomography and scintigraphy are the diagnostic methods of choice. Diagnostic percutaneous puncture can be followed by therapeutic percutaneous drainage (PD). The diagnosis "intraabdominal abscess", however, is not sufficient for a rational therapeutic strategy. Therapy of intraabdominal abscesses (IAA) depends upon etiology and localization of the process and the individual situation of the patient.

Abdomen↗
PubMed1989

[Preoperative staging of rectal cancer: endosonography versus computerized tomography].

In a prospective study in 49 patients with rectal carcinoma the correlation of pre- and post-operative staging by CT and endorectal ultrasound (EU) was compared according to TNM-classification. With CT the pre/postoperative results correlated in T1 in 9/10, in T2 in 10/16, in T3 in 13/15 and in T4 in 6/8 patients. By EU identical results were found in all T1, in 10/12 T2, in 17/20 T3 and in 6/7 T4 stages. Overall, pre- and postoperative identical results were found by CT in 38 and by EU in 43/49 patients. Overestimation of the tumor stage was similar with both methods: 5 by CT and 4 by EU. Underestimation of the stage was more often by CT in 5 than by EU in 2 cases. (CT: accuracy 77.5%, sensitivity 88.3%, specificity 94.4%; ES: accuracy 87.7% sensitivity 91.5%, specificity 97.8%). Criteria for interpretation are discussed. In early tumor stages the depth of tumor invasion can be better evaluated by EU. In late stages both methods give important information for surgical strategy.

Adenocarcinoma↗
PubMed1989

Monitoring of the inflammatory response in early peritonitis.

The inflammatory response which is similar in all forms of peritonitis was recorded by determining the levels of parameters shown to represent the activation state of plasmatic and cellular systems as well as the inhibitory capacity of the plasma. In a selected series of patients with different underlying diseases, blood sampling was started at the time of admission when the clinical finding of an acute abdomen led to emergency laparotomy. Depending upon the duration of the illness and the severity of the peritonitis, a significant increase in fibrinopeptide A and of C3a could be detected within a few hours, which was followed by an increase in the elastase alpha-1-proteinase inhibitor complex. Differences due to variable cause could not be found. There was a striking correlation between the preoperative values of these three parameters and the postoperative course of the patients. Additionally, there was a significant enhancement of an endothelial proliferation-inhibiting capacity in the serums of the lethal group, whereas endotoxin could only be detected in trace amounts in four patients with intraabdominal infection in the preoperative period.

Adult↗
PubMed1989

[The value of transrectal sonography and computerized tomography in the diagnosis of rectal cancer].

In a prospective study in 49 patients with rectal carcinoma the correlation of pre- and postoperative staging by CT and endorectal ultrasound was proven according to TNM-classification. With CT the pre/postoperative results correlated in T1 in 9/10, in T2 in 10/16, in T3 in 13/15 and in T4 in 6/8 patients. By endorectal ultrasound identical results were found in all T1, in 10/12 T2, in 17/20 T3 and in 6/7 T4 stages. Totally, pre- and postoperative identical results were found by CT in 38 and by endorectal ultrasound in 43/49 patients. Overestimation of the tumor stage was similar with both methods: 5 by CT and 4 by endorectal ultrasound. Underestimation of the stage was more often by CT with 5 than by endorectal ultrasound with 2 cases (CT: accuracy 77.5%, sensitivity 88.3%, specificity 94.4%; endorectal ultrasound: accuracy 87.7%, sensitivity 91.5%, specificity 97.8%). Criteria for interpretation are discussed. In early tumor stages the depth of tumor invasion can be better evaluated by endorectal ultrasound. In late stages both methods give important information for the surgical strategy.

Adult↗
PubMed1989

[Significance of ultrasonic-guided pleural punctures/thoracic drainage after abdominal procedures and blunt abdominal/thoracic trauma].

The sensitivity of ultrasonographic diagnosis of pleural fluid accumulations and the value of ultrasonographically guided thoracentesis were studied prospectively. One hundred ten patients were examined after abdominal operations and chest trauma. Most of the examinations were performed in a half-sitting position. Pleural fluid of clinical relevance, diagnosed by real-time ultrasonography, was treated by thoracentesis under ultrasonographic guidance in 38 cases. The amount of aspirated fluid ranged from 150 to 1350 ml. The sensitivity of the method was 97.1%. The complication rate was 2.6%. There are now 240 patients treated by ultrasonographically guided thoracentesis and 160 cases with pleural drainage. In our view, ultrasonographically guided thoracentesis represents the method of choice in critically ill and immobile patients.

Abdomen↗
PubMed1989

[Computed tomography of complications of cholecystitis].

In cases of acute cholecystitis, especially with cholecystolithiasis, the diagnosis is usually quickly made. In contrast, the symptoms in the presence of such complications as penetration, perforation and local abscess are often unspecific, and diagnostic procedures may be time-consuming, extending into weeks. One reason for this is the rareness of the entity. The same is true for emphysematous cholecystitis, although this presents with more acute symptoms. Computed tomography seems to be the most effective imaging method. Therefore, it should be used in cases of nonspecific problems in the upper abdomen.

Adult↗
PubMed1989

[The pathomorphology of the liver after unilateral hepatic duct obstruction with laboratory-chemical observations of the course in the dog].

UNLABELLED: In an experimental study the morphological and functional changes of the liver with unilateral hepatic duct obstruction were investigated over a period of 13 months. In 4 series different parts of the liver were excluded of the bile drainage by hepatic duct ligation after cholecystectomy (group I = 25%, group II = 50%, group III 75%, group IV = 100% of the liver, series V = control group was cholecystectomy only. The clinical outcome, biochemical parameters, liver biopsy were examined regularly. Bacteriologic investigation of the bile and hepatic flow measurement were performed at the beginning and at the end of the study. RESULTS: The clinical symptoms were discrete and the biochemical parameters showed a typical course. After 6 weeks, atrophy of the excluded liver with contralateral compensatoric hypertrophy was found. The microscopic correlation was the secondary sclerosing cholangitis (SSC). After 6 weeks, a concentric periductal fibrosis was to be observed in the periportal area. After 12 weeks, bile duct vanishing with persistence of the arteries and veins was found. After 36-48 weeks, biliary cirrhosis and total destruction of the liver parenchyma was found respectively. Simultaneously a chronic disturbance of the hepatic perfusion was seen. It was caused by a perivenous fibrosis of the terminal vein with obliteration of the lumen by endangiitic proliferations and cavernous transformation. The genesis of SSC seemed not be be influenced by bile contamination. The ligated as well as the unligated bile ducts were infected in 20-50% only. There was no difference in the liver specimens with sterile or contaminated bile. The hepatic flow measurement showed a reduction of the portal blood flow and a rise of the arterial flow depending on the amount of the excluded liver. A better understanding of the pathophysiological sequelae of the unilateral hepatic duct obstruction suggests that the drainage by surgical or radiological methods may not invariably be necessary.

Animals↗
PubMed1988

[The value of ultrasound diagnosis in blunt abdominal and thoracic injuries].

In a prospective study, real-time ultrasonography was applied as the initial imaging procedure in 103 consecutive patients with blunt abdominal or thoracic trauma. Additional peritoneal lavage was not performed. Pathological findings were present in 22 patients (21%). Sensitivity of the examination was 95.5%, with two false positive results, specificity was 97.5% with one false negative result. Lesions of intraabdominal or thoracic organs were demonstrated directly by ultrasonography in 14 patients. In the remaining patients free fluid was discovered in the abdominal cavity. Splenic and hepatic lesions occurred most frequently followed by hematothorax. Ultrasonography can be recommended as the initial imaging procedure, giving a high amount of information in the primary diagnosis of blunt abdominal thoracic trauma.

Abdominal Injuries↗
PubMed1988

Myoelectric activity of the small bowel in mechanical obstruction and intra-abdominal bacterial contamination.

The myoelectric activity of the small bowel was evaluated in 6 rabbits following 24 h of complete small-bowel obstruction and in 6 rabbits during an intra-abdominal perfusion with a bacterial suspension containing Bacteroides fragilis and Escherichia coli. Myoelectric recordings were performed before and during pharmacological small-bowel stimulation with ceruletide. Following small-bowel obstruction both slow-wave frequency and spike activity were reduced. Ceruletide stimulation demonstrated a significantly decreased spike activity after 24 h of obstruction. Intra-abdominal bacterial contamination did not affect spontaneous slow-wave frequency and spike activity but induced complete resistance to ceruletide stimulation. Pharmacological stimulation is recommended as an additional method to evaluate the impairment of myoelectric activity in motility disorders.

Abdomen↗
PubMed1986

[Diagnosis and therapy of pseudo-obstruction of the colon].

Pseudo-obstruction of the colon (Ogilvie's syndrome) occurred in 18 patients as an acute abdominal emergency. It was characterized by massive distension of the caecum or the entire colon in the absence of any organic cause. Usually there was an underlying extraintestinal disease. Diagnosis of this entity depends on careful radiological investigation of the abdomen, whereby barium enema reveals the absence of organic obstruction. Increasing distension in untreated patients may lead to spontaneous perforation of the caecum.

Cecal Diseases↗