With the hypothesis that mucosal enzymes are a reflection of villous height, an investigation was carried out on 34 jejunal biopsy samples from children with mucosal injury. These were classified into 4 groups (B-E) according to villous to crypt ratio (VJC) and were compared with normal biopsies and those from cases of luten sensitive enteropathy (CSE)-:
Summary. From 1965From --1970 injuries to blood vessels were treated at the Chirurgische Klinik rechts der Isar der Technischen Universit~t, Munich. In over 800/o of the patients other injuries like fractures, brain injuries or ruptures of the inner organs etc. were also present. The presence of hypovolaemic shock in multiple injuries can make the diagnosis of a vascular lesion much more difficult. An indication for immediate surgery is the threat of a fatal haemorrhage resulting from injuries to the main blood vessels. In most cases, however, the diagnosis of a vascular lesion will be confirmed by the selective use of angiography and phlebography.In about 30 °/0 of our patients the injuries to the blood vessels were associated with fractures. A stable osteosynthesis will make the restoration of the damaged blood vessels much easier. Injuries to veins should be attended to before arterial lesions and where necessary a thrombectomy carried out at the same time. To shorten the period of ischaemia and to avoid thrombosis in venous sections we usually establish a temporary intra-luminal shunt before commencing the osteosynthesis.
Zusammen]assung. In den Jahren 1965--1970 wurden an der ChirurgischenKlinik rechts der Isar der Technischen Universit~t Mfinchen 151 Gef~13verletzungen vcrsorgt. Bei fiber 80 °/0 der Patienten lagen zus~tzliche Verletzungen wie Frakturen, Sch~del-Hirntraumen oder Rupturen innerer Organe usw. vor.Der hypovol~misehe Schock bei Kombinationsverletzungen kaml die Diagnose einer Gef~Bl~sion erheblich erschweren. Die Indikation zum sofortigen chirurgischen Eingreifen wird durch den drohenden Verblutungstod bei Verletzungen der Stammgef~l]e gestellt. In den meisten F~llen wird jedoch die Sicherung einer Gef~Bver-letzung durch Angiographie oder Phlebographie, wenn nStig selektiv, m6glich sein.In unserem Krankengut waren rund 30 °/0 der Gef~l]verletzungen mit Frakturen kombiniert. Die stabile Osteosynthese erleichtert die Wiederherstellung der vcrletzten Gef~l]e. VenSse Verletzungen solltcn vor der Arterienl~sion, wenn notwendig mit gleichzeitiger Thrombektomie versorgt werden. Zur Verkfirzung der Isch~imie-zeit und zur Vermeidung yon Thrombosen im venSsen Abschnitt legen wir vor Beginn dcr Osteosynthese einen tempor~iren, intraluminalen Shunt an.
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