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Biomedical subjects

B Kohler

Publications and source records attributed to B Kohler.

At least 91 records · Page 5Linked to original sources
PubMed1989

[Hemosuccus pancreaticus following rupture of a hepatic artery aneurysm].

We describe the rare case of a hemosuccus pancreaticus as the cause of an upper gastrointestinal bleeding. A perforated common hepatic artery aneurysm caused a bleeding into the pancreas and the pancreatic duct. Besides the hepatic artery-aneurysm aneurysms of the coeliac trunc and the splenic artery were found. After the bleeding had been localised by pancreoscopy and angiography, the coeliac trunc, the tail of the pancreas and the spleen were resected without any complication.

Ampulla of Vater↗
PubMed1988

[Palliative laser therapy of advanced rectal carcinoma].

During a 20 months period (1. 10. 1985-31. 5. 1987) 20 patients with advanced rectal carcinoma received palliative treatment by laser (Neodymium-YAG), 18 for subtotal rectal stenosis, two for profuse bleeding from an exophytic tumour. Re-establishment of intestinal passage or stoppage of bleeding was achieved in all patients, after a mean of 3.4 (1-5) applications. The treatment was well tolerated, cured the anaemia, removed the obstruction and ended painful stool evacuation. To-date 11 patients have died, seven of the malignant tumour. Nine patients are still alive. The mean survival time for all 20 patients is 5.3 months so far, similar to that after a palliative colostomy. There were no complications.

Aged↗
PubMed1988

Spontaneous esophagotracheal fistula resulting from ulcer in heterotopic gastric mucosa.

In a 50-yr-old male patient, a spontaneously perforating peptic ulcer located in a patch of heterotopic gastric mucosa in the upper part of the esophagus led to the development of an esophagotracheal fistula. The histologic workup revealed, in addition to ulcer necroses and granulation tissue, glands of the fundic type, with chief and parietal cells. On the basis of histologic results, the fistula was successfully occluded with the aid of a fibrin adhesive applied endoscopically. After the second session, the patient immediately became free of symptoms. Under medical treatment with an H2-receptor blocker, the patient has been completely symptom-free for 1 yr.

Choristoma↗
PubMed1988

[Streptococcal abscesses of the liver: diagnosis and therapy using ultrasound controlled puncture].

Three male patients without accompanying diseases, 27, 47, and 52 years of age, were admitted with fever of unknown origin. Focal liver disease was seen on ultrasound and the diagnosis of an abscess was confirmed by sonographically-guided fine-needle puncture. Microaerophilic streptococci were found in two cases, streptococcus viridans once. Two patients had cryptogenic abscesses; one had previously undergone surgery for a rectal abscess. All three patients were cured of their condition by appropriate antibiotic coverage and evacuation of the abscess by needle aspiration.

Adult↗
PubMed1988

Synthesis and biological activity of 2-lactonyl penems.

A series of potent antibacterial agents have been prepared. These agents are penems carrying a lactone ring in the C-2 position. Excellent activity against Gram-positive and Gram-negative organisms--except Pseudomonas aeruginosa--was found.

Anti-Bacterial Agents↗
PubMed1988

[Possibilities and limitations of laser therapy of the gastrointestinal tract].

Endoscopic laser therapy today is representing a promising branch in gastroenterology. Accepted indications are palliative recanalisation of tumor stenoses in the upper GI-tract and the rectosigmoidal part as well as bleeding GI-lesions. Reopening of tumor stenoses is possible in 90-95% of the cases with a low complication rate. Similar results are obtained with endocavital tumor destruction in the stomach and the rectum. Stop of GI-bleeding can be achieved equally effective by alternative methods like electrocoagulation and sclerotherapy. Only the tumor bleeding is better controlled by laser. Benign stenoses may be treated with laser as well, however conventional endoscopic techniques reveal similar results. Limits of laser therapy should be kept in mind. Uncritical use has to be avoided. Prior to laser therapy necessary diagnostic procedures have to be evaluated in order not to miss curative tumor surgery. An interdisciplinary approach including surgeons and radiologists is mandatory to obtain optimal results. Palliation today is the most important indication for laser therapy. Whether early cancer of the stomach will become an indication for curative treatment using photodynamic therapy remains to be seen in the future.

Endoscopy↗
PubMed1988

[AIDS and gastroenterologic endoscopy. Survey of current practice].

Endoscopy has not remained unaffected by the increasing number of AIDS patients. A survey among German gastroenterologic centers has shown that most endoscopists pay close attention to this problem. It may be true that the safety precautions, considered to be necessary by some if a patient's HIV status is unknown, are exaggerated; the procedures undertaken for HIV positive patients are, however, in accordance with the recommendations made so far. The risk of infection is considered to be moderate to minimal, the procedures undertaken until now to disinfect endoscopes are considered to be adequate.

Acquired Immunodeficiency Syndrome↗
PubMed1987

[Esophagotracheal fistula caused by an ulcer in heterotopic gastric mucosa of the cervical esophagus. Diagnosis and endoscopic therapy].

A tracheo-esophageal fistula occurred spontaneously in a 50-year-old man. At endoscopy it was found to be due to a perforated ulcer localized in heterotopic gastric mucosa in the cervical esophagus. Histological examination revealed ulcer necrosis and granulation tissue, as well as glands of the stomach type with chief and other cells. Malignant or specific genesis was excluded. Based on the histological finding, the attempt was successfully made of closing the fistula with fibrin glue in two sittings. All symptoms ceased immediately after the second sitting. Later radiological and endoscopic examinations no longer demonstrated either the fistula opening nor a fistulous tract.

Choristoma↗
PubMed1987

Obstructive jaundice due to an intraductal melanoma metastasis.

In a 63-year-old patient with known malignant melanoma, newly developed jaundice was shown, endoscopically and histologically, to be due to an isolated metastasis in the distal common bile duct. The condition was eliminated by implanting, endoscopically, a bilio-duodenal endoprosthesis. This cause of jaundice is unusual, since this condition is generally a consequence of diffuse liver metastasis.

Bile Duct Neoplasms↗
PubMed1987

[Obstructive jaundice caused by a blood clot--an unusual complication following endoscopic papillotomy].

Endoscopic papillotomy as therapeutic procedure of first choice for common bile duct stones is related with a relatively low complications rate and exhibits a very low method-related mortality. Major complications are cholangitis, pancreatitis, retroduodenal perforation and hemorrhage. In rare cases minor bleedings after papillotomy may lead to coagulation with consecutive obstruction of the papilla. Jaundice without major clinical symptoms will occur. Diagnosis is established by repeated retrograde cholangiography; conservative management is satisfactory and efficient.

Aged↗
PubMed1987

Incidence of bacteremia after endoscopic laser treatment of stenosing processes in the upper gastrointestinal tract.

Bacteremia following endoscopic interventions has been repeatedly described. This prospective study was intended to establish the extent to which this condition can occur after endoscopic laser therapy. A total of 32 procedures to treat stenosing processes in the upper gastrointestinal tract had been performed on the 20 patients admitted to the study. The incidence of bacteremia was found to be 34%. Two patients developed sepsis that required antibiotic treatment, despite which, however, one of the patients died. Routine prophylactic antibiotic administration would, at present, appear to represent overtreatment. However, patients with cardiac diseases or artificial heart valves need antibiotic prophylaxis. Should a fever develop in patients undergoing laser therapy, immediate broad-band antibiotic cover is urgently recommended to prevent septic complications.

Esophageal Neoplasms↗
PubMed1987

[Heterotopic gastric mucosa in the upper gastrointestinal tract: endoscopic incidence, appearance and clinical significance].

Heterotopia is understood as the occurrence of locally atypical tissue. Heterotopic gastric mucosa may occur throughout the whole GI-tract. In an unselected series of upper GI-endoscopies 6.3% of heterotopic gastric mucosa could be detected. Main localisation was the upper esophagus with 70%, followed by the duodenal bulb with approximately 25%. In 86% histological proof of ectopic mucosa was possible. In the esophagus the lesion looks like a red spot, in the duodenal bulb in contrast more like polypoid formations without discoloration. In our experience there is no significant relation of heterotopic mucosa to clinical symptoms. The clinical significance of heterotopic gastric mucosa however may be underscored by its possible complications.

Choristoma↗