PubMed Health⌕ Search

Biomedical subjects

K Muehlenberg

Publications and source records attributed to K Muehlenberg.

8 recordsLinked to original sources
PubMed2002

[Intestinal pseudoobstructions and gastric necrosis in mitochondrial myopathy].

HISTORY AND CLINICAL FINDINGS: A 24-year-old female patient suffered for 4 months from recurrent abdominal pain, vomiting and diarrhea. Signs of an acute abdomen were the initial reason for admitting the patient to our hospital. The slim, pale patient had a complete bloated abdomen. Neurological status was normal. INVESTIGATIONS, TREATMENT AND COURSE: Radiographic examination showed a paralytic ileus with a megacolon. The recurrent abdominal symptoms were due to a covered perforation of the stomach. This was shrunken, scarred and had to be resected. Further intestinal pseudoobstructions were accompanied by substantial exsudations in the lungs, intestines and abdomen. At this time mutism like behavior patterns and an ophthalmoplegia appeared. Leukoencephalopathy in brain MRI scans and increased liquor-lactate suggested mitochondrial myopathy. DIAGNOSIS: The diagnosis of a mitochondrial myopathy was confirmed by increased liquor-lactate level, muscle biopsy with ragged-red fibers as well as abnormal mitochondrias and molecular-genetic investigations (mtDNA point mutation A3243G). Associations to MELAS (mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes) and MNGIE (mitochondrial neuro-gastrointestinal encephalomyopathy) syndrome are discussed. CONCLUSIONS: Unclear recurrent gastrointestinal symptoms even in the absence of neurological changes may reflect a mitochondrial disease. This applies especially to young patients with recurrent anorexia, vomiting and pseudoobstruction. In case of additional symptoms like ophthalmopathy, deafness, diabetes mellitus or signs of a MELAS syndrome the search for a mitochondrial system disorder is mandatory.

Adult↗
PubMed2001

[Cardiopathia fantastica: case report and literature review].

We describe the case of a 71-year old medical technician, who was treated for instable angina pectoris in 29 different hospitals 38 times over 9 years. Dramatically presented retrosternal pain regularly started in crowded places, such as bus or railway stations or directly in front of the hospital. Ultrasound and ECG gave evidence of an old inferior myocardial infarction. Invasive diagnostic procedures were rejected by the patient because of an alleged allergy for contrast media. The single, retired patient never admitted former cardiac hospitalizations and restrained the physicians from contacting his local doctor. The patient mostly left the hospital against medical advice and achieved hospitalization in another clinic sometimes the same day. Because of his personality structure, the dramatic presentation of his complaints and the numerous hospitalizations in various hospitals with self-discharge, we made the diagnosis of a cardiac Munchausen syndrome, a so-called cardiopathia fantastica, in the presence of an accompanying coronary heart disease. In the literature we found 52 cases of cardiopathia fantastica since the first description of this phenomenon in the year 1953. Interestingly enough, mostly men were identified. Angina pectoris is by far the most frequent symptom of cardiopathia fantastica. In 8 of 53 patients (15%) an additional cardiac manifestation was present in addition to cardiopathia fantastica. Cardiopathia fantastica on the one hand is an important differential diagnosis of coronary heart disease; on the other hand it may develop in the presence of an underlying cardiac disease.

Adult↗
PubMed1995

[Clip migration in the common bile duct and consecutive calculus formation after laparoscopic cholecystectomy].

In 1991 a 64-year old woman underwent laparoscopic cholecystectomy for symptomatic gallstones. The follow-up was uneventful. Two years later a painless obstructive jaundice appeared. Endoscopic retrograde cholangio-pancreatography revealed a freely floating surgical clip within the common bile duct. It was a FILSHIE-Clip, commonly used to ligate the cystic duct. The endoscopic extraction of the foreign body was unsuccessful because the clip slipped into a small intrahepatic bile duct. Smaller gallstones that had probably crystallized around the clip could be extracted. Finally the clip itself disappeared spontaneously after endoscopic sphincterotomy through the papilla. It is discussed why movement of a surgical clip into the common bile duct appears after laparoscopic cholecystectomy.

Cholecystectomy, Laparoscopic↗
PubMed1992

[Acute liver failure in metastatic melanoma].

Only seven cases of occult malignancy clinically presenting as acute liver failure due to liver metastases have been outlined in literature so far. In six cases the primary tumor originated histomorphologically from pancreas, bronchus or mamma, in one case the patient died before histological diagnosis. This case report describes the only ten days lasting anamnesis of a 42-year-old man, who felt completely healthy before. Only the autopsy and the immunohistological staining of the taken biopsies led to the diagnosis of an amelanotic melanoma. The site of the primary lesion remained unclear.

Adult↗