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Biomedical subjects

D Wurbs

Publications and source records attributed to D Wurbs.

At least 19 recordsLinked to original sources
PubMed1991

Intraductal mucin-hypersecreting neoplasms of the pancreas. A clinicopathologic study of eight patients.

Intraductal mucin-hypersecreting neoplasms of the pancreas with extreme dilatation of the main duct were studied in eight patients. They included five men and three women, aged 47-85 years. Five patients had a history of symptoms mimicking pancreatitis; four developed steatorrhea and/or diabetes. At endoscopic retrograde pancreatography, five patients showed an open ampulla filled with mucin, and six patients showed patchy filling defects in the ectatic main duct. Morphological examination showed extreme dilatation of the entire pancreatic duct in six patients and its tail segment in two patients. The duct segments filled with viscous mucin were lined by well-differentiated mucin-secreting cells, forming papillary foldings and occasionally showing cellular atypia. None of the patients had invasive tumor or metastasis. Six patients whose lesions were resected are alive and doing well (mean follow-up, 5.5 years). It is concluded that intraductal mucin-hypersecreting neoplasm is a pancreatic tumor with favorable prognosis. Because it shares many features with intraductal papillary neoplasm, a common pathogenesis of these pancreatic tumors is suggested.

Adenocarcinoma, Mucinous↗
PubMed1991

Splenic injury as a complication of endoscopy: two case reports and a literature review.

Two cases of splenic injury - one after a difficult colonoscopy and the other after routine ERCP - are reported. Splenic injury as a complication of endoscopic procedures is relatively rare, but over the past several years this complication has been increasingly reported. Review of the literature revealed 11 cases occurring after colonoscopy and one after ERCP. Although most of the patients presented with acute abdominal symptoms, some had mild vague symptoms. In two cases the injury was overlooked entirely. Diagnosis was established at laparotomy in four cases, by CT in four, by ultrasonography in two, by chance observation in two, by angiography in one and by paracentesis in one. All patients except the most recent three reported underwent surgery, with one mortality occurring three weeks after the operation.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1985

Lithotripsy of urinary concrement in the sigmoid after ureterosigmoidostomy.

A urinary concrement which appeared in the sigmoid of a 63-year-old man after ureterosigmoidostomy was extracted by endoscopy. The stone was situated proximal to a radiogenic stenosis. Because of the disproportion between the stone and the sigmoidal stenosis, mechanical lithotripsy had to be done before the concrement could be completely extracted.

Colon, Sigmoid↗
PubMed1982

Elimination of bacteria in biliary tract infections during ceftizoxime therapy.

A transpapillary indwelling catheter was inserted to prevent stone impaction in six female patients who were suffering from choledocholithiasis. The bile withdrawn via the catheter was infected on six occasions with Escherichia coli. In one of these cases Klebsiella sp. and in another Salmonella sp. were also identified. All bacteria were sensitive to ceftizoxime (the MIC was between 0.007 and 0.06 mg/l). The bacterial counts in the bile were determined before and during treatment by means of membrane filtration. In all six cases there was a rapid decline in the colony count. The concentration of ceftizoxime in bile samples was several times higher than the MIC of ceftizoxime for the corresponding pathogens. Overall, the therapeutic results with ceftizoxime were good. Three of eight pathogens were eliminated from the bile within eight to 24 hours. In one case a change of pathogen was seen after 24 hours. Forty-eight hours after beginning treatment, four of eight pathogens had been eliminated from the bile. After 72 hours the colony count in six patients was less than 10 pathogens/ml. In two patients a change of pathogen occurred; in one patient treatment had to be stopped after the first injection because of urticaria.

Aged↗
PubMed1979

[Therapeutic endoscopy in the gastrointestinal tract].

In selected chapters of the therapeutic endoscopy we tried to represent secure knowledge, actual tendencies and partly future prognoses. Hereby completeness cannot be expected. However, it became clear that numerous physical principles became useful for the therapy with the endoscope. Chemical techniques, such as the litholysis of gall-stones are only at present used in our field. With all scepticism against the own field of interest one may say that the operative therapeutic endoscopy, as it is seen at the instance of the classification of polyps, has led to an improvement of the diagnostics, Its advantages in the therapeutic field are based on the fact that it substitutes larger operations. In the polypectomy- the intervention, avoiding laparotomy and colotomy, is reduced on the minimum given by the size of the polyp. The risk of endoscopic operations is small, compared with the alternative surgical interventions. Shortening of the duration of the disease and hospitalisation leads to lower expenses. Methods, such as the endoscopic haemostypsis or the obliteration of the pancreatic duct, need further detailed examinations. There is no doubt that the modern endoscopy has a strong technical fascination for many young physicians. It gets the greatest value in the hands of a clinically experienced physician.

Cholelithiasis↗
PubMed1979

[A comparison of percutaneous transhepatic cholangiography and endoscopic retrograde cholangiopancreatography (author's transl)].

Results of percutaneous transhepatic cholangiography (PTC) with the Chiba needle were compared with those obtained by endoscopic retrograde cholangiopancreatography (ERCP). PTC was used in 102 cases, most often after ERCP had been inconclusive or had failed. Overall success rate of PTC was 79%. Contrast medium could be injected in only 66% of cases with normal-sized bile passages, but in 98% of those with enlarged passages. The most frequent side effect was temporary pain in the right upper abdominal quadrant. One patient had transitory severe peritoneal irritation with shock. Emergency operation was never required. PTC is technically simpler, takes less time and causes less stress to the patient, but it is less informative than ERCP. If, therefore, both methods are mastered technically, ERCP should be employed first. If it fails to provide the diagnosis, PTC can be performed at once. Biliojejunal anastomoses and pancreatic pseudocysts are absolute indications for the primary use of PTC to investigate the cause of biliary stasis. On the other hand, allergies to iodine or contrast medium and disorders of coagulation are absolute indications for ERCP.

Adult↗
PubMed1978

Santorini's Duct--an insignificant variant from normal or an important overflow valve?

In a retrospective examination 250 consecutive pancreatograms obtained by ERCP were controlled on the existence of a D. Snatorini. Starting from the genetic development of the pancreatic ducts the question is investigated whether a second open pancreatic duct is responsible for a better drainage of the pancreas. Thus this duct may prevent hyperamylasemia and hyperlipasemia following ERCP. From an etiological point of view the elevation of these pancreatic enzymes is insufficiently understandable. If a D. Santorini is detectable the results demonstrate a reduction of the increased pancreatic enzymes in a statistically significant manner. A valve mechanism of the D. pancreaticus minor with volume or pressure reduction is postulated.

Amylases↗
PubMed1978

Gas sterilization of fiber endoscopes.

Excitants of disease can be transmitted by endoscopes from one patient to another. Owing to their complicated construction and the heat-sensitive material fiber glass endoscopes are difficult to disinfect or sterilize. Of the known procedures of sterilization only gas sterilization with ethylene oxide can be used. Clinical examinations and laboratory experiments demonstrate the reliable efficacy of this procedure of sterilization of fiber glass endoscopes. On account of known risks the indications for gas sterilization are compiled.

Bacteria↗