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Biomedical subjects

P Sandbichler

Publications and source records attributed to P Sandbichler.

28 records · Page 2Linked to original sources

[Endoscopic sclerotherapy of bleeding Mallory-Weiss mucosal tear].

Based on a review of 66 patients with the Mallory-Weiss syndrome, the problems of diagnosis and treatment in general, and the application of sclerotherapy in particular in patients with bleeding tears is discussed. At emergency endoscopy 32 patients (48.4%) had an acute bleeding episode which could be stopped by sclerotherapy in 26 of 27 cases. The importance of control endoscopy after 48 hours and its influence on prognosis are emphasized.

Adolescent↗

[Peptic ulcer with a visible non-bleeding vascular wall--early elective surgery or endoscopic therapy?].

The records of 71 patients with the endoscopic finding of a peptic ulcer with a non-bleeding visible vessel, treated between 1982 and 1987 were retrospectively analysed. 16 patients underwent early surgical treatment (group I), 15 patients were treated conservatively (group II) and 40 patients by endoscopic haemostasis (group III). Recurrent bleeding was observed in 6.25% patients in group I, in 53.3% in group II and in 25% in group III, in which case endoscopy was performed again. The patients with arterial bleeding underwent early elective operation after endoscopic haemostasis. Deaths occurred only in the postoperative period: group I 6.25%, group II 13%, and group III 5%. These findings indicate that primary endoscopic treatment in selected patients leads to results equal to those achieved with early surgery. Conservative therapy cannot, however, be recommended.

Adult↗

[Infectious complications in the early phase following kidney transplantation].

A retrospective analysis of 533 patients receiving kidney transplantation was performed to study the incidence of infection in the early postoperative period. Mostly localized in the lungs and renal system, bacterial complications arose in 133 patients. As compared with the unproblematic management of the urinary tract infections, 45 pulmonary infections were characterized by difficulties in diagnosis and treatment. Poor graft function was closely related to pulmonary infections: mean creatinine was 2.4 mg% (in patients without pneumonia - 1.5 mg%). Out of 45 patients with pneumonia, the graft failed in 16 patients. 6 patients died as a result of pneumonia. Rapid detection of the pathogenic organism is required, if necessary by invasive diagnosis. The administration of erythromycin before identification of the responsible pathogen may be indicated, in view of the fatal outcome in several patients subsequently diagnosed as having Legionella infection.

Adolescent↗

Vascular lesions after percutaneous biopsies of renal allografts.

On the basis of two arteriovenous fistulas, one arteriocaliceal fistula, and the literature concerning these complications, clinical symptoms, diagnostic measures, and therapeutic strategies are discussed. Decreased renal function, severe hypertension, and a bruit over the transplant site - particularly after core biopsy - are said to be indicative of an arteriovenous fistula, while persisting hematuria is seen as evidence of an arteriocaliceal fistula. In both cases, angiographic evaluation is indicated. Therapeutic possibilities include selective angiographic embolization and surgical repair. Large intraparenchymal fistulas may require wedge resection.

Adult↗

[Modified ureterocystostomy: a low rate of urological complications in kidney transplantation].

A total of 31 urological complications (4.6%) were noted between January 1974 and July 1987 among 670 renal transplantations: ureteral stenoses (n = 18), ureteral leaks (n = 8), vesicorenal reflux in the transplant with chronic urinary-tract infection (n = 1), and urolithiasis in the area of the transplant (n = 4). There were six ureteral leaks among 110 extravesical ureterocystoneostomies, while there were only two leaks among 560 anastomoses done by a modified method of Leadbetter and Politano. Restoration of urinary flow integrity was achieved without organ loss or functional impairment.

Constriction, Pathologic↗

[Gallstone ileus].

From 1965 to 1985 gallstone ileus was diagnosed and treated in 19 patients. The mean preoperative period of symptoms was five days; the correct diagnosis was made in only half the cases. Enterolithotomy alone has proven to be, in comparison with other methods, a reliable procedure with the fewest postoperative complications. Treatment of bilioenteric fistula was limited to symptomatic cases. Improvement of the results can be expected once the interval from first symptoms to operation is reduced.

Aged↗

[Aneurysm of the popliteal vein as the source of a lung embolism].

A case of pulmonary embolism secondary to a clinically unsuspected aneurysm of the popliteal vein is presented. The importance of venography in establishing the source of pulmonary emboli is stressed in comparison to other diagnostic investigations such as ultrasonography, computed tomography or pletysmography. The aneurysm was suitable for local venous reconstruction. Previously reported cases are reviewed, etiology, diagnosis and treatment of this uncommon condition are discussed.

Aneurysm↗

Hepatocellular transplantation into the lung in chronic liver failure following bile duct obstruction in the rat.

Injection of hepatocytes or cell-free supernatant into the lung was able to prevent death from surgically induced fulminant hepatic failure in the rat in over 90% and 53% of subjects, respectively. The aim of this study was to investigate whether this technique can be applied in chronic liver failure. Chronic liver failure was induced in Lewis rats by ligation and transection of the common bile duct, which led to cirrhosis after 3-5 wk in all animals. Four groups of animals were formed: group 1 (n = 5), normal rats, serving as control; group 2 (n = 15), cirrhotic rats, no further treatment; group 3 (n = 14), hepatocyte transplantation by injection of cell suspension transcutaneously into the right lung of cirrhotic animals four wk after bile duct ligation; group 4 (n = 17), injection of 1 mL cell-free supernatant intravenously at two-day intervals, starting 4 wk after ligation. Liver function tests, prothrombin time and serum protein levels were measured weekly before and every two days after transplantation. In group 2 all animals had died 56 (49-69) days after ligation. Survival in groups 3 and 4 was similar: all rats had died from liver failure 61 (51-72) and 60 (49-76) days following bile duct ligation. Survival rates and laboratory investigations showed no significant differences between treated and untreated cirrhotic animals. These data suggest that hepatocyte transplantation into the lung as well as supernatant injection do not have any significant effect on chronic hepatic failure, at least in the rat model.

Animals↗

Civilian popliteal artery trauma.

An 18 year experience involved 36 civilian popliteal artery injuries is described. There were no operative or hospital deaths and the amputation rate was 3.6%. Penetrating traumas accounted for 30.6% and blunt traumas for 69.4%. In 20 patients (55.5%) the popliteal artery injury was associated with fracture and/or dislocation of the long bones and/or the knee joint. The average ischaemic time was 7.3 hours and postoperative angiography was performed in 25 patients (69.4%). Surgical reconstruction of the popliteal artery was accomplished by interposition or bypass of autogenous saphenous vein graft in 29 (80.5%), by saphenous vein patch in 5 (13.9%) and by primary end-to-end anastomosis in 1 (2.8%) and by PTFE prosthesis in 1 patient (2.8%). In all cases with bone fracture and/or dislocation bone stabilization was followed by the vascular procedure. The average time of follow-up was 76 months, 28 patients could be evaluated in the postoperative study: in 25 (89.2%) the reconstruction was patent, in 3 (10.8%) occluded. In 13 patients (46.4%) there was a complete success, 7 had a nerve deficit (25.0%), 3 had a claudication (10.7%), in one patient an amputation was necessary (3.6%) and 4 (14.3%) suffered from miscellaneous skeletal problems. Of the 36 patients originally operated, 29 (80.5%) received anticoagulant therapy for at least one year.

Accidents, Traffic↗