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Biomedical subjects

H Jantsch

Publications and source records attributed to H Jantsch.

At least 19 recordsLinked to original sources
PubMed1993

[Drain fistulography. Radiological sphincter identification in high anal fistulae].

To warrant permanent surgical cure of high anal fistulae, while avoiding at the same time faecal incontinence due to inadvertent division of the puborectalis muscle, distinction between a trans- and suprasphincteric fistula track is essential. This differentiation is often crucial, since digital rectal palpation and conventional fistulography tend to be unreliable. Therefore we developed a radiological technique of imaging the anorectal fistulous track, "drain fistulography". After silicon drainage of the fistula the contrast visualization of anal canal, rectum and fistula drain allows to assess the topographic relation between fistula and anal sphincters as well as the sphincteric functional component above the fistula. A trans-sphincteric fistula track was demonstrated in 7 of 8 patients (5 with recurrent fistulae) by means of "drain fistulography", permitting complete laying open of each fistula in a second operation. In one patient a suprasphincteric fistula track was found and a "mucosal flap repair" was carried out. After a mean observation time of 53 months all patients are perfectly continent and free of recurrence. The method of "drain fistulography" is a valuable diagnostic tool to select the appropriate definitive surgical procedure in the treatment of high anal fistulae.

Adult↗
PubMed1992

[X-ray measurement of the level of rectal carcinomas and its dependence on the functional status of the pelvic floor].

The influence of the various functional states of the pelvic floor on the radiological assessment of the tumour levels and the distant tumour-free distance in rectum neoplasms was investigated. The parameters "anal canal length", "anorectal angle" and "impression of the puborectalis muscle" were measured in lateral distant views of the rectum in a series of healthy controls (n = 160). In addition, these parameters and the "distant tumour-free distance" were measured in patients with rectal cancer (n = 40). For each patient the lateral distant view at rest, during contraction and during maximal relaxation (straining) of the pelvic floor, were available for retrospective analysis. Depending on the various functional states of the pelvic floor, the differences between the same parameters were statistically significant (p less than 0.001). The average difference between the distal tumour-free distances during contraction and straining was 1.5 cm. Therefore, measurements of this distance in one lateral distant view exclusively may result in an inaccurate assessment of the tumour level. For the individual planning of extreme sphincter-saving surgery in low rectal cancer based on lateral distant view, the view at rest appears to be the most suitable. However, additional x-rays during contraction and maximal relaxation of the pelvic floor, respectively, should be available to identify the view at rest for an accurate assessment of the tumour level and to avoid misinterpretations which would have falsely influenced the planning of rectum surgery in 20% of our cases.

Adult↗
PubMed1991

Sonographic demonstration of septicaemia with gas-forming organisms after liver transplantation.

Sepsis with gas-forming organisms, e.g. Clostridium perfringens and anaerobic streptococci occurred in three of 120 liver-transplant recipients (2.5%). The diagnosis was made in all three patients by bedside ultrasound, before blood cultures revealed bacterial growth. Floating high amplitude echoes within the extra- and intrahepatic portal veins and persistent small high amplitude echoes in the non-dependent portion of the liver are indicative of portal venous gas and should prompt further laboratory investigations.

Adult↗
PubMed1991

[Balloon dilatation of benign esophageal stenoses].

Benign stenoses of the oesophagus have been conventionally treated by endoscopic bougienage and were operated on in case of failure. Now that balloon catheters with large balloon diameters are available, interventional radiological dilatation of enteric strictures can be easily performed. In case of eccentric high-grade stenosis with or without blind loop, stenosis is often easier to manage and associated with less risk with an angiographic guide wire and catheter than by endoscopy. 53.3% of the patients were referred to balloon dilatation after failed endoscopic bougienage. The indications for balloon dilatation were anastomotic stenosis (66.2%), peptic stenosis (16.9%), achalasia (7%), pylorospasm (5.6%) and stenosis due to pemphigus vulgaris, acid ingestion and (in one case) a Schatzki ring. The complication rate was low at 1%. The experience collected with 297 dilatations in 71 patients with benign oesophageal stenosis, is reported.

Adult↗
PubMed1991

[The ultrasonic diagnosis of an ulnar nerve lesion in the sulcus area].

The diagnostic accuracy of ultrasound in ulnar nerve irritation syndrome was evaluated. 7 patients were examined and compared to a control group of 5 healthy persons. We correlated pathological changes with clinical signs and symptoms, nerve conduction velocity and with the operation report. Ultrasound yielded no false negative or false positive results and is therefore a valuable method for the evaluation of the ulnar nerve irritation syndrome especially in cases of vague localisation of the nerve lesion.

Adult↗
PubMed1991

[The percutaneous catheter drainage of pancreatic pseudocysts].

The results of CT/US-guided percutaneous drainage in 35 patients with pancreatic pseudocysts are reported. 27 patients recovered without surgery and no further treatment was required. 8 patients required a subsequent surgery due to recurrence. The role of CT/US-guided percutaneous drainage in pancreatic pseudocysts as well as an analysis of the technical aspects associated with a successful procedure are discussed. Although US may be used, we believe CT is safer and allows more precise localisation and guidance in the treatment of pseudocysts.

Adult↗
PubMed1990

Endoscopic tube implantation for the palliation of malignant esophageal stenosis.

One hundred endoscopic tube implantations were carried out on 95 patients with malignant esophageal stenosis. Palliative treatment was performed in 43% of cases because of the advanced stage of the tumor, and in 57% of cases because of risk factors which made resection inadvisable. Clinical mortality was 16%, with six deaths caused by technical complications (perforation, arrosion bleeding), and ten by cardiopulmonary problems. Dislodgement or obstruction of the prostheses was observed in 20% of cases, but could readily be corrected. The median survival time was two months, with 17% of the patients still alive after six months. Poor general health, advanced age and the presence of distant metastases were established as unfavorable prognostic indications with a significant influence on postoperative mortality. Functional results were good: 87% of patients were able to eat solid or pulpy food post-operatively.

Adult↗
PubMed1990

[Pneumothorax in intensive care patients. The value of tangential views].

In 55 intensive-care patients an additional tangential view of the chest was taken to demonstrate or exclude a pneumothorax in patients with sudden deterioration of gas exchange and negative ap-chest x-ray, if there was a suspicion of pneumothorax or a confirmed small pneumothorax in the ap-view. In 14 of 42 cases (33.3%) with negative or suspected ap-chest x-ray the tangential view revealed a pneumothorax. 6 of these 14 pneumothoraces were under tension. In 7 out of 11 patients (63.6%) with small pneumothorax, the tangential view showed additionally a tension pneumothorax.

Adult↗
PubMed1990

[Angiography following liver transplantation].

39 angiographic studies performed on 34 out of 150 patients following a total of 159 orthotopic liver transplantations until the year 1989 were reviewed in retrospect. All of the studies were carried out within a period of two months after transplantation (1-45 days). Angiographic techniques remain the "gold standard" for the assessment of vascular problems after liver transplantation. Arterial complications were seen in fourteen cases (8.8%); complications confined to the portal and inferior caval veins were found in six (3.8%) and twelve cases (7.5%), respectively. Angiography yielded normal postoperative findings in nine patients.

Adolescent↗
PubMed1990

Lymphoid follicular hyperplasia in excluded colonic segments: a radiologic sign of diversion colitis.

Double-contrast barium enema (DCBE) studies showed lymphoid follicular hyperplasia (LFH) in excluded colonic segments after colostomy in 12 of 40 patients. In most patients with LFH, more than 80% of the excluded colon was affected. In eight patients, regression of LFH was demonstrated with DCBE studies after reanastomosis. This work suggests that LFH is the most common DCBE study finding in diversion colitis.

Adult↗
PubMed1989

[Sonographic staging of pancreatic cancer. Report of 100 cases].

The ultrasound studies of 100 patients with proven pancreatic carcinoma were reviewed and correlated with the intraoperative and pathoanatomic findings. Ultrasound had a sensitivity of 87% in detecting the malignant lesion. The extension of the tumour and the infiltration of peripancreatic structures and visceral vessels was interpreted correctly in 85% of the cases. The sensitivity for liver metastases was 90.9%, whereas for lymph node involvement it was 78.3%. 19 patients had carcinosis peritonei. Ultrasonography could only detect the carcinosis in two cases. Malignant ascites was found in 15% (sensitivity of US 88.2%). 31% of the pancreatic carcinomas were resectable.

Adult↗
PubMed1989

[Sonography of gallbladder carcinoma. Correlation with surgical findings in 60 cases].

60 patients with carcinoma of the gallbladder were staged preoperatively by sonography (staging scheme by Nevin and TNM scheme of the UICC). This was correlated with the operative and histopathological findings. The tumour was diagnosed by sonography in 70% of the patients, 15% were diagnosed at operation and 15% histopathologically. The criterion for malignancy was tumour invasion into the liver (94.7% Sensitivity) and/or into adjacent tissues (36.8% Sensitivity). Most tumours were in an advanced stage (98.5%) and only one early carcinoma (1.5%) was found histopathologically. No improvement in the diagnosis of early carcinomas was achieved by ultrasound in our series.

Adult↗
PubMed1989

[Ultrasonic diagnosis following liver transplantation].

Realtime and duplex sonography were used routinely for the postoperative and long-term follow-up of liver transplantation patients. In the early postoperative period 90 patients exhibited diffuse (67.7%) and focal (33.3%) alterations of the liver parenchyma; in 53% of patients various liquid lesions were diagnosed in the abdominal cavity. In case of diffuse alterations of the liver parenchyma, no correlation could be established between sonomorphology and histopathologic findings; especially rejection could not be diagnosed by using sonography. In case of focal intrahepatic lesions highly echogenic areas of infarction could be differentiated from poorly echogenic changes such as necrosis, haematoma and abscess--these entities had to be further distinguished by means of CT or needle biopsy. 20 patients showed biliary pathology (biliomas: 5, cholangiectasis: 15). In 73.3% of cholangiectasis the cause of obstruction could be demonstrated sonographically (biliary thrombus, stenosis of the anastomosis of the common bile duct, recurrence of tumour). In 13 patients major vascular complications were diagnosed predominantly by means of duplex sonography (hepatic artery occlusion: 4, hepatic artery stenosis: 1, portal vein occlusion: 1, partial thrombosis of portal vein: 2, portal vein stenosis: 2, stenosis with incomplete thrombosis of the inferior vena cava: 3, VCI stenosis: 1). 13 patients developed recurrent malignancy in the late postoperative period.

Adolescent↗
PubMed1989

Dislocated Atkinson tubes: removal and repositioning with a balloon catheter.

Atkinson tubes are inserted endoscopically for palliation of obstructing esophageal carcinoma. A technique was developed to reposition or remove dislocated tubes that involves the use of a dilation balloon catheter. The technique was successful in treating three partially dislocated tubes and one of two completely dislocated tubes (tubes completely dislodged into the stomach). The only complication occurred in two patients who coughed up a small amount of blood.

Aged↗