Lege Artis Medicinae

[„It’s not the attitude but the nature of the matters that changed …”]

NAGY András László

MAY 20, 2001

Lege Artis Medicinae - 2001;11(05)

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Lege Artis Medicinae

[Diagnostic problems of ischemic colitis]

DEMETER Pál, SIKE Róbert, SZÉKELY György, KISS Sándor, SZILVÁS Ágnes

[Ischemic colitis is mainly caused by the impaired circulation of the inferior mesenteric artery. Most frequently it occurs as part of general arteriosclerotic disease or impaired left ventricular function, but it may also occur after abdominal aortic reconstruction. In connection with cocaine users, thrombophylia and vasculitis can also happen among young patients. Colonoscopy plays the most important role in making the diagnosis. In case of transitional ischemia conservative treatment is recommended, but surgery is needed in the progressive gangrenous form or when stricture in the colon developed. Authors describe the case of an 80-year-old man and discuss the etiology, clinical aspects, classical and up-to-date methods of diagnostics and the possibilities of conservative treatment.]

Lege Artis Medicinae

[Selective abortion in twin pregnancies discordant for congenital fetal anomaly]

PATKÓS Péter, HRUBY Ervin, PAPP Csaba, TÓTH-PÁL Ernő, PAPP Zoltán

[INTRODUCTION - In special cases of twin pregnancy where one of the fetuses is affected by severe congenital anomaly or disease confirmed with prenatal diagnostic methods and the other fetus is healthy, selective abortion has been accepted as the method of choice for twenty years to save the healthy sibling and to improve its life expectations. PATIENTS AND METHODS - The authors present their clinical experience of the past 15 years from 14 cases of selective abortion performed in twin pregnancies discordant for congenital fetal anomaly. Indication for the intervention was the anomaly of the second fetus in eleven cases and the anomaly of the first twin fetus in three cases. RESULTS - Out of eleven selective abortions performed on the second twin fetus, only one ended with the loss of the entire pregnancy. All three cases of selective abortion performed on the first twin fetus resulted in abortion of the entire twin pregnancy. All ten surviving fetuses were born living and healthy, followed by unharmed infant and childhood development. CONCLUSIONS - To offer the possibility of selective abortion to the parents seems to be indicated only in those cases of twin pregnancy where the discordant fetal disease or congenital anomaly is severe, placentation is dichorionic or at least diamniotic and where the second twin is affected.]

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[The memory of Pal Gyulay]

KAPRONCZAY Károly

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