Low-dose iloprost infusions compared to the standard dose in patients with peripheral arterial occlusive disease Fontaine stage IV. DAWID Study Group.

Background: Intravenous iloprost, titrated from 0.5 up to 2.0 ng/kg/min has been shown in patients with PAOD III/IV to significantly improve healing of trophic lesions, relief of rest pain, and reduce the rate of major amputation or death at 6 months as compared to placebo.

[Atraumatic rupture of the esophagus (Boerhaave syndrome)].

The complete atraumatic rupture of an intact esophageal wall had been described first by Boerhaave in 1724. We reviewed 424 published cases from that time until 1985 regarding the clinical feature and different types of diagnosis and treatment. An over all mortality rate between 28 and 85% was found which is highly influenced by the time the right diagnosis is made and by the choice of treatment.

[Problems of idiopathic chylothorax].

Conservative management of a chylothorax in a 57-year-old man was unsuccessful (25 l chylous fluid removed over three weeks). But chylous flow ceased immediately after thoracotomy with ligation and resection of the thoracic duct. The aetiology of the chylothorax remained obscure despite extensive preoperative diagnostic measures and histological examination of the thoracic duct.

[Surgical treatment of esophageal tuberculosis].

Esophageal tuberculosis, being rare, traditionally has been treated by antituberculous drug therapy, respectively by esophagectomy. A 66-year-old women is reported showing a productive/caseous tuberculosis of the mid-esophagus without pulmonary lesions. In suspicion of a benign tumor thoracotomy was done, and an enlarged oval excision of the esophagus wall with a longitudinal closure was performed.