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Biomedical subjects

M Clemens

Publications and source records attributed to M Clemens.

At least 91 records · Page 5Linked to original sources
PubMed1979

[Surgery in patients with obstructive jaundice caused by carcinoma (author's transl)].

Malignant disease obstructing the bile ducts is diagnosed in most cases at a time, when radical surgery is not possibly any more. Diagnostic procedures applied up to now are not suited for early diagnosis. 5 years survival rates of patients with carcinoma of the bile ducts are maximally 6%, in patients with carcinoma of the papilla 36%. In the Department of Surgery of the Münster University, 126 such patients have been treated in the recent time; in 104 cases jaundice was apparent clinically. Radical pancreatoduodenectomy could be done only in 24 patients.

Adult↗
PubMed1978

[Replacement of the common bile duct by an autologous vein (author's transl)].

3 cm of the common bile duct was removed in 19 dogs and the defect was bridged by an autologous vein. The interposition of a vein graft was performed with a double end-to-end anastomosis. In four cases a T-drain was additionally placed into the transplant. GOT, GPT, LDH, AP and bilirubin were tested in regular intervals. The patency of the transplant was proved by radiography with dogs which survived longer than 6 weeks. 5 dogs died within the first 4 weeks, 4 were killed after 2 months, because of incrustation of the T-drain for a regular percutaneous rinsing of the drainage was not possible. 10 dogs survived for 6 to 12 months. These animals showed increasing laboratory results up to two months, then the tests normalized. The function of the transplanted vein was without complication and the liver histology did not show any pathological alteration. After two months the transplanted vein was bridged by bile duct epithelium.

Alanine Transaminase↗
PubMed1978

Endoscopic retrograde cholangiography (ERC) in surgical emergencies.

Twelve patients, presenting with an acute abdomen of suspected biliary tract origin, had endoscopic retrograde cholangiography performed. Eight patients had either traumatic, spontaneous, or postoperative biliary tract fistulas with five leading to the peritoneal cavity, one to the colon, one to the bronchial tree, and one to the liver parenchyma from a ruptured gall-bladder. Each was confirmed by endoscopic retrograde cholangiography. Four patients with jaundice, following traumatic rupture of the liver, had a pathological communication between the intrahepatic biliary tracts and the hepatic vascular system. It is concluded that ERC is a reliable method for obtaining precise localization of biliary tract problems in surgical emergencies both pre- and post-operatively.

Adolescent↗
PubMed1978

[The multiple stomach carcinoid].

Carcinoid tumors can be found in the entire alimentary tract. Stomach carcinoids make up about 3% of all carcinoids; 0.39% of all stomach tumors are carcinoids. Multiple stomach carcinoid is a medical rarity. In spite of an invasive growth, carcinoids with a diameter of less than 1 cm are considered semimalignant, those with a diameter of more than 1 cm are considered sure malignant. There are 8 cases of multiple gastric carcinoids described in the literature. In our case we found macroscopically 31 polyps with a diameter of between 0.4 and 2 cm in the stomach. Histologically they were growing invasively with small tumor groups in the lymph ducts. Therapeutically total gastrectomy was necessary.

Carcinoid Tumor↗
PubMed1978

[Hemobilia and bilhemia complicating liver trauma (author's transl)].

Hemobilia and bilhemia are typical complications of liver trauma which have been found more often during the last years. Today gastroduodenoscopy, retrograde cholangiography, selective angiography and scintillation scanning of the liver make an exact diagnosis possible. In the case of hemobilia a ligature of the corresponding artery might be successful, whereas in the case of bilhemia only partial resection of the liver leads to success.

Adolescent↗
PubMed1978

[Bileduct reoperations (author's transl)].

After cholecystectomy reoperations are required in 7%. A reoperation in indicated by pathologic alterations overlooked at the first operation, not working biliodigestive anastomoses and injuries to the common bile duct. 138 reoperations of the bile duct wer performed within 4 years which were aimed at reconstructing the normal bile duct anatomy. Mortality rate 8,7%.

Ampulla of Vater↗
PubMed1978

[Juxtapapillary diverticula of the duodenum and bilio-pancreatic symptoms (author's transl)].

Juxtapapillary diverticula of the duodenum are more frequent than has been assumed up to now. Among 2100 patients undergoing duodenoscopy 135 duodenal diverticula have been found. These diverticula may cause symptoms of diverculitis as well as of bilio-pancreatic disease. Such diverticula ought to be treated by surgery. In our department diverticula are turned inward, or a papillo-diverticulotomy is done depending upon the localization of the diverticula.

Cholangitis↗
PubMed1977

[Diverticula of the stomach - diagnosis of their importance (author's transl)].

Gastric diverticula may be due to dilatation or traction. 75% are found in the fundus, 15% in the prepyloric antrum. In 10% they were situated elsewhere. Symptoms are unspecific. Radiography has to be combined with endoscopic investigation of their nature. Smaller diverticula are mainly treated conservatively, the larger ones will require surgery because of chronic symptoms and complications.

Diagnosis, Differential↗
PubMed1977

[Bronchobiliary fistula. Pathogenesis, diagnosis, therapy].

The case demonstrated shows the pathomechanism of bronchobiliary fistula. In most cases, bronchobiliary fistulae are caused by stenosing lesions of the common bile duct. For diagnosis the combined cholangio-bronchography is the preferred method. Removal of the obstructing lesion is the aim of operative treatment. Usually spontaneous healing of the bronchobiliary fistula results.

Adult↗
PubMed1976

[Lymphogenic osteomyelitis of the foot (author's transl)].

The special way of infection of the lymphogenic osteomyelitis caused by trivial trauma is demonstrated in 4 cases. Germ ascension is done by lymphatics or fissures in the tissue, as it is well known in the panaritium ossale. The treatment consists in removing the focus of infection, irrigation-suction drainage and specific antibiotic therapy. Trivial trauma of the lower extremity should be treated according to the principles of asepsis.

Adult↗