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Biomedical subjects

Ch Meyenberger

Publications and source records attributed to Ch Meyenberger.

3 recordsLinked to original sources
PubMed2003

[Non-healing gastric ulcer].

HISTORY AND ADMISSION FINDINGS: A 47-year-old Angolan complained of upper abdominal pain, fever, weight loss and night sweats. Abdominal ultrasound performed by his general practitioner showed enlarged lymph nodes at the liver hilum. Physical examination was negative except for slight tenderness over the right upper abdomen. INVESTIGATIONS: A tuberculin skin test was clearly positive. Upper gastrointestinal endoscopy revealed multiple gastric ulcers and the Helicobacter pylori test was positive. The lymph nodes at the liver hilum were needle-aspirated, this showed granulomatous inflammation similar to the biopsies of the ulcers. Eradication of Helicobacter pylori and therapy with proton pump inhibitors were initiated. DIAGNOSIS, TREATMENT AND COURSE: Epigastric pain and the ulcers persisted unchanged. The culture of the lymph node aspirate grew multiresistent Mycobacterium tuberculosis. With adequate tuberculostatic therapy the patient improved rapidly and the further course was without any complications. CONCLUSION: Tuberculosis should be included in the differential diagnosis in non-healing ulcers of the gastrointestinal tract, especially in immigrants from endemic areas.

Biopsy, Needle↗
PubMed2003

[Biliary stents].

Endoscopically implantable stents are today the mainstay for therapy of biliary stenoses. It is important to know if a benign or a malignant stenosis is the cause of the biliary obstruction. Generally benign stenoses are treated with plastic-stents whereas malignant stenoses are managed by implantation of a metallic stent. The main indications for plastic stents are postoperative strictures in the biliary tree for example, after biliary tract surgery or liver transplantation, primary sclerosing cholangitis and postoperative biliary leakage. Metallic stents are implanted in palliative circumstances like in stenosing cholangiocarcinoma or in situations where a hepatic metastasis exerts an extrinsic compression on the biliary tract with consecutive cholestasis. The materials used for manufacturing both stent types are biologically inert and thus biocompatible. A current poorly resolved problem is the occlusion of the stent lumen (by sludge, bacterial degradation products etc.) which occurs in both stent types with time. These problems lead to stentocclusion around three to six months after implantation and necessitate endoscopical re-interventions in order to overcome the occlusion. The patency rate for metallic stents is better than for plastic ones. The endoscopic stenttherapy is equivalent to surgical therapy (Intestinal bypass-procedures).

Bile Duct Neoplasms↗