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Biomedical subjects

T Heimann

Publications and source records attributed to T Heimann.

28 records · Page 2Linked to original sources
PubMed1979

Surgical management of ileosigmoid fistula in Crohn's disease.

Seventeen cases with Crohn's disease and ileosigmoid fistula were reviewed. They have been subdivided into four groups according to the anatomic site and extent of disease. Seven patients had disease localized to the terminal ileum and a fistula to normal sigmoid. Five were treated by ileocolic resection and simple of the sigmoid fistula (group I. All seven cases with concomitant sigmoid involvement had a double resection (group II). Two patients with diffuse ileocolitis (group III) had subtotal colectomy and ileostomy. One case (group IV) had left-sided colonic disease with a fistula to normal ileum and was treated with a double resection. In six patients, a temporary ileostomy was performed to protect the anastomoses. Forty-seven percent of patients had granulomatous involvement at only one end of the fistula. Resection of the diseases bowel and simple closure of the fistula can be performed safely in most patients in this group.

Colon, Sigmoid↗
PubMed1978

Familial polyposis coli. Management by total colectomy with preservation of continence.

Two cases of familial polyposis coli were managed by total colectomy and endorectal pull-through with excellent long-term results. The performance of a temporary loop ileostomy is advisable to prevent anastomotic complications. In addition, it avoids the excessive diarrhea and perianal excoriation that frequently occur in the early postoperative period until full continence is regained. This is the only method that allows the preservation of rectal function and prevents the occurrence of rectal cancer. It should be considered as a real alternative to either subtotal colectomy and ileorectal anastomosis or total colectomy with construction of an ileostomy.

Adolescent↗
PubMed1976

Urinary osmolal changes in renal dysfunction following open-heart operations.

Forty consecutive patients who underwent open-heart procedures using a hyperosmolar perfusion prime were studied to determine the significance of free-water clearance and urinary osmolality early after bypass in predicting the likelihood of postoperative renal dysfunction, defined as a blood urea nitrogen (BUN) level over 50 mg/100 ml. Urinary osmolality increased in all patients during the first 18 hours after bypass, but the increase was substantially less for those who subsequently developed renal dysfunction. Free-water clearance, which was significantly less negative in the patients with renal dysfunction by 2 hours after bypass and remained so throughout the 18 hours of this study, served as an early postoperative indicator of impaired renal function in the patients who eventually developed BUN elevation. Moreover, it was more sensitive as an index of renal dysfunction than was osmolality alone. Early recognition of renal impairment is important, as it may prevent dangerous fluid overloading and allow for corrective measures to be undertaken before frank renal failure develops.

Blood Pressure↗