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E Deltz

Publications and source records attributed to E Deltz.

At least 37 records · Page 2Linked to original sources
PubMed1990

Small bowel transplantation: report of a clinical case.

Extensive small bowel resection may become necessary for several reasons in children and adults. The only causal therapy of short bowel syndrome is small bowel transplantation. So far severe immunological problems have caused deleterious results despite technically successful transplantation. A clinical case of small bowel transplantation in a child is reported. The 3-year-old boy had been operated on for volvulus which had led to nearly total gangrene of the whole small bowel. Finally, only 4 cm of jejunum could be saved. Total parenteral nutrition (TPN) therefore became necessary. Small bowel transplantation was carried out with the mother as donor; transplantation technique is described in detail. Postoperative immunosuppression was performed by administration of cyclosporin A and prednisolone. Because of graft rejection, the graft had to be removed on the 12th postoperative day. At present, the child is well and on TPN again. This case shows that small bowel transplantation by living related organ donation is technically possible without impairment of the donor's quality of life. Further experimental and clinical work should be encouraged.

Child, Preschool↗
PubMed1989

Small bowel transplantation in a child. Morphologic, immunohistochemical, and clinical results.

A small bowel transplant was performed on a five-year-old boy with a short bowel syndrome. The donor was the child's mother. Despite immunosuppressive therapy, the transplant was acutely rejected and had to be explanted on the twelfth day. Morphologic and immunohistochemical investigations on subsequent biopsies taken from the small bowel transplant were carried out. Besides typical changes in epithelial cells and the presence of T-cell infiltrates and Ig-deposits in vessels, many macrophages were seen. The submucosa in particular was invaded before rejection by numerous macrophages with positive results of antimonocyte/macrophage antibodies Ki-M6 and Ki-M7. The number of the macrophage antibodies Ki-M6 and Ki-M7. The number of the monocyte/macrophage cells and the immunohistochemical characteristics of the same may be important parameters for monitoring small bowel transplantations.

Child, Preschool↗
PubMed1989

[Tricks, errors and dangers in use of staplers in the upper gastrointestinal tract].

Special technical procedures are the prerequisite for the successful use of stapling techniques in surgery of the upper GI tract. Organ surfaces which are to be connected by staplers have to be cleaned meticulously of all fat and mesenterium. Purse string sutures in the hiatus oesophagei should be done by hand. The instrument has to be inserted carefully to avoid leasons of the mesenterium. Kinking of bowel segments has to be avoided; the bowel or gastric segments must be spread over the circular staplers. Anastomoses should be checked for bleeding and patency. Thus stapling can be done successfully in routine resections of the stomach and in the transabdominal approach to cardia region and lower esophagus.

Anastomosis, Roux-en-Y↗
PubMed1989

[First successful clinical small intestine transplantation. Tactics and surgical technic].

A case of successful clinical small bowel transplantation is demonstrated. A segment of 60 cm of jejunum and ileum has been harvested from the sister of the recipient and has been brought in heterotopic position in the first operative step. It was anastomosed to the recipient's GI-tract 6 weeks later. This procedure has the advantage that the graft can recover from ischemic damage in heterotopic position and that an immunological steady state can be achieved. This case of successful clinical small bowel transplantation offers a new causal therapy for patients with short gut syndrome.

Adult↗
PubMed1989

[Surgical indications status in ileus using a simple clinical index].

Based on a retrospective analysis of a group of patients with ileus disease in regard of the indication for operative intervention an "ileus index" was created which is derived from simple clinical and radiological findings and laboratory data. Prospective evaluation of this index showed its effectiveness in separating patients who had to undergo an emergency operation from those who could be operated electively after preceding diagnostic procedures or could be treated conservatively.

Gastrointestinal Motility↗