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Biomedical subjects

R Pointner

Publications and source records attributed to R Pointner.

66 records · Page 4Linked to original sources

Endoscopic removal of a pedunculated bronchial lipoma by means of the hot snare.

The complete endoscopic removal by means of the hot snare of a pedunculated bronchial lipoma with a carcinoma in situ in its covering bronchial epithelium is reported. To our knowledge, the endoscopic removal of peripheral polypoid bronchial lesions has not been reported to date. The advantage of this technique lies in its ability to permit an exact histologic examination of the lesion, in contrast to laser vaporisation.

Aged↗

Gastric stump cancer: etiopathological and clinical aspects.

Between 1959 and 1987, at the Innsbruck University Hospital, 359 cases of carcinoma were diagnosed in the gastric remnant. While until 1975 in 203 patients suffering from stump carcinoma the tumor stages T3 and T4 were significantly prevalent, a strong tendency towards the less advanced tumor stages T1 and T2 was observed in the last decade. Among 94 patients operated on since 1981 the tumor was located at the anastomosis in all but 5 cases, suggesting a strong connection between previous resection and stump carcinoma. In accordance with Lauren's classification no difference was found in the incidence of intestinal and diffuse lesions in 94 cases with stump carcinoma--in contrast to 69 cases of patients with a non-resected stomach. An analysis of the occurrence of acidity, atrophic gastritis and bacterial invasion in 70 patients with previous Billroth II resection and 30 patients with Billroth I resection, revealed no difference between the two types of resection. Gastric remnant carcinoma does not occur exclusively in the Bilroth II remnant, but, increasingly, following Billroth I operations. The finding of a statistically highly significant increase at the 5% level using standard chi 2-technique for a 2 x 5 table in stump carcinomas following Billroth I resections supports the thesis that there is no difference in the etiopathology of carcinogenesis in the Billroth I as compared with the Billroth II remnant.

Aged↗

["Brown bowel" syndrome--lipofuscinosis of the intestine as a cause of atonia].

We report on a 42 year old male patient having been ill with pseudo-pobstruction and gastroinstestinal atonid for 24 years. He was thought to suffer from Crohn's disease and was treated conservatively. Since the therapy proved to be insufficient, explorative laparatomie was performed and parts of the small and large intestine which were thought to be inflamed, were removed. The histologic examination revealed the deposition of a significant amount of lipofuscin in the muscularis propria. This so-called brown bowel syndrome is known to be responsible for the development of gastrointestinal atonia. It is generally believed that this syndrome is caused by a vitamin E deficiency which may occur due to malabsorption. The brown bowel syndrome is treated sympomatically, and until now only one case achieving a remission of the disease has been reported.

Adult↗

Endoscopic treatment of Dieulafoy's disease.

The "exulceratio simplex Dieulafoy" is an uncommon and dangerous cause of upper gastrointestinal hemorrhage. In all patients admitted to our hospital with signs of acute gastrointestinal hemorrhage in whom Dieulafoy's disease was diagnosed at emergency endoscopy, an attempt was made to stop the bleeding or to prevent further hemorrhage by local injection of polidocanol, or by bipolar electrocoagulation, or by a combination of both. Since 1979 an exulceratio simplex has been diagnosed in 22 patients. All patients were treated endoscopically, 18 of them with satisfactory results. Four patients had to be operated on after emergency endoscopy had failed. Knowing the location of the bleeding site, the operations could be planned exactly and performed quickly. All patients, whether they had undergone endoscopic or surgical treatment, made an uncomplicated recovery and none had a further bleeding episode after discharge from the hospital.

Adult↗

Early cancer of the gastric remnant.

Early carcinoma of the gastric remnant was diagnosed in 19 patients between January 1976 and January 1986. In all patients early cancer was suspected at endoscopy and confirmed by biopsy and histology. The main reason for endoscopic examination was diffuse epigastric pain suggestive of stump gastritis. The surgical procedure was stump gastrectomy. Two of the 19 patients were not operated on because of advanced age. In contrast with the poor prognosis of patients with cancers of the gastric remnant of tumour stages T2 to T4 according to the TNM-classification regardless of their NM-stage, patients with tumour stage T1N0 and T1N1 have a good prognosis.

Adult↗

Endoscopic aspects of aortointestinal fistula.

The etiology, diagnostic difficulties and treatment of five cases of aortointestinal fistulas are presented. In all of them, endoscopy played a major diagnostic role. Early diagnosis is essential for elective surgery since reconstruction in the massive bleeding stage has a mortality of up to 80%.

Adult↗

[Problems of esophagojejunal anastomosis following gastrectomy].

Experiences with 76 patients with esophagojejunoplication after total gastrectomy are reported. Clinical results are compared with a control group of 33 patients who underwent gastrectomy followed by terminolateral esophagojejunostomy as we did formerly. Performing this method of esophagojejunoplication the rate of leakage (2/76 respectively 3/33) of the anastomosis was reduced as well as the occurrence of reflux complaints (9/62 respectively 15/21).

Adult↗