Deutsche medizinische Wochenschrift
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Dtsch. Med. Wochenschr. · Mar 1991
Case Reports[Spontaneous splenic rupture in chronic pancreatitis].
A 50-year-old woman complained of upper abdominal pain for several weeks, getting worse and radiating towards the left shoulder in the 24 hours preceding her hospital admission. Plain X-ray film of the abdomen revealed plaque-like calcifications projecting onto the tail of the pancreas. Ultrasound imaging demonstrated splenic rupture with free intra-abdominal fluid. ⋯ Endoscopic retrograde cholangiopancreatography revealed chronic pancreatitis with a 3 cm pseudocyst in the tail of the pancreas. A papillotomy was performed, after which the symptoms rapidly regressed and the pancreatic enzyme concentrations fell. This was thus a case of spontaneous splenic rupture associated with previously undiagnosed chronic pancreatitis with inflammatory papillary stenosis and pseudocyst in the pancreatic tail.
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Dtsch. Med. Wochenschr. · Jan 1991
Comparative Study[Carboxyhemoglobin in smokers and a preoperative smoking cessation].
The proportion of carbon monoxide-haemoglobin (COHb) in blood was determined before elective surgery on 50 patients (12 women and 38 men; mean age 39.5 [21-68] years) who were smoking at least 20 cigarettes a day, at two moments: during ad lib smoking and after a smoking halt of more than nine hours. 50 nonsmokers (25 women and 25 men; mean age 29.5 [20-48] years) served as controls. COHb proportion before smoking halt averaged 6.9 +/- 1.8%, after halt it averaged 3.8 +/- 1.1% (P less than 0.001). ⋯ The results show that measures to improve oxygen transport capacity, such as blood transfusion or oxygen breathing, are indicated early, especially in an emergency, in smokers and those with uncertain smoking habits. Smoking halt of at least nine hours should be recommended to all heavy smokers before elective surgery.
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Dtsch. Med. Wochenschr. · Nov 1990
Case Reports[Floating right atrial thrombus as the cause of recurring pulmonary embolisms].
After an attack of pleuropneumonia a 25-year-old woman developed persistent dyspnoea due to pulmonary emboli, as demonstrated by scintigraphy. There was no clinical or phlebographic evidence of the peripheral venous system as the source. Two-dimensional echocardiography demonstrated a floating spherical tumour in the right atrium, attached to the interatrial septum and prolapsing into the right ventricle during ventricular diastole. ⋯ It proved to be myxoma-like, 3 x 3 cm in diameter. Histologically it was a thrombus without evidence of myxoma. No further thromboemboli occurred under phenprocoumon anticoagulation.