A complete family history as to the past seizures experienced by the patient or by members of his family may be revealing and helpful in establishing a diagnosis of abdominal epilepsy. In our study 19 of the 46 children revealed a past history of seizure state and 25 had experienced febrile seizures in infancy. Detailed consideration of the type of pain, its site, and allied symptoms should be evaluated carefully. Disorientation during an episode of pain followed by exhaustion and sleep is suggestive of abdominal epilepsy. Electroencephalography is usually helpful in supporting the clinical diagnosis of abdominal epilepsy. Discussion with the child and his parents, when practical and possible, in regard to the diagnosis and therapy, is recommended. Clarification and definition of the regimen and of the condition are essential, as the term "epilepsy" still carries a stigma to the lay person. Consideration of the patient and parental feelings and attitudes leads to understanding, co-operation, and ultimate success in the control of symptoms.
Operative Treatment in a Doctor's SurgerySummary. The preconditions are given for operations in a doctor's surgery. Such operations are only indicated in particular cases. Nearly 8,000 operations performed under local anesthetic are reviewed. No complications worth mentioning occurred. Key words: Outpatient surgery -Preconditions.Zusammenfassung. Es werden die Voraussetzungen ffir die Indikation zur Operation in der chirurgischen Fachpraxis angeffihrt. Diese Indikation kann nur in Einzelfall gestellt werden. Unter den geschilderten Kautelen wurden nahezu 8,000 operative Eingriffe (ohne Wundversorgungen) durchgeffihrt. Wesentliche Komplikationen haben sich nicht ereignet. Eine summarische Obersicht fal3t die Arten der Eingriffe in der Praxis zusammen. Schliisselwiirter: Ambulante Operationen -Voraussetzungen -M6glichkeiten.Die ambulante chirurgische T/itigkeit in der chirurgischen Fachpraxis gliedert sich in die operativen und nicht operativen Aktivit/iten. Den Grol3teil der t~iglichen Arbeit stellen die nicht operativen Aktivit~iten dar (Tabelle 1). Es sind die Nach-und Weiterbetreuung der aus der Klinik entlassenen Operierten und Verletzten aller Schweregrade und der in der eigenen Praxis operativ versorgten Patienten, die Konsiliart~itigkeit fiir die niedergelassenen )~rzte aller Fachgruppen, die Diagnostik und Therapie von leichteren Verletzungen im Rahmen der Unfallchirurgie wie Versorgung von Wunden usw., Prellungen, Zerrungen, Gelenkdistorsionen und Luxationen kleiner Gelenke, Schleudertraumen, Commotiones sowie die konservative Frakturbehandlung. Zum nicht operativen Krankengut z/ihlen auch die relativ h/iufigen Schmerzsyndrome des Bewegungsapparates. Je nach Ausbildungsstand des Chirurgen kommen ,,Spezialit~iten" hinzu, z.B. Diagnostik und
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