Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen
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Congenital malformations, tumors and aortic infections are rare and mostly asymptomatic. Unspecific clinical symptoms may cause delayed verification of the underlying disease. ⋯ Aortic tumors must be resected by open surgery, aortic infections in general require medical treatment and anomalies, if indicated, are treated more and more by endovascular or hybrid procedures. Therefore, it is recommended to treat these entities in an interdisciplinary approach in specialized aortic centers.
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Review
[Is a different view on the pathophysiology of sepsis the key for novel therapeutic options?].
Sepsis remains a critical problem in virtually all fields of clinical medicine. Despite intensive scientific and clinical efforts no significant progress has emerged in the fight against sepsis mortality. Solely the algorithm of the "surviving sepsis campaign" has proven to result in significantly enhanced survival of sepsis patients when consequently adopted. ⋯ Others favor a different view on the pathophysiology of sepsis and support the notion that the manifestation of organ failure may be the dominant therapeutic target. Due to the fact that breakdown of the microcirculation and disruption of the microvascular barrier are critical events preceding organ failure, experimental therapeutic efforts to address these events led to promising results. Taken together, in view of the many initially promising experimental data and the failure to translate them into successful clinical therapies, a different view on the pathophysiology of sepsis is warranted to obtain the key for novel therapeutic options.
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The aim of the perioperative management of anticoagulation in patients with long-term oral anticoagulation is to minimize bleeding complications of surgical interventions. ⋯ The perioperative management of coagulation is still a challenge. While there are consolidated decision aids for phenprocoumon, the approach under DOAC treatment is still controversial due to limited data.
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Diagnostic imaging with positron emission tomography (PET) is becoming increasingly more involved in oncological therapy management. ⋯ Hybrid imaging with PET computed tomography (CT) and PET magnetic resonance imaging (MRI) further improves diagnostic imaging and increases the acceptance of PET further.
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Review Case Reports
[Acute appendicitis mimicking cholecystitis. Case reports and review with focus on medicolegal aspects].
Since 1955 simultaneous presentation of acute appendicitis und acute cholecystitis have been described. These cases are understood as concomitance on the one hand and as imitation or induction of acute cholecystitis due to acute appendicitis. In laparoscopic surgery for inflammatory diseases, in particular acute cholecystitis, exploration of the entire abdomen should be more than cursory. In remarkable postoperative courses after cholecystectomy in acute cholecystitis, acute appendicitis should be taken into account if it could not be excluded intraoperatively.