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E Nowakowska-Duława

Publications and source records attributed to E Nowakowska-Duława.

At least 19 recordsLinked to original sources
PubMed2003

Acute biliary pancreatitis in a 9-year-old child treated with endoscopic sphincterotomy.

Acute biliary pancreatitis is a well recognized complication of gallstone disease in adults. Acute pancreatitis in childhood is usually caused by congenital anomalies of the pancreatico-biliary ducts, viral infections, drug toxicity or abdominal trauma. We report the case of a 9-year-old girl with acute biliary pancreatitis and cholangitis. On urgent endoscopic retrograde cholangiopancreatography a bulging papilla with impacted stone was seen. She was treated with endoscopic sphincterotomy without complications. The disease resolved rapidly and uneventfully after the endoscopic treatment.

Acute Disease↗
PubMed2002

Accuracy of linear endoscopic ultrasonography in the evaluation of patients with suspected common bile duct stones.

BACKGROUND AND STUDY AIMS: Endoscopic ultrasonography (EUS) with radial scanning is an efficient diagnostic tool where there is suspicion of common bile duct (CBD) stones. Little is known about the use of linear EUS in this condition. The aim of this study was to evaluate the diagnostic efficiency of linear EUS in a large group of patients suspected to have bile duct stones, using endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic sphincterotomy and exploration of the CBD using a Dormia basket, or surgical choledochotomy with choledochoscopy, as diagnostic "gold standards." PATIENTS AND METHODS: 134 patients with clinical suspicion of CBD stones were included in the study and prospectively evaluated, using EUS, and ERCP with endoscopic sphincterotomy (127 patients), or choledochotomy with choledochoscopy where ERCP was unsuccessful (seven patients). EUS was done before ERCP using an echo endoscope (Pentax FG 32 UA; 5 - 7.5 MHz) and Hitachi EUB 405 ultrasound machine. ERCP was done using the TFJ 100 or TJ 20 Olympus duodenoscope. ERCP was carried out within a mean of 2 days after EUS. The longest time between EUS and ERCP was 3 days. The examiners were blinded to the results of the other method used. RESULTS: CBD stones were found in 91 (68 %) patients at ERCP with ES or at surgery. The correct diagnosis was established by EUS in 85 patients. The remaining 43 patients without CBD stones were correctly diagnosed in 41 cases by means of EUS, giving an accuracy of 94 %, sensitivity of 93 %, specificity of 93 %, a positive predictive value of 98 %, a negative predictive value of 87 %, and a Youden's index of 89 %. CONCLUSIONS: Linear EUS is a fairly reliable method for the evaluation of patients with high suspicion for CBD stones. The usefulness of linear EUS in the evaluation of patients with low or moderate suspicion for CBD stones warrants further study.

Adult↗
PubMed2001

The frequency of bile duct crystals in patients with presumed biliary pancreatitis.

BACKGROUND: Previous studies of biliary microlithiasis in acute pancreatitis of uncertain etiology were conducted a few weeks to months after the acute episode. Bile obtained during urgent ERCP (less than 24 hours after admission) was studied for the presence of microlithiasis during the acute phase of acute pancreatitis of suspected biliary origin. METHODS: Fifteen consecutive patients with acute pancreatitis of suspected biliary origin were recruited from a population of 309 patients with acute pancreatitis (5%) treated during the last 4 years. Patients with gallstones on US and/or ERCP and those in whom the etiology of acute pancreatitis was certain were excluded. RESULTS: Microlithiasis (mostly calcium bilirubinate granules) was found in 12 (80%) cases. Despite endoscopic sphincterotomy 3 patients died within 2 weeks because of multisystemic organ failure. Among the 12 remaining patients, 2 (16%) developed gallbladder stones and 1 underwent cholecystectomy for cholecystitis (8%) during follow-up. The average length of follow-up was 30 months. No episodes of acute pancreatitis were noted during follow-up. CONCLUSIONS: In the acute phase of acute pancreatitis of suspected biliary origin, biliary microlithiasis was found in most cases. Endoscopic sphincterotomy appears to protect patients from further episodes of acute pancreatitis.

Acute Disease↗
PubMed1997

[Endoscopic ultrasonography in the preoperative localization of a pancreatic tumor producing insulin (insulinoma)].

Pancreatic endocrine tumors include insulinomas, gastrinomas and some other less frequent neoplasms produce different GI hormones. Preoperative localization of the tumor in patients with evident clinical and biochemical features is usually difficult to obtain in conventional imaging methods. This is due to typically small size of these tumors. Non-invasive methods (conventional ultrasound, computerized tomography, nuclear magnetic resonance, positron emission tomography) and invasive methods (visceral angiography, portal veins catheterization) are often of no use in such condition, as their sensitivity is low. Preoperative localization is of importance for the surgeon, as he can plan his operation for reducing the length of the procedure with obvious consequences. This paper describes for the first time on Polish literature the usefulness of endoscopic ultrasonography in preoperative assessment of insulinoma in one patient. This finding was confirmed during surgery. The operation led to enucleation of two small insulinomas in the head of the pancreas and resulting in complete healing of the patient as found in one year follow up.

Adult↗
PubMed1994

[Peak fibrinogen level as a prognostic indicator in acute biliary pancreatitis].

Early prediction of acute pancreatitis outcome is based on clinical classifications, but their complexity is limiting factor. The aim of this study was prospective, dynamic evaluation of plasma fibrinogen (Fb) concentration in acute pancreatitis and testing preselected, single Fb value as predictor of pancreatic and systemic complications. Serial measurement of Fb was done in 64 patients with acute biliary pancreatitis. Peak concentration of Fb was 5.93 +/- 1.08 g/L and was found 5-8 days following onset of the disease. The peak concentration differentiated patients with mild and complicated course of pancreatitis (5.68 +/- 1.00 g/L vs 6.31 +/- 1.10 g/L; p < 0.05), with the 67% sensitivity and 72% specificity. Similarly, Ranson's score distinguished mild from complicated form of pancreatitis (1.7 +/- 1.1 vs 2.6 +/- 1.3 points; p < 0.01), with the 58% sensitivity and 73% specificity. These data indicate that peak Fb concentration is useful as a single prognostic factor in acute biliary pancreatitis.

Acute Disease↗
PubMed1993

[Isotope methods in diagnosis of portal vein occlusion].

The dynamic intravenous hepato-scintigraphy with pertechnetate Tc-99m enables a quantitative evaluation of portal and arterial blood flow in the liver. A case is presented of thrombotic occlusion of the portal vein with rapidly growing oesophageal varices in which hepato-scintigraphy showed the absence of portal blood flow in the liver, being the decisive diagnostic method. Using the dynamic transrectal porto-scintigraphy an evaluation was done of the degree of collateral circulation development in the area of the inferior mesenteric vein, obtaining indirect information about localization and duration of portal vein occlusion.

Adult↗
PubMed1993

[Occurrence of Helicobacter pylori in mucous membrane of stomach in patients with duodenal ulcer and inflammation of stomach mucous membrane].

In 1990-1991 microbiological studies were performed aimed at determination of frequency of occurrence of Helicobacter pylori in patients treated because of peptic ulcer in Department of Gastroenterology in Katowice. Studies were performed in 112 patients. Out of these, in 73 duodenal ulcer was detected endoscopically (group I), in 26--inflammation of stomach mucous membrane with erosion (group II), and in 13--both duodenal ulcer and erosion of stomach membrane (group III). Samples from mucous membrane of pylorus and of stomach taken endoscopically were tested microscopically and in culture. Helicobacter pylori was found in 74 patients (66.1%). Frequency of isolation was different in individual groups. Helicobacter pylori was found in 51 patients (70%) of group I, 15 (58%) of group II and in 8 (61%) of group III. Helicobacter pylori was most frequently isolated from patients with duodenal and stomach ulcer (81.3%).

Adult↗
PubMed1993

[Effect of bismuth salts in elimination of Helicobacter pylori from gastric mucosa in patients with duodenal ulcer].

Bismuth salts belong do basic drugs used for elimination of Helicobacter pylori (HP), a microorganism which is postulated to participate in etiopathogenesis of duodenal ulcer. The study was aimed at evaluation of effectiveness of application of tripotassium bismuth citrate (Ventrisol-Polfa) in elimination of HP and its influence on treatment of the ulcer. In 30 patients with diagnosed endoscopically duodenal ulcer, Ventrisol in tablets was applied (2 x 2); it was also used in its fluid form (4 x 5 ml). The time of treatment amounted to 28 days. During endoscopy, samples from various parts of the stomach were taken for microbiological inspection and they were studied in direct smear and in culture. HP was isolated from 20 out of 30 patients (37%) before treatment. After application of Ventrisol, the bacteria were present in 11/30 (34%) treated patients (p < 0.05). There was no influence of the form of drug for elimination of HP. No dependence was also found between elimination of HP and healing of the ulcer.

Adult↗
PubMed1992

[Manometric evaluation of the effects of intravenous administration of glucagon, buscopan and papaverine on the contractile activity of the sphincter of Oddi].

Endoscopic manometric technique was used to investigate the effects of spasmolytic drugs on the sphincter of Oddi (s.O.) motility. 41 patients were randomly divided into 4 groups. In every patient the characteristics of the s.O. was monitored before and during 5 min. period after i.v. administration of: 20 mg buscopan, 1 mg glucagon, 40 mg papaverine or 2 ml of 0.9% NaCl solution. After buscopan administration the amplitude and frequency of phasic contractions of the s.O. were decreased as well as a baseline pressure in the s.O. Glucagon reduced frequency and amplitude of phasic contractions of the s.O. without influencing the baseline pressure. Papaverine reduced only frequency of phasic contractions. Physiological saline caused no change in pressure characteristics of the s.O.

Adult↗
PubMed1991

[Emergency endoscopic sphincterotomy in acute obstructive cholangitis].

In 45 patients with acute obstructive cholangitis (AOC) endoscopic sphincterotomy (ES) was performed within 24 hours after admission. Criteria for the diagnosis of AOC were as follows: clinical symptoms consisting of fever and chills, right upper abdominal pain, and jaundice (Charcot's triad) with coexisting laboratory data as elevated WBC, ERS, bilirubin level and evidence of obstructive biliary disease confirmed by endoscopic retrograde cholangiopancreatography. The causes of AOC were: in 38 patients (84.5%)--common bile duct stones, in 2 patients (4.5%)--carcinoma of the papilla of Vater, and in 5 patients (11%)--benign stenosis of the papilla of Vater. A rapid clinical improvement was observed in 40 patients after ES. Within 24 hours after ES patients had relief of pain, fever subsided and white blood cell count returned from 11.7 +/- 6.9 G/l to 7.0 +/- 3.0 G/l. Bilirubin level decreased from 101 +/- 86 mumol/l to 77 +/- 68 mumol/l. Endoscopic drainage failed only in 4 patients (9%) who required surgery. One patient (2%)--died. In the treatment of acute obstructive cholangitis urgent endoscopic sphincterotomy should be a method of choice. Surgery should be reserved only for patients in whom ES failed.

Acute Disease↗
PubMed1990

A synthetic prostaglandin E2 analogue, enprostil, hastens gastric emptying of solids in patients with an active duodenal ulcer.

The effect of gastric emptying of two doses (35 and 70 micrograms) of enprostil given orally was evaluated in eight patients with endoscopically confirmed duodenal ulcer. Gastric emptying of a radiolabelled solid meal was assessed with the use of a gamma camera. Enprostil dose-dependently accelerated gastric emptying of solids; the gastric emptying index, Ix, increased from 1.62 +/- 0.38 min-1.10(-2) after placebo to 2.77 +/- 0.56 min-1.10(-2) after 35 micrograms enprostil (p less than 0.05 versus placebo) and to 3.65 +/- 0.64 min-1.10(-2) after 70 micrograms enprostil (p less than 0.005 versus placebo). The fraction of the radiolabelled food retained in the stomach at the end of the gastric emptying examination (that is, after 90 min) amounted to 50.5 +/- 6.9% after placebo, 35.2 +/- 7.4% after 35 micrograms enprostil, and 24.1 +/- 8.4% after 70 micrograms enprostil. It is concluded that enprostil elicits a significant speeding up of solid-phase gastric emptying in duodenal ulcer patients.

Administration, Oral↗
PubMed1990

[Effect of acute biliary pancreatitis on liver metabolism of phenazone].

In 22 patients with acute pancreatitis caused by biliary calculi and 9 healthy controls the rate of hepatic elimination of phenazone was measured. The aim of the study was evaluation of the oxidative-detoxicating action of the liver in this disease in relation to its severity. In pancreatitis patients the half-time (T2) of phenazone was significantly (p less than 0.01 longer than in healthy subjects (23.6 +/- 10.5 vs 13.2 +/- 7.2 hrs). The T2 of phenazone was not correlated with the concentrations of transaminases, bilirubin and prothrombin, but was correlated positively with the concentration of hepatic lactic dehydrogenase (p less than 0.001). In the initial stage of pancreatitis the T2 of phenazone was without prognostic significance and showed no agreement with Ranson's clinical-laboratory classification of the severity of the disease. The degree of impairment of the hepatic metabolism of phenazone measured with the percent difference between T2 of phenazone in both tests was significantly (p less than 0.05) greater in the group of patients with complications than in those without pancreatitis complications (70.7 +/- 64.4% vs 21.4 +/- 16.2%). Biliary pancreatitis impairs the oxidative-reductive function of the liver proportionally to the degree of hepatic lactic dehydrogenase in the serum. Evaluation of the rate of hepatic elimination of phenazone in the initial stage of this pancreatitis was without prognostic importance for the severity of the disease.

Acute Disease↗
PubMed1989

[Measurement of blood flow of the portal system in liver cirrhosis using the Doppler method].

Portal and splenchnic blood flow was studied in a group of 31 patients with hepatic cirrhosis and splenic veins. The authors used Acuson 128 with sector head 3,5 MHz enabling a simultaneous Doppler examination by means of impulse wave. A control group consisted of 50 healthy volunteers. Two patients had regressive flux in the portal vein, one patient had a reflux in the splenic vein. It was found that portal blood flow was significantly lower in the group examined than in the control group, and the splenic one was significantly higher. The sensitivity and specificity of the method of measuring the blood flow in the portal vein was 80%, and 88.2% respectively. 67.7% of patients had a different shape of the Doppler spectrum in the portal vein. That spectrum did not show the normally seen waves due to the heart beats. The authors' examinations show that the measurement of blood flow in the portal and splenic veins by means of the method using Doppler phenomenon provides valuable information on the haemodynamics of the portal system.

Adult↗