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H J Nüesch

Publications and source records attributed to H J Nüesch.

At least 19 recordsLinked to original sources
PubMed1981

[Mild spontaneous course of a case of pseudomembranous colitis. Case report and literature review].

Pseudomembranous colitis (PMC) caused by a toxin produced by Clostridium difficile is described in the literature as a severe diarrheal disease with a high mortality rate. A case which tends to absolve PMC from this reputation is reported involving an outpatient who developed well documented PMC subsequent to ampicillin therapy but required no treatment. The number of unreported cases of antibiotic-associated colitis with and without pseudomembrane formation is probably very high, since only severe cases of diarrhea are thoroughly investigated. In a chronological literature review an attempt is made to update the nomenclature of antibiotic-associated colitis. There are recent reports of a connection between the Clostridium difficile toxin and the chronic inflammatory "non-bacterial" intestinal diseases ulcerative colitis and Crohn's disease. The authors finally consider whether in cases of antibiotic-associated diarrhea efforts should be made to isolate Clostridium difficile and/or demonstrate the presence of its toxin, for the purposes of prognosis and therapy.

Ampicillin↗
PubMed1979

[Salmonella colitis].

Salmonella colitis is defined on the basis of 3 case reports and 75 well-documented cases from the literature. Salmonella colitis is an acute ulcerative colitis occurring in enteric salmonellosis. There is complete clinical and endoscopic remission within 4--8 weeks and no relapse. The disease is to be distinguished from idiopathic ulcerative colitis in a salmonella carrier state. The difficulties of this differential diagnosis are demonstrated in a further case report.

Adult↗
PubMed1979

[Drug-induced esophageal ulcers].

In cases without a history of gastrointestinal or cardiac disease, acute odynophagia prompts the tentative diagnosis of drug-induced esophageal ulcer. Possible causes are tetracycline, clindamycin, emepronium bromide, potassium chloride, etc. Other diseases such as carcinoma can be ruled out by endoscopy and biopsy. To avoid such esophageal lesions drugs should be taken with sufficient fluid and not immediately before bedrest.

Adult↗
PubMed1979

[Clinical pathology of colonic mucosal polyps].

Of 636 polyps removed during endoscopy between 1973 and 1975 at the University Hospital, Zurich, 36 (5.5%) were of the hyperplastic and 18 (2.8%) of the juvenile type. One polyp was seen in a female patient with Peutz-Jeghers syndrome. The vast majority of the polyps (581, 91.5%) were neoplastic in origin; 70% were tubular adenomas, 16% villous adenomas, and 14% intermediate forms or tubulo-villous adenomas. On the basis of a continuous spectrum in histologic structure and similar cellular dedifferentiation, these three types of adenoma may be viewed as different forms in the development of the same neoplastic process. Hyperplastic and hamartomatous polyps are innocuous, whereas the neoplastic forms may well turn aggressive. Malignant change was observed in 5.1% of our material, particularly in villous adenomas and in polyps exceeding 1 cm in diameter. The presence or absence of invasive growth through the muscularis mucosae is of prime importance for therapy. In accordance with WHO nomenclature, the term carcinoma is used only in the presence of such infiltration. If, in addition, the tumor tissue is not well differentiated, additional segmental resection may be required. The term "focal carcinoma" is no longer in use and has been replaced by "severe focal atypia". In these cases, primary polypectomy for diagnostic purposes is also the optimal therapy, and is as effective here as in cases of benign adenoma.

Adenoma↗
PubMed1979

[Large colonic polyp: endoscopic or surgical removal?].

93 neoplastic polyps measuring more than 2 cm in diameter have been removed from the colon by endoscopy. 15% of the polyps showed severe atypia (focal carcinoma), and in 15% an invasive carcinoma was found. Polypectomy was complicated in 14 cases by bleeding, in 12 cases it was cured by endoscopy. In 1 case in which the colon was injured by coagulation the lesion healed spontaneously. The surgery rate due to complications of the endoscopic removal procedure or due to invasive carcinoma was 7% for the polyps with a diameter of 2-3 cm, 15% for those of 3-5 cm and 50% for polyps with a diameter of more than 5 cm. It is therefore suggested that neoplastic polyps of more than 5 cm in diameter should be removed by endoscopy in high risk patients only.

Carcinoma↗
PubMed1979

[Angiodysplasia of the colon: diagnosis and therapy].

Angiodysplasias of the colon are rare causes of intestinal bleeding. Diagnosis is by angiography or colonoscopy. In 6 patients with severe anemia in whom conventional methods had failed to reveal the source of bleeding, colonoscopy demonstrated angiodysplasias in the cecum or ascending colon. They were treated endoscopically. In a follow-up period of 3 months to 4 years only 1 patient has sometimes suffered occult fecal blood loss, but is adequately treated by oral iron therapy. No patient has had a severe recurrence of bleeding, nor was colonic resection necessary. It is concluded that endoscopic therapy of angiodysplasias is a valuable alternative to surgery with low risk and high efficiency.

Aged↗
PubMed1979

[Nonspecific ulcer of the colon: a report on 12 endoscopically diagnosed cases].

Report on 12 patients with nonspecific ulcers of the colon diagnosed by colonscopy and biopsy. In 10 patients the course was favorable with conservative management. In 2 patients the symptoms were aggravated; in both patients this was due to a penetrating malignant tumour diagnosed at laparotomy a few weeks later. It is proposed that nonspecific ulcers of the colon should be managed conservatively. Further investigations and laparotomy are indicated only when symptoms progress.

Aged↗
PubMed1979

[Proximal selective vagotomy with or without pyloroplasty?].

Proximal gastric vagotomy without drainage is the operation of choice for uncomplicated duodenal ulcer. There are few contraindications for PGV as uremia, diabetes, hypertension, age over 65 years and a history of splenectomy. Only in cases of severe pyloric stenosis or bleeding ulcer or perforation in the pyloric area, a pyloroplasty should be added. The Wangensteen pyloroplasty is a safe drainage procedure and especially recommended in case of extensive scarring of the pylorus.

Drainage↗