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Biomedical subjects

C H Hammar

Publications and source records attributed to C H Hammar.

53 records · Page 3Linked to original sources
PubMed1992

[Proctoscopic Doppler ultrasound in diagnosis and therapy of symptomatic first degree hemorrhoids ].

Within the framework of a prospective study two comparable collectives with each 62 patients and symptomatic first grade hemorrhoidal disease were examined. Guiding symptom was painless hematochezia. The hemorrhoids of collective A were evaluated with the aid of transproctoscopic Doppler ultrasound. The depth of the vessels was determined and a Doppler located injection therapy was performed. The patients of collective B were only investigated by means of proctoscopy and sclerosed without Doppler. Sclerosing injection was carried out in all cases with 6 ml Phenylamygdalic oil by 3, 7 and 11 o'clock lithotomy position. Success of therapy was controlled in all patients 2 weeks later Doppler sonographically. In 87% of the Doppler controlled treated patients the hemorrhoids were completely eliminated and no more arterial blood flow could be scanned. On the contrary only 37% of the initially not Doppler scanned patients were cured. Endoscopic Doppler ultrasound is and effective method in evaluation and treatment of symptomatic first grade hemorrhoids.

Blood Flow Velocity↗
PubMed1991

[Dual cause of obstructive jaundice: cholangiolithiasis and malignant choledochal stenosis].

Endoscopic retrograde cholangiopancreatography in a 78-year-old woman with right-sided upper abdominal pain and jaundice (total bilirubin 8.9 mg/dl) revealed two stones, of about 1 cm diameter each, in the biliary duct. They were removed after papillotomy. Because of persisting jaundice (total bilirubin 7.6 mg/dl) and a history of two years of recurrent cholecystitis a cholecystectomy was performed. At operation an advanced carcinoma of the gallbladder was discovered, with tumour compression of the extrahepatic choledochal duct. After removal of the gallbladder the stenosis was bridged with a T-drain. For permanent bile diversion of a self-expanding stent was endoscopically implanted. The patient has been symptom-free so far for 6 months. It is stressed that, especially in elderly patients, malignant choledochal stenosis must be included in the differential diagnosis of obstructive jaundice caused by stones and diagnostic procedures undertaken accordingly.

Age Factors↗
PubMed1975

[Cerebellar ataxia due to hypothyroidism in adults (case report)].

Cerebellar ataxia was diagnosed in a 62-year-old woman, its signs regressing almost completely within six weeks during treatment with thyroxine and triiodothyronine. The cause of cerebellar ataxia in association with hypothyroidism remains unknown. No typical morphological changes in the cerebellum have been described. It is assumed that a thyrogenic, specific metabolic factor is responsible which aggravates already existing non-specific cerebellar changes. The prognosis is very good. On the other hand, cerebellar ataxia resulting from congenital hypothyroidism has typical histological cerebellar changes and prognosis is very poor unless thyroid treatment is started soon after birth.

Cerebellar Ataxia↗
PubMedDate not supplied

Diagnosis and treatment control of bleeding colorectal angiodysplasias by endoscopic Doppler sonography: a preliminary study.

The diagnostic accuracy and practical impact of trans-endoscopic Doppler ultrasonography were prospectively investigated in an open preliminary study of patients with hemorrhage from colonic vascular malformations. From January 1, 1991, to December 31, 1992, 437 consecutive patients were seen with lower gastrointestinal bleeding. In 15 cases the source of hemorrhage proved to be colorectal angiodysplasias (3.4%). In all cases bleeding had stopped spontaneously before the endoscopic examination. Upper gastrointestinal causes of bleeding were excluded endoscopically in each patient. To detect the superficial arterial vessels responsible for the hemorrhage a total of 32 lesions were scanned by trans-endoscopic Doppler ultrasonography. Twenty-nine vascular malformations in 12 patients were Doppler-positive (91%) and 3 lesions in 3 patients were Doppler-negative without an arterial signal. All Doppler-positive lesions had injection therapy with epinephrine and polidocanol. Twenty-six of the 29 sclerosed angiodysplasias (90%) in 9 patients could not be found endoscopically 2 weeks later, confirming the success of therapy. Doppler noise was still recorded in 3 visible malformations in the remaining 3 patients, indicating insufficient treatment. Further injections were made into these lesions, and the vascular anomalies were finally eliminated. During 6 months of follow-up, one of the 12 treated patients relapsed with an actively bleeding cecal angiodysplasia. After repeated endoscopic hemostasis, no further hemorrhage was observed in this patient. No bleeding recurred in the 3 patients with Doppler-negative lesions. Endoscopic Doppler sonography may help in the identification of intestinal angiodysplasias. The technically simple method allows objective evaluation of the endoscopic findings and enables monitoring of local endoscopic therapy.

Angiodysplasia↗
PubMedDate not supplied

Doppler-controlled injection treatment of Dieulafoy's disease.

Dieulafoy's anomaly is a vascular malformation of the upper stomach, which typically causes massive and recurrent haemorrhage. Emergency endoscopy is the most effective method of diagnosing the disease. Until recently, the therapy of choice was surgical resection. Five patients with spontaneously stopped bleeding from Dieulafoy's ulceration were investigated. Transendoscopic Doppler ultrasound was used to identify arterial blood flow from the lesions. Local injection treatment was performed. Successful therapy resulted in the disappearance of arterial pulsations and no rebleeding occurred. The endoscopic Doppler is of diagnostic value in the evaluation of Dieulafoy's ulcer and enables control of endoscopic sclerotherapy.

Adult↗