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Biomedical subjects

L Berkhouse

Publications and source records attributed to L Berkhouse.

6 recordsLinked to original sources
PubMed1995

Combined endoscopic ultrasound and stimulated biliary drainage in cholecystitis and microlithiasis--diagnoses and outcomes.

BACKGROUND AND STUDY AIMS: It is becoming increasingly evident from a number of studies that endoscopic ultrasound (EUS) is much more sensitive in the diagnosis of cholecystitis than transabdominal ultrasound (TUS). The present study was undertaken to further evaluate this relative sensitivity. PATIENTS AND METHODS: Sixty-six patients with biliary-type pain and a negative transabdominal ultrasound examination underwent combined endoscopic ultrasound and stimulated biliary drainage (EUS/SBD). Stimulated biliary drainage was obtained following intraduodenal infusion of magnesium sulfate or intravenous sincalide, a CCK analogue. EUS was considered positive if sludge or small stones were seen in the gallbladder. Stimulated biliary drainage was considered positive if calcium bilirubinate granules or cholesterol crystals were seen on microscopic examination of aspirated bile. RESULTS: At operation, 61 of the patients had cholecystitis documented histologically. Fifty-eight of the patients had gallbladder sludge or small stones on EUS. One patient had a negative EUS, but had calcium bilirubinate granules in the bile. Twenty-one patients were followed post-operatively for a period of seven to 17 months, with an average of 10.5 months. Nineteen patients (90.5%) remain free of biliary pain. CONCLUSIONS: Combined endoscopic ultrasound and stimulated biliary drainage (EUS/SBD) had a high sensitivity of 92.4% and a positive predictive value of 100% in the diagnosis of cholecystitis when transabdominal ultrasound was negative. A significant majority (90.5%) of patients with positive EUS/SBD who underwent cholecystectomy had resolution of their biliary pain.

Cathartics↗
PubMedDate not supplied

Endoscopic ultrasound: combining sight and sound for cancer and benign disorders.

Endoscopic ultrasound (EUS) is one of the most significant advances in the history of gastrointestinal endoscopy. It is unsurpassed in local and regional staging of cancer of the esophagus, stomach, pancreas, and rectum. Recently, EUS has been applied to a number of benign conditions such as achalasia, difficult-to-diagnose gallbladder disease, and submucosal tumors. As EUS gains in popularity and increased clinical application in the United States, it is imperative that gastroenterology nurses and associates be aware of this ground-breaking technology and its indications.

Cost-Benefit Analysis↗
PubMedDate not supplied

Endoscopic ultrasound for chronic abdominal pain and gallbladder disease.

Endoscopic ultrasound (EUS) is a major advance in gastrointestinal endoscopy. EUS, which is invaluable in the diagnosis and staging of gastrointestinal cancer, is now being used in the diagnosis of chronic upper abdominal pain. EUS combined with stimulated biliary drainage (EUS/SBD) aids in the diagnosis of choledocholithiasis, cholecystitis, microlithiasis, and various conditions of the upper gastrointestinal tract. This article describes the EUS/SBD procedure and nursing care. Two case histories illustrating potential benefits to patients are presented.

Abdominal Pain↗