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Das Frieren des Magens zur Behandlung des peptischen Geschwürs; eine therapeutische Möglichkeit?

Eine kritische Stellungnahme auf Grund tierexperimenteller Untersuchungen und einer Übersicht über die Literatur

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Zusammenfassung

Auf Grund eigener tierexperimenteller Untersuchungen wird zumFrieren des Magens als neuer Methode zurBehandlung des peptischen Geschwürs Stellung genommen. Temperaturmessungen an der Magenwand des Hundes lassen es zweifelhaft erscheinen, daß die Methode in ihrer gegenwärtigen klinischen Anwendungsform den Magen bis zur Eiskristallbildung im Gewebe friert. Im Tierexperiment hat Frieren des Magens für nur wenige Minuten unausweichlich Nekrosen zur Folge. Lokale Gewebsschäden stellen auch beim Menschen die wesentlichsten Komplikationen dar. Sie müssen als Ausdruck lokaler Erfrierungen aufgefaßt werden. Die beschriebenen therapeutischen Erfolge mit Schmerzlinderung und initialer Säuredepression sind wahrscheinlich Folgeerscheinungen einer temporären thermischen Vagotonie und einer Kälteanalgesie wie sie auch bei Erfrierungen der Extremitäten anzutreffen ist. Beide Effekte treten offensichtlich schon bei Temperaturen über 0° C auf und sind nurvon kurzer Dauer. Einige pathophysiologische Besonderheiten der Kälteschädigung des säureproduzierenden Anteils der Magenschleimhaut, die sich im Tierexperiment ergaben, werden erörtert. Sie führen zu der Schlußfolgerung, daß der belegzellenenthaltende Anteil der Magenschleimhaut Erfrierungen gegenüber besonders anfällig ist. Die Anwendung des Verfahrens mit dem Ziel zu frieren, sollte unterlassen werden.

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Author notes

  1. Fredrick W. Marx Jr. (Instructor in Surgery)

    Present address: Department of Surgery, UCLA Center for the Health Sciences, 90024, Los Angeles, California

Authors and Affiliations

  1. Department of Surgery, UCLA Center for the Health Sciences, 90024, Los Angeles, California

    Gerhard Kolig (Wissenschaftlicher Assistent)

  2. Chirurgischen Universitätsklinik, Kirschnerstraße 1, 6900, Heidelberg

    Gerhard Kolig (Wissenschaftlicher Assistent) & Fredrick W. Marx Jr. (Instructor in Surgery)

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  1. Gerhard Kolig
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Kolig, G., Marx, F.W. Das Frieren des Magens zur Behandlung des peptischen Geschwürs; eine therapeutische Möglichkeit?. Arch. f. klin. Chir 309, 133–156 (1965). https://doi.org/10.1007/BF01440872

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