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Biomedical subjects

L Broeckaert

Publications and source records attributed to L Broeckaert.

30 records · Page 2Linked to original sources
PubMed1980

A microscopic and ultrastructural study hemostasis after laser photocoagulation.

Fiberoptic-coupled, Neodymium-Yag laser beams were directed at induced bleeding mucosal lesions in the stomachs of 13 dogs. Hemostasis was achieved in all cases. The lesions induced by photocoagulation were examined by light microscopy and transmission electron microscopy. Phototherapy induces an endothelial reaction followed by the formation of a platelet thrombus in the damaged vessels. Hemostasis starts shortly after coagulation therapy has been performed.

Acute Disease↗
PubMed1980

Crohn's disease of the stomach and duodenum: A clinical study with emphasis on the value of endoscopy and endoscopic biopsies.

The aim of this study was to correlate endoscopic, radiological and pathological observations in 30 patients with Crohn's disease, with involvement of the stomach and/or duodenum. The incidence of gastroduodenal involvement in our patients with Crohn's disease is about 3%. 22 of the 30 patients had intrinsic lesions of the stomach and/or duodenum; in 8 patients the lesions seemed to be produced by involvement from contiguous diseased bowel. Radiological studies and endoscopy of the gastroduodenal region are complementary. Endoscopy allows better visualisation of mucosal defects. Other features, for example a diminished expansion and the presence of contiguity lesions, are better demonstrated by barium meal. The mucosal lesions found at endoscopy are heterogenous, but irregularly-shaped ulcers and erosions in a disrupted mucosal pattern are typical for gastroduodenal Crohn's disease. Pathological examination of endoscopic "forceps"-biopsies permitted a conclusive diagnosis based on the presence of granulomas, in 15/22 (68%) of the cases with intrinsic gastroduodenal disease. This observation indicates that simple forceps biopsy is a very useful diagnostic tool. Involvement of the first part of the duodenum in Crohn's disease was complicated by a biliary fistula in two patients.

Adolescent↗
PubMed1980

Histologic appearances of endoscopic gastric mucosal biopsies 10--20 years after partial gastrectomy.

Fifty-six symptomatic patients, who had had a partial gastrectomy 10--24 years previously for benign disease, were examined by endoscopy and multiple mucosal biopsies. No patient had a completely normal gastric mucosa. Varying degrees of gastritis, intestinal metaplasia, foveolar hyperplasia and dysplasia were seen. Seventeen patients (30%) had extensive areas of dysplasia associated with acute or chronic inflammation. Severe dysplasis, however, was detected in only one case. In five patients a "diffuse type" carcinoma of the gastric stump was found. While it is generally accepted that significant dysplasia (moderate or severe dysplasis) is premalignant, the degree of risk is unknown. This makes management of individual patients difficult.

Adult↗
PubMed1980

Randomised open controlled trial of colloidal bismuth subcitrate tablets and cimetidine in the treatment of duodenal ulcer.

In a study of 28 outpatients with endoscopically proven duodenal ulcers, 14 patients (with a total of 15 ulcers) were treated with bismuth tablets (colloidal bismuth subcitrate, De-Nol, Gist-Brocades NV) and 14 patients (14 ulcers) were treated with cimetidine (Smith, Kline, and French). Clinical and endoscopic assessments were made after four and six weeks' therapy. After four weeks, 10 of the bismuth treated ulcers (67%) and eight of the cimetidine treated ulcers (57%) were completely healed. After six weeks of therapy, complete healing was seen in 86% of both the bismuth treated and the cimetidine treated ulcers. Twenty of the 24 completely healed ulcer patients (10 of each group) cooperated in a three month follow-up study. Pain recurred in three patients of the bismuth group and four of the cimetidine group and they were examined endoscopically. A recurrent ulcer was found in one of the bismuth treated patients and in three of the cimetidine treated patients. These observations indicate that colloidal bismuth subcitrate was at least as effective as cimetidine in the healing of duodenal ulcer.

Adult↗
PubMed1979

Leiomyosarcomatosis of the gastrointestinal tract.

A case report of a patient suffering from diffuse leiomyosarcomatosis of the gastrointestinal tract is presented. The endoscopic features of the lesions localized in the stomach, the small bowel and the colon are compared with the radiological data. A description of the pathology of these polypoid lesions is given. The origin of this widespread leiomyosarcomatosis of the gastrointestinal system is discussed.

Colonic Neoplasms↗
PubMedDate not supplied

Palliative Nd:YAG laser therapy for cancer of the esophagus and gastroesophageal junction: impact on the quality of remaining life.

Endoscopic laser therapy (ELT) for palliation of cancer of the esophagus and the gastroesophageal junction was evaluated in 31 patients with far advanced disease. Initial technical success (94%) and initial improvement of symptoms (81%) were comparable to data reported previously. Complications were bleeding (6%), sepsis (6%), and tracheoesophageal fistula (6%). This analysis, however, addressed the impact of ELT on the remaining life of the patients. In 9 patients (29%) ELT was the only palliative alternative, and in 7 of these patients a fair functional success was achieved. In 13/21 (63%) of the patients with good initial functional result palliation could be preserved by repeated ELT until death from cachexia. Eight patients, however, were intubated in the follow-up period because of failure to keep the esophagus open. The dysphagia-free interval was only 4 weeks, and repeated ELT became progressively more difficult because of increased tumor load and increasing debility of the patient. 32% of the patients experienced ELT as more difficult than repeated dilations. Our data also suggest that duration of palliation after ELT alone lasts longer than palliation after dilation followed by ELT. Results of ELT were best in patients with recurrent cancer at the esophagogastric or esophagojejunal anastomosis.

Adult↗
PubMedDate not supplied

The long-term morbidity and mortality rate in a cohort of patients with liver cirrhosis and oesophageal varices.

BACKGROUND/AIMS: A long-term study and follow-up of an uniform treatment strategy for esophageal varices was evaluated to plan future strategies more effectively. MATERIAL AND METHODS: Morbidity and mortality in 101 patients with liver cirrhosis followed up for 5 years in a single center after the first detection of oesophageal varices were studied. RESULTS: Definitive hemostasis of the first variceal bleeding episode could not be obtained in 31.5%, despite emergency endoscopic sclerotherapy in combination with vasopressin and/or balloon tamponade. Mortality related to this bleeding was 26% in this cohort of patients. Overall mortality from variceal bleeding during the 5 year period was 38%. Death occurred predominantly in patients with advanced liver disease, since the Child-Pugh score of patients who bled and survived was 8 +/- 2 as compared to 11 +/- 2 (p<0.01) in those who bled and died. If fundic varices were the origin of the hemorrhage, the mortality reached 78% within 6 months. Eighty-five percent of the fatalities were related to the liver disease. Besides variceal bleeding, infection was the predominant trigger leading to liver failure; occurring in 25%. The cause of non-liver related death was malignancy of esophagus, lung and pancreas. Only 13% of the patients with liver failure had undergone an orthotopic liver transplantation. CONCLUSION: Since variceal hemorrhage still carries a high mortality rate, primary prophylaxis for patients at high risk is indicated. The systematic, concomitant use of vasoactive drugs to sclerotherapy and the early performance of TIPS in case of failure of sclerotherapy have to be evaluated. Finally patients with an advanced liver disease and increased risk factors for variceal bleeding should be considered earlier for liver transplantation.

Cohort Studies↗