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Biomedical subjects

C H Hammar

Publications and source records attributed to C H Hammar.

At least 37 records · Page 2Linked to original sources
PubMed1994

Extragastric Dieulafoy's disease as unusual source of intestinal bleeding. Esophageal visible vessel.

Dieulafoy's disease is a gastric vascular malformation, which typically causes massive hemorrhage. The lesion is most often found in the proximal stomach, but has also been reported in the esophagus and in the small intestine. Three patients with esophageal Dieulafoy's anomaly and recurrent bleeding are reported. For the first time, transendoscopic Doppler ultrasound was used to identify arterial blood flow from the lesions. The ulcerations were treated by injection of adrenaline. Successful therapy resulted in the disappearance of arterial pulsations and no rebleeding occurred. Doppler-controlled endoscopic intervention should be the first line of treatment in the esophageal vessel stump.

Adult↗
PubMed1994

[Pronounced flush symptoms in carcinoid syndrome without liver metastases].

The case of a 78 years old patient with impressive flush symptoms is reported. 5-Hydroxyindoleacetic acid and serotonin were elevated. The responsible pathomorphological structure is a 8 x 4.5 x 6 cm ileocaecal neoplasm. Pre-, intra- and postoperatively liver metastases could not be detected during a 18 month period. After surgery of the carcinoid flush disappeared, so that the tumour seize resulting in enormous secretion of metabolites with endocrine activity should be claimed responsible for causing this symptom.

Aged↗
PubMed1994

[A rare etiology for HBs-Ag negative acute hepatitis B--coinfection by hepatitis B and delta].

An unusual case of a 25-year-old male Italian is reported. The patient endured an acute hepatitis without detectable HBs-antigen by coinfection with hepatitis-B and Delta. Coincidently, a cured hepatitis-C was present. Firstly hepatitis-B-virus DNA could be demonstrated in a small quantity by serodiagnosis (6 pg/ml, hybridization technique). Subsequently, the identification of B-virus DNA was only possible in liver tissue (PCR-technique), but no longer by serodiagnosis. The probable enduring inhibition of hepatitis-B-virus replication by Delta virus resulted in a self limitation of the disease within 2 months (HDV-RNA negative, HBs-Ag and HBe-Ag negative; Anti-HBs negative, Anti-HBe and Anti-HBc positive). In spite of negativation of replication markers for hepatitis-B a subsequent reactivation of the infection was possible by viral material which persisted in liver tissue.

Acute Disease↗
PubMed1994

[Fibronectin in human bile--a new parameter for diagnosis of malignant bile duct processes?--A pilot study].

In a pilot study it was investigated whether concentration of the glycoprotein fibronectin in the bile fluid can assist in differentiating between malignant and benign biliary tract obstructions. During endoscopic-retrograde cholangiography (ERC) and percutaneous transhepatic cholangiography (n = 3) native bile was aspirated in 29 patients. The concentration of fibronectin was determined by time resolved fluorescence immuno-assay. In 19 patients no biliary malignoma was present (choledocholithiasis: n = 9, normal finding: n = 10). Ten patients suffered from biliary or pancreatic cancer (infiltrating pancreatic cancer: n = 6; primary biliary tract cancer: n = 3, Klatskin tumor: n = 1). In the non malignant group a median fibronectin concentration of 12.0 ng/ml (lower-upper quartile 5-30 ng/ml) was found. A highly significantly elevated (p < 0.001, non parametric Kruskal-Wallis-test) median fibronectin concentration of 1675 ng/ml (lower-upper quartile 155-3430 ng/ml) could be determined in the malignant group. Our results show that in analogy to ascites, the concentration of biliary fibronectin is an important and easily determinable parameter in the differential diagnosis of benign und malignant diseases of the biliary tract.

Adult↗
PubMed1993

[Life-threatening arterial bleeding in hemorrhagic-necrotizing salmonella ileitis].

A 23-year-old man in otherwise good health had diarrhoea for two days during a holiday on Maldives. Two months later he suddenly collapsed and had to be admitted to hospital. Haemoglobin concentration was found to be 76 g/l, with a haematocrit of 0.22, WBC count of 17,800/microliters and platelets of 22%. Massive passage of bright red blood in the stools (none previously) could not be explained by abdominal sonography, oesophagogastroduodenoscopy, coloscopy, technetium scintigraphy or angiography of the superior mesenteric artery. Exploratory laparotomy revealed severe inflammatory changes in the terminal ileum with enlargement of the regional lymph-nodes and spurting bleeding from a branch of the ileocolic artery. Histological examination showed focal necrotizing, ulcerative and haemorrhagic ileitis. After ileocaecal resection and end-to-end anastomosis to the ascending colon the patient quickly recovered. Salmonella Livingstone was isolated from the stool and the infection was treated with ciprofloxacin, 200 mg twice daily intravenously for 5 days. Subsequent stool samples were negative but follow-up continues.

Adult↗
PubMed1993

Proctoscopic Doppler ultrasound in diagnostics and treatment of bleeding hemorrhoids.

PURPOSE: Endoscopic Doppler sonography is a relatively new technique in the diagnostics of intestinal hemorrhage. It has been used mainly for bleeding gastroduodenal ulcers, but can also be utilized in the lower digestive tract. METHODS: In the study presented 80 patients with symptomatic hemorrhoids of first degree and previous hemorrhage were randomized in two groups. The 40 patients in Group A were examined by transproctoscopic Doppler ultrasound. After measuring the vessels depth, local injection treatment with 5 percent phenol almond oil followed. The patients in Group B had been given conventional sclerotherapy without the aid of Doppler investigation. The success of treatment was checked using Doppler sonographics six weeks later and the results were statistically compared. RESULTS: In the patients in Group A, the hemorrhoids proved to be totally eliminated in 93 percent vs. 38 percent of the patients in Group B (P, 0.1 percent). CONCLUSIONS: Proctoscopic Doppler ultrasound is useful in the evaluation and sclerotherapy of symptomatic first-degree hemorrhoids.

Adult↗
PubMed1993

[Endoscopic pseudocysto-gastric drainage involving the stomach after Billroth II operation].

A 45 years old female patient developed a large pseudocyst after an acute pancreatitis in 1987. In 1982 gastric resection with Billroth's anastomosis was performed. The patient underwent surgical internal and percutaneous external drainage in 1988, which both resulted unsuccessfully. The current admission was due to a complete occlusion of the gastric anastomosis, induced by a recurrent pseudocyst of 9.2 x 7.3 cm in diameter. Endoscopically guided pseudocysto-gastric drainage by means of electrocauterization was successful with nearly complete evacuation.

Anastomosis, Surgical↗
PubMed1992

[Stent implantation in post-stenotic retention pneumonia caused by inoperable bronchial carcinoma].

The 65 year old patient referred to in this report has been suffering from an inoperable squamous cell carcinoma of the right superior lobe of the lung for the last two years. After therapeutic irradiation the disease subsided temporarily. Subsequently the patient became severely ill and was referred to hospital with high fever and refractory pneumonia. X-ray film revealed atelectasis of the right superior and central lobes and a pneumonic infiltration of the right inferior lobe. Bronchoscopy showed complete tumour stenoses of the superior and central lobes. The lower lobe of the lung was visualised as subtotally stenosed and obstructed by pus. Despite pathogen-directed antibiosis the poststenotic retention pneumonia did not heal. After laser recanalisation of the right inferior lobe we implanted an endobronchial stent. Subsequently, the pneumonia receded and the patient survived for five months relatively free from complaints.

Airway Obstruction↗