Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · May 2004
[Health care ethics committees in German university clinics. A survey of all medical directors and directors of nursing].
Health Care Ethics Committees (HEC) are new ways of implementing clinical ethics in hospitals and nursing homes. In the US all health care institutions must provide some structure to handle ethical conflicts in everyday patients' care. However, in Germany only a minority of hospitals, often members of the Protestant or Catholic Hospital Associations, have founded HEC. No studies exist in regard to the situation at German university hospitals. ⋯ Our data show a high need for information about HEC in German university hospitals. The tasks, working methods and chances for further development of HEC are neither known nor used in the majority of German university hospitals.
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Dtsch. Med. Wochenschr. · Apr 2004
Case Reports[Iatrogenic perforation of the esophagus during transesophageal echocardiography. A rare cause of severe dysphagia].
A 65-year-old patient underwent transesophageal echocardiography which caused a perforation of the upper esophagus. Three months after esophagostomy and gastrostomy the reconstruction was accomplished by a colon interposition graft. The patient postoperatively developed an ischemic necrosis of the graft, followed by a cervical fistula. Food intake and swallowing became impossible. ⋯ Transesophageal echocardiography is a common diagnostic procedure with a low complication rate. Even though serious complications may occur in rare cases, the patient must be informed about the risk. The perforation of the esophagus is an emergency situation that requires surgical treatment immediately. Primary reconstruction and preservation of the esophagus is the recommended strategy.