[The ERCP as the method of choice in the diagnosis of choledochus stenoses].
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Biomedical subjects
Publications and source records attributed to H Platzbecker.
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The diagnostic potentialities in cholestasis and cholangitis could be considerably improved by endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous transhepatal cholangiography (PTC) with a thin needle (0.7 mm). First ERCP was performed, enabling us to establish pathological findings in 62 per cent of the 233 examinations in the period 1975--1977. Gallstones were most often found-in 65 cases (28%). Second to be found was the suptapapillary stenosis of the bile ducts and obstruction of the bile ducts--42 cases (18% of the examined), caused by surgical interventions, tumours of the bile ducts and processes in the region of the head of the pancreas. When ERCP fails to provide sufficient data or is ineffective - PTC is performed. Correct diagnosis was made in 15 cases out of 23 examinations, in six - partial data were obtained and in two - the examination failed.
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In the light of 8 observations, made by the authors, vasoanomalies underlying the syndrome of the unilateral hyperlucent lung are discussed in their correlation to homolateral bronchial lesions. There were 3 cases with unilateral aplasia of the pulmonary artery in which the unilateral hyperlucency was found always on the healthy side. In these cases there was a normal bronchogram on both sides. The vascularization by the bronchial arteries causes characteristic changes both in the X-ray-picture and endoscopy. Hypoplasia of the pulmonary artery occurring simultaneously with hyperlucency of the affected side of the lung was found in five cases, 4 times in connection with homolateral, severe, diffuse deforming bronchitis and bronchiectases and 1 case with congenital bronchus stenosis. There is the opinion that besides a congenital form of the hypoplasia of the pulmonary artery a (virus?) --pneumonia, acquired in early childhood, can lead to a pulmonary hypoplasia and a bronchopulmonary dysplasia. The diagnosis can be made only after several special examinations performed in a multi-step system. The significance of the lung scintigraphy within the scope of this complex diagnostics is especially emphasized. Indication for surgery should be made very cautiously. Antibiotic long-term therapy and dsipensary care are considered to be essential.
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