[Infestation of the pancreas with Echinococcus cysticus].
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Adult↗
Biomedical subjects
K Klose
Publications and source records attributed to K Klose.
Computed tomography in xanthogranulomatous pyelonephritis.
Two cases of xanthogranulomatous pyelonephritis (XGP) examined preoperatively by computed tomography are reported. In one, preoperative diagnosis of an inflammatory abscess-forming disease was possible. Several features of computed tomography in XGP permit differentiation from renal carcinoma. Global renal enlargement, the presence of calculi, the spread of infiltration into the fatty capsule with thickening of Gerota's fascia, and the characteristic density differences between cortex and medulla as a result of reduced contrast medium concentrations in the pyramids are suspicious of this special form of interstitial nephritis.
Diagnosis, Differential↗
[Sonography for the preoperative localization of islet cell tumor].
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Adenoma, Islet Cell↗
Magnification of the endoscope during endoscopic retrograde cholangiography--a reliable standard for exact measurement of bileduct and bilestones.
In 57 patients undergoing endoscopic retrograde cholangiography (ERC) the magnification of the endoscope was determined by measurement of its diameter depicted on the X-rays. A magnification of 30.2 +/- 10.6% (mean +/- SD) ranging from 8 to 58% in individual patients was recorded. The clinical reliability of the method was confirmed by comparing the diameters of 13 bile duct stones assessed in-situ and after removal respectively. Although the magnification tended to be higher in obese patients, no correlation between body weight and the degree of the magnification could be established. Our data add further doubt to the reliability of the radiologic bile duct measurement if not referred to a reliable standard which can be easily provided by the endoscope. This is particularly important whenever therapeutic interventions are planned which critically depend on exact determination of diameters, like bile duct stone removal with or without endoscopic papillotomy, lithotripsy or introduction of transpapillary enthoprothesis.
Body Weight↗
[Accuracy of computer tomography in urinary bladder cancer. Study of 74 patients following radical cystectomy].
The accuracy of computed tomography in staging bladder carcinoma has been investigated in 74 patients who underwent cystectomy (n = 70) and pelvic lymphadenectomy (n = 74). The results of the initial CT findings (prospective analysis) and the results of reviewing all CT scans retrospectively by 3 investigators have been compared. Retrospectively, T-staging was correct in 64%, overstaging was seen in 26% and understaging in 10%. N-staging was correct in 99% (n = 73/74) and obstruction of the upper urinary tract with dilatation of the ureter could be diagnosed in every case. The differences between retrospective and prospective analysis are discussed. Staging errors are seen in patients with tumor infiltration of the prostate or the uterus, with microscopic invasion of the perivesical fat, after irradiation of the pelvis or previous surgery. Metastatic involvement of lymph nodes below 1.5 cm diameter cannot be recognized.
Adolescent↗
[Sonographic spectrum of lateral head and neck soft tissue].
Sonography was performed in 206 patients with space-occupying processes in the region of the lateral soft parts of the neck, of the parotid gland or the submandibular gland (3.5; 7.5 and/or 8-10 MHz real-time contact field scanner). This sonographic examination enabled differentiation of 166 solid from 40 cystic space-occupying masses: 102 lymphatic node enlargements, 12 primary tumours of the neck, 24 neck cysts, one thymus and epidermoid cyst, on carotid aneurysm, diseases of the salivary glands (35 neoplasias, 8 cysts, 9 inflammatory tumours, 6 cases of sialolithiasis, 5 abscesses, 2 intracapsular lymphomas). The following valuable additional information was gained from sonography in respect of surgical treatment: 1. In the region of the lateral soft parts of the neck, it was possible to effect a clear differential diagnosis of the original findings based on palpation; differential diagnostic clarification of the tumour volume; spatial location of fixed tumours of the neck in relation to the adjacent soft parts of the neck, such as vessels, musculature etc.; quantification of tumour regression subsequent to chemotherapy or radiotherapy. 2. In case of diseases of the salivary glands, differentiation between salivary calculi, neoplasia, inflammation and cyst; extension of tumour; localisation of processes in the immediate vicinity; preoperative localisation of salivary calculi.
Carcinoma, Squamous Cell↗
[Self-retaining loop catheter for percutaneous bile duct drainage].
A percutaneous catheter which can be looped by means of a nylon thread was used in 32 patients for percutaneous biliary drainage. The catheter can be fixed in this way and is thereby prevented from migrating from the biliary system. The catheter is not suitable for proximal obstructions. Problems may arise during the removal of the nylon thread and loss of looping of the point of catheter.
Bile Duct Neoplasms↗
[Percutaneous transhepatic disintegration of gallstones and fragment extraction].
Attempts at percutaneous removal have been made in 13 patients with solitary and multiple intra- and extra-hepatic biliary duct stones measuring 5 to 30 mm. The stones were fragmented with a Dormia basket and the fragments removed transhepatically. In ten patients the procedure was successful, including one patient with multiple intra-hepatic stones. The procedure can be recommended for cases of calculous obstruction of biliary anastomoses or of stones which could not be removed by endoscopy, or where there is already biliary drainage being carried out, or in patients with a high operative risk. In two patients, dilatation of the papilla was also carried out, in four patients a stenosis was dilated and in a further two patients, dilated and in a further two patients, electro-incision of a stenosis was performed.
Aged↗
[Sonography in blunt abdominal trauma].
Ultrasonic examination was performed in 79 patients with blunt abdominal trauma, using 3.5 mHz real-time sonography. The examination aimed at clarifying intraperitoneal and retroperitoneal haemorrhage and injury to organs. Sonographic detection of haemorrhage succeeded in 13/13 of spleen ruptures and in one case of a liver rupture. 6 renal traumas were recognised by means of indirect signs and only twice by the direct identification of a band-shaped interruption of the parenchyma. Non-invasive sonography can be employed primarily in place of diagnostic peritoneal lavage for the detection of life-threatening intraperitoneal haemorrhages with an accuracy of more than 90%. Primary diagnosis of the source of haemorrhage is limited to individual cases because of the unfavourable conditions under which examination is performed. In unclear cases essential additional information is supplied by sonographic examination of the course of the disease.
Abdominal Injuries↗
[Results of percutaneous abscess drainage].
Between 1978 and 1983 fifty-two abdominal abscesses in 44 patients were drained percutaneously. 79% of the abscesses occurred as postoperative complications. The overall success rate was 60%, whereas only 42% of left subphrenic abscesses were cured. Complications were encountered in 4.5%. Reasons for drainage failures were: liver sequestration, loculation, fistulae and recurrences. Percutaneous abscess drainage is an alternative, and valuable addition, to surgery.
Adolescent↗
[Percutaneous transhepatic electroincision of stenosed biliodigestive anastomoses].
Percutaneous transhepatic electroincision is a new method for the treatment of stenoses after hepatico-jejunostomy. Using the percutaneous transhepatic approach the stenosis is cut with the aid of a papillotome by applying high frequency current. In all 5 patients treated the anastomis was patent. In one case multiple calculi in the intrahepatic bile ducts necessitated operative stone removal later on. In view of the problems of surgical correction percutaneous electroincision offers an attractive alternative to operation.
Bile Duct Diseases↗
[Postvagotomy complications: stomach bezoars - case report and review of the literature].
A 59 year old female with multiple gastric surgical procedures (Billroth I and Billroth II) for recurring ulcer disease developed a gastric phytobezoar following an additional truncular vagotomy within 2 months. Already 1 month after complete endoscopic removal the phytobezoar recurred in spite of dietary restrictions. The phytobezoar was successfully dissolved by oral Cellulase-therapy. The truncular vagotomy and its influence on gastric motility has to be considered as the cause of the repeated bezoar formation.
Bezoars↗
Transrenal ureteral occlusion with a detachable balloon.
Transrenal ureteral occlusion using a detachable balloon was successfully employed to stop urinary flow in seven patients. The balloon was filled with low-viscosity silicone rubber and released in the distal ureter. Percutaneous nephrostomy provided external drainage. Indications were painful dysuria and large urinary fistulas in advanced pelvic malignancy. The method is preferable to ureteral embolization with tissue adhesive.
Embolization, Therapeutic↗
[Massive retroperitoneal haemorrhage in the Bourneville-Pringle syndrome (author's transl)].
Case-report of a 54 year-old patient who was admitted with the clinical picture of an acute abdomen on the basis of intraabdominal haemorrhage. X-ray investigation discounted the diagnosis of ruptured aortic aneurysm, the CAT scan showed a suspected acute haemorrhagic necrotising pancreatitis. At laparotomy, a fatty, bleeding kidney tumour was found growing into the retroperitoneal tissue. The histological frozen-section showed a leimyo liposarcoma of the kidney. Bourneville-Pringle's disease was only afterwards known to be the basic illness of the patient, as was verified at postmortem examination. From the knowledge of these new facts, both the CAT-scan and the intra-operative and histological findings could be correctly interpreted.
Acute Disease↗
[Extrabiliary obstructive jaundice].
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Cholestasis↗
[The anatomy, radiology and clinical features of fractures of the sacrum (author's transl)].
In the presence of multiple injuries, 30% of fractures of the sacrum are missed on the first examination. The clinical features are non-specific and are often obscured by other injuries. Interruption or displacement of contrast lines on the A. P. view, if bilateral, are definite evidence of a fracture. In evaluating films of the sacrum it is therefore recommended that these lines be examined carefully. Such changes were found in two thirds of longitudinal and one third of horizontal fractures. Special attention should also be paid to the lateral and cranial articular processes, since these are areas of weakness in the pelvis and are predisposed to fracture.
Accidents, Traffic↗
[Superselective embolisation in the urogenital tract with tissue adhesives (author's transl)].
The tissue adhesive butyl-2-cyanoacrylate mixed with lipiodol and tantulum powder is an excellent agent for superselective catheter embolisation of small vessels. The mixture is low viscous and can be injected through fine catheters. Occlusion is independent of blood clotting and is permanent. A coaxial catheter technique is recommended or, in cases of difficulty, a ballon catheter can be floated in. Super-selective embolisation was used in 15 patients, in seven for the kidney in eight for the pelvis. Indications were bleeding from the kidney, partial defunctioning of the kidney, tumours in single kidneys and bleeding from carcinomas in the bladder, prostate or cervix.
Adenocarcinoma↗