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K Seitz

Publications and source records attributed to K Seitz.

At least 19 recordsLinked to original sources
PubMed2005

[The neck -- a sonographically interesting region for many medical fields].

The soft tissues of the neck can be examined at the highest resolution with ultrasound probes of high frequencies due to their superficial position. There are many clinically important diagnostic issues concerning the thyroid gland, the parathyroid, lymph nodes, vessels of the neck, salivary glands and other structures of the field of ENT and even the nerves of this region. Numerous different medical departments therefore work in this field either together or I a parallel fashion. In addition to different sub-specialties of internal medical and surgical departments, radiologists, neurologists, ENT doctors, gnathologists and radio-oncologists are all active here. Even intensive care personnel and anaesthesiologists use ultrasound for sonographically guided punctures. It is therefore obvious that the cervical region is of special importance for an interdisciplinary journal, constituting a large part of publications. In the last 2 (1/2) years, we published two articles about cervical lymph nodes , eight concerning the topic of vessels , two articles about salivary glands and three dealing with the parathyroid glands . The present issue again contains three publications concerning this area, characteristically from three different medical specialties, each of great significance for various medical fields. An important article deals with deQuervain thyroiditis . Albeit this is not a common disease, any clinician working on the cervical region should be well aware of this entity, as the patients concerned often go through a medical "odyssey" with different specialists before the right diagnosis is made. An important addition to sonographical interventional techniques is percutaneous instillation therapy for focal autonomous adenomas of the thyroid : it is fast acting and effective, representing a genuine therapeutic alternative to surgery or radioactive iodine treatment in many cases. The case report on a - fortunately non-permanent - partial laryngeal necrosis resulting from the instillation of 96 % alcohol demonstrates the potential damage an established method can cause if applied without expertise. It is therefore mandatory to be aware of potential side effects and carry out the intervention proficiently, strictly keeping in mind the indication for therapy. A further case report demonstrates in an impressive way the importance of cervical sonography for the detection and landmarking of parathyroid adenomas. The fact that the author is a surgeon might serve as valid proof, as the surgery of parathyroid glands almost solely depended on the experience and the explorative skill of the surgeon until recently.

Humans↗
PubMed2004

[Sonographic diagnosis of diverticulitis: the burdensome way to acceptance].

Since the middle to the end of the 80 s, the sonographic detection of diverticulitis has been increasingly improved. In a paper including a larger number of patients published in 1992, W. B. Schwerk demonstrated a high sensitivity and specificity. The detection of diverticulitis was the final entry into the chapter of acute abdominal sonography, after the diagnosis of gastrointestinal perforation, acute appendicitis and ureterolithiasis had been achieved with high reliability. Until then, diverticulitis was a classic surgical disease and a contrast enema with water-soluble contrast medium the diagnostic method of choice. Invariably, the radiologist added the well known comment: Cancer of the sigmoid colon cannot be excluded with certainty. What has changed in the 12 years after Schwerk's publication? Many internists practising sonography have discovered the sonographic diagnosis of this condition and, depending on the severity, treat the less complicated cases with intravenous antibiotics and parental nutrition or with oral antibiotics and low-ballast diet. Soon, abscesses were healed with sonographically guided aspiration and drainage. For a long time, the older generation of surgeons stayed with contrast enemas and prolonged parenteral therapy and, in case of complications, surgical interventions, though surgeons early recognized the diagnostic contribution of sonography. Influenced by radiologists and the Anglo-American literature, surgeons increasingly used computed tomography (CT) as standard method for the initial diagnostic work-up for the last five to eight years. A physician dedicated to gastrointestinal sonography cannot accept this approach, in particular, since sonography is easy and reliable, provides a reasonable differential diagnosis and was found to help the surgeons. An exception is the deep-seated diverticulitis in the sometimes barely accessible distal sigmoid colon. Furthermore, an experienced clinician will anyhow proceed to CT in any unexplained discrepancy between clinical and sonographic findings. It reflects the high value given to sonography if our surgical colleagues use this diagnostic method in the primary diagnosis of acute diverticulitis and achieve results that are as good as the results of the expensive and by all criteria more elaborate CT. The extended application of ultrasound for the omentum and in necrotic epiploic appendagitis should be mentioned here as well. Altogether, CT can be easily refrained from in 80 % to 90 % of cases with suspected diverticulitis. In view of the DRG era, this is an important argument, and emphasizes the economic role of sonography, the necessity of correct coding of sonographic procedures and the need of more sonographic training. Only quality will increase the acceptance of sonography as diagnostic tool as repeatedly demanded and presented in this journal. If this fails, it is highly likely that the diagnostic potential of sonography will remain unexploited or, under the best of circumstances, rediscovered after a 5-year expiration date in a new literature search in 10 years.

Diverticulitis↗
PubMed2004

Detection of therapeutically relevant diagnoses made by sonography of the upper abdomen: portable versus high-end sonographic units -- a prospective study.

AIM: To compare the efficiency of a portable sonographic unit with a high-end unit used for sonographic examinations of the upper abdomen to detect therapeutically relevant diagnoses and to answer clinical questions. METHODS: Over a period of five years, 575 patients were examined by four examiners as part of the daily routine work. Patients without known diagnoses were examined first with the portable SonoSite 180 system, with documentation of the findings and diagnoses, and immediately thereafter with the high-end Philips HDI 5000 system. Subsequently, any discrepant findings and diagnoses were recorded. The assessment was confined to therapy-demanding diagnoses and to the resolution of the clinical question (major findings) as well as to other therapeutically relevant findings (minor findings). RESULTS: Of the 575 data sets (duplicated examinations), 574 could be evaluated. The major findings coincided in 447 (78 %) of 574 cases and were discrepant in 121 (22 %) cases in which the major findings were solely detected with the high-end Philips HDI 5000 system and missed with the portable SonoSite 180 system. Findings of the upper abdomen coincided in 252 (85 %) of 297 cases and were undetectable with the portable unit in 44 (15 %) cases. For 166 intestinal examinations, the proportion of coinciding major findings was 58 % (96 of 166 cases), with 42 % (71 of 166 cases) overlooked with the portable unit. For examinations of the pleura, the findings coincided in 99 (89 %) of 111 cases. The findings of emergency examinations coincided in 138 (75 %) of 185 cases, with 47 (25 %) findings exclusively detected with the HDI 5000 system. In emergencies without intestinal involvement, the findings coincided in 105 (89 %) of 118 cases. CONCLUSION: As expected, the high-end unit is markedly superior to the portable sonographic unit, especially for clinical questions requiring a high physical resolution, as needed for gastrointestinal structures, biliary system and pancreas. The portable unit provided its best results for examinations of the pleura and for emergency examinations as long as the gastrointestinal tract is excluded. For the routine use of portable sonographic units, it is important to know the limitation of the particular unit.

Abdomen↗
PubMed2003

[Efficiency of a portable B-scan ultrasound device in comparison to a high-end machine in abdominal ultrasound. Results of a pilot study].

AIM: To determine the comparative performance of a portable sonography device in abdominal ultrasound. METHOD: In the daily routine of abdominal ultrasound scanning, the portable device SonoSite was tested against the high-end machine ATL 5000 HDI by two examiners with more than 5 years of ultrasound experience. The examination was restricted to the B-scan with a hands-on scanning time of 10 minutes. Patients with unknown diagnoses were first examined with the SonoSite, and the findings and diagnoses documented. Consecutively, the examination was repeated using the ATL HDI 5000. Differing findings and diagnoses were documented in a written form. RESULTS: There were 62 identical results in 60 patients. The high-end device yielded 23 additional findings. Examination with the portable device did not allow a definite diagnosis in 4 more cases. This difference is statistically significant with a confidence interval of 95 %. CONCLUSION: Portable ultrasound devices are surprisingly effective in the hands of experienced examiners. Imaging quality is predictably inferior to so-called high-end devices. Nearly all acute and therapeutically relevant diagnoses and findings were registered, even though nearly a quarter of the findings diagnosed with the high-end device were overlooked. These findings were mostly clinically irrelevant or very small in size. As could be expected, problems arose with pathological findings requiring high resolution, i.e., liver metastases, tiny gallstones, appendicitis, Crohn's disease etc. These form a clear indication for a high-end ultrasound examination.

Abdomen↗
PubMed2003

[Giant haemangioma of the liver - clinical and diagnostic problems - a case report].

Typical echodense haemangiomas of the liver can easily be identified by B-scan ultrasound. Atypical or giant haemangiomas of the liver, however, need to be differentiated from secondary tumours or primary liver carcinomas and cholangiocarcinomas. Until recently, computed tomography or magnetic resonance tomography were required to confirm the diagnosis, and not so rarely even a fairly risky fine-needle puncture had to be performed. Contrast media-assisted sonography, in general, offers the same scope of differentiating liver tumours as the radiographic tomography methods. Contrast media-assisted sonography is not yet widely available and has not been sufficiently evaluated. One important limitation is thought to be the lack of echo depth. We demonstrate the diagnostic value of this method in the case of a liver haemangioma measuring more than 20 cm in diameter. The resulting clinical questions are being discussed.

Aged↗
PubMed1999

[Ultrasound guided forceps biopsy of the pleura].

AIM: Between cytology of pleural effusion and thorascopy there is a gap for another non invasive biopsy method to diagnose pleural diseases, especially since Adam's and Ramel's blind pleural biopsy is uncommon. Therefore it is suggestive to test feasibility and usefulness of pleural forceps biopsy. METHOD: It is possible to take biopsies under ultrasound guidance with the help of a biopsy-forceps from the diaphragmatic pleura or pleural appositions through a 2.5 mm canula with a stop cock and a rubber vent. The specimen can be used for histological or immunohistochemical examinations. The procedure is coducted in a closed system to avoid pneumothorax. The puncture was done in 12 patients with a puncturable pleural effusion. RESULTS: In 11 of 12 patients it was possible to get the final diagnosis. In one of three cases of mesotheliomas a rebiopsy was necessary. In 9 cases a malign tumor was diagnosed, effusion cytology was negative in 4 of 7 tumors. In 5 patients with a history of a former tumor pleural carcinosis was related three times correctly to the former cancer and twice to a secondary cancer. In one case a fibrous plaque was found. There were two patients with pleuritis, in one case a pulmonary tuberculosis was found 8 weeks later. In one patient with a mesothelioma inoculated metastasis were present in the sites of the punctures. In all pleural forceps punctures we got enough biopsy material for histological and immunohistochemical diagnosis. CONCLUSION: The ultrasound guided forceps biopsy of the pleura is a very promising less invasive method to diagnose pleural tumors. Additional improvements of the equipment are possible. Definitive evaluation of the procedure especially in infectious pleural diseases requires a higher number of cases.

Adult↗
PubMed1998

[Incidental ultrasound findings of the gallbladder].

The low threshold for sonographic examinations of the gallbladder, the relative high incidence of gall bladder disease and the extraordinary quality of ultrasound imaging leads to a remarkable number of chance findings. The image quality of new ultrasound scanners allows in most cases a rapid diagnostic decision. Therapeutic consequences depend in the first line on the following carefully directed anamnesis. The most common findings are gallstones, cholesterinosis, polyps and sludge. Rare but important findings are porcelain gallbladder, adenomyomatosis and cysts of the common bile duct.

Cholelithiasis↗