PubMed · 5477965
The source did not provide an abstract. Follow the original record for more information.
Explore connections, maps & timelines
T Kozu, P Deyhle, M Classen, H Koch, L Demling. 1970-10-23. [New methods for proctoscopy].. https://doi.org/10.1055/s-0028-1108806
Cite the original work for its findings. Save a collection to share your selection of sources.
KEEP EXPLORING
The localization of the carcinoid tumors of the gastrointestinal tract--as a part of the APUD system--is extremely seldom at the region of ampulla of Vater. A case of congenital neurofibromatosis is reported in a 49-year-old male patient, with a carcinoid tumor of the ampulla of Vater in the background of long-standing, atypical biliary complaints. Periampullary neoplasm of neural-crest origin are very rare, up to this time 73 cases of Vater papilla carcinoid tumors were described. Regarding the development of VP carcinoid in neurofibromatosis, our patient is the 21st reported case in the world literature, and the first one in Hungary. The authors review the literature, giving special attention to the risk of periampullary neoplasms in von Recklinghausen's disease, the need of accurate diagnosis and the correctly selected operative intervention.
3757 elective nonmalignant biliary tract operations are evaluated retrospectively in the 17-year period from January 1, 1974 to December 31, 1990. The operations were divided into four periods according to development and frequency of intraoperative diagnostics: I. period without examinations of common bile duct (511 operations), II. selective period (848 operations), III. routine period (906 operations), IV. restricted routine period (1492 operations). The authors experienced improvement in their results if they carried out intravenous cholangiography routinely. Comparing eight characteristic factors they believe that their results are favourable if they performed intraoperative common bile duct examinations (manometry, cholangiography, flow rate measurement) in 39.6% rate and if they employed praeoperatively EST if necessary. They propose the selective intraoperative cholangiography. In the period of 39.6% intraoperative cholangiography (restricted routine period) they found common bile duct stones in 10.7%, unsuspected stones in 0.4%, retained stones in 1.6%, unnecessary choledochotomies in 2.7% and intraoperative common bile duct injuries in 0.2%. The overall mortality rate was 0.4%. They deal with the intraoperative differential diagnostics of Vater papilla stenosis and spasm.
The case of a 50-year-old man with abdominal pain and abnormal liver test results is described. Endoscopic retrograde cholangiopancreatography with manometric studies showed biliary dilatation, poor ductal drainage, and sphincter of Oddi dysfunction. Clinical and radiographic clues suggested the possibility of an ampullary lesion; a small ampullary adenoma was detected after endoscopic sphincterotomy, and ampullary carcinoma was found in the operative specimen. Malignancy can cause sphincter dysfunction not only in the esophagus (as pseudoachalasia) but in the ampulla of Vater as well.