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Biomedical subjects

M Mörl

Publications and source records attributed to M Mörl.

At least 55 records · Page 3Linked to original sources
PubMed1982

[Blind liver puncture or laparoscopy?].

The discussions as to the priority of laparoscopy or blind liver puncture have not ended in a "either-or" decision, but, rather, have come out unequivocally in favour of both techniques. The procedure of blind liver puncture is suitable for the diagnosis and follow-up of diffuse diseases of the liver (fatty liver, acute hepatitis, with restriction, chronic persistent and chronic aggressive hepatitis, pre-alcoholic liver cirrhois damage). Laparoscopy is employed primarily in cases with equivocal liver palpation findings, for the initial diagnosis of chronic inflammatory, focal and tumorous diseases of the liver. For both techniques, there needs to be a careful weighing up of indications and contraindications, risks and limitations and they should not be carried out by any and every ward physician.

Biopsy, Needle↗
PubMed1982

[Echinococcosis. Rational diagnosis and therapy].

The most dangerous of the parasitoses seen in Middle Europeans, are cystic and alveolar echinococcosis which, here in Germany, varies considerably in frequency. Cystic echinococcosis is found throughout the entire world; the disease is seen mostly in "guest workers". Alveolar echinococcosis may be observed sporadically in all the Alpine countries, in Bavaria, and also in Baden-Württemberg. As a result of slow growth, the onset of the symptomatology is considerably delayed. Dangerous complications are jaundice, stenosis of the pylorus of the stomach, incidents resulting from portal hypertension, infections of the cysts, and perforation of the lesion into the neighbouring organs or into the free abdominal cavity. The complement-binding reaction, indirect haemagglutination and the indirect enzyme immuno test, together, achieve a sensitivity of up to 97%. Static scintigraphy of liver and spleen, ultrasonography, laparoscopy, X-ray survey, angiography, and, in particular, computerized tomography, are further diagnostic procedures. If at all possible, treatment should be surgical. The only conservative measure worth trying is the administration of mebendazole (Vermox).

Animals↗
PubMed1981

[Portal vein hypertension in chronic liver diseases].

As a rule, the fate of patients suffering from chronic liver disease is determined by the most severe complications of portal hypertension (oesophageal variceal haemorrhage, hepatic coma). By means of laparoscopic transhepatic manometric measurements, we determined the pressures in the branches of the portal and hepatic veins of 161 patients suffering from chronic inflammation of the liver classified in various diagnostic groups. It was discovered that, in patients with pre-cirrhotic alcohol-induced damage, the pressure in the portal vein rises progressively with the increasing daily alcohol consumption. In all the various forms of chronic hepatitis, the portal vein pressures were higher than the upper limit of normalcy. A comparison of pressures among individual cirrhotic groups (alcoholic, pigmentary, congestive and hepatic cirrhoses) revealed a significant difference only between the hepatic and congestive forms of cirrhosis. The mortality rate was greatest among patients with hepatic cirrhosis, followed by the group with alcoholic cirrhosis.

Blood Pressure Determination↗
PubMed1981

[Prognosis of portal hypertension in hepatitic cirrhosis of the liver (author's transl)].

Laparoscopic transhepatic measurement of pressures in the branches of the portal vein (and hepatic vein) were performed in 42 patients with hepatitic cirrhosis of the liver and compared with those obtained in patients with other defined causes of cirrhosis (alcohol, pigment, Budd-Chiari syndrome, right heart failure). Mean portal vein pressure was 27.2, mean hepatic vein pressure 14.5 mm Hg. A significant pressure difference (Kruskal-Wallis test) was present only between hepatitic cirrhosis and congestive cirrhosis, not alcohol or pigment cirrhosis. During the period of observation (1975-1978) there was a high incidence of deaths and complications in the hepatitic group compared with other forms of cirrhosis: 6 treatment-resistant and 2 successfully treated cases of bleeding from oesophageal varices. The risk of bleeding begins at a pressure above 27 mm Hg, but in individual cases it cannot be used to prognosticate.

Female↗
PubMed1981

[Inflammatory biliary tract diseases].

Acute cholangitis, as a serious, sometimes life-threatening clinical picture, is often clearly distinguishable by virtue of its clinical symptomatology (fever, upper abdominal pain, possibly also jaundice). Chronic cholangitis, primary sclerosing cholangitis and chronic destructive, non-suppurative cholangitis are, although clearly defined, without symptoms in the early stages, and can be diagnosed only on the basis of long-term observations. Clinical symptomatology, diagnosis and differential diagnosis, therapy, course and prognosis are discussed.

Cholangitis↗
PubMed1981

On the diagnosis of the Budd-Chiari syndrome and cardiac cirrhosis.

The diagnostic procedure to be followed in cases of Budd-Chiari syndrome and cardiac cirrhosis cannot be schematized. Although laparoscopy and histology can point the diagnostician in the right direction, they are not decisive for the localization of the occlusions. In the presence of lumen-constricting processes, the representation of the hepatic veins has reached its limits. In this situation, laparoscopic transhepatic segmental venography or portography may help. Here, a report is presented on 5 cases with a variety of problems.

Adult↗
PubMed1981

Laparoscopic transhepatic manometry in portal hypertension in patients with alcoholic liver damage.

Liver damage influenced by alcohol is already associated with the development of a portal hypertension at an early stage. With the aid of laparoscopic transhepatic manometry we determined the pressure levels in the branches of the portal and hepatic veins in 15 patients (16 examinations) comprising 14 men and 1 women, with alcoholic toxic liver damage. It was shown that already with alcoholic parenchymal damage associated with portal and centrolobular fibrosis, a portal hypertension is initiated, the greatest manifestation of which is found in the group with histological changes taking the form of a remodelling (distorsion of architecture) or cirrhosis. The level of alcohol consumption has no direct influence on the level of pressure in the vascular systems investigated. Ther is, however, a correlation between the level of alcohol consumption, extent of fibrosis and portal hypertension. For the clinico-chemical parameters investigated (Gamma-glob., GOT, GPT, GLDH, gamma-GT, alkaline phosphatase, bilirubin) no significant differences were found dependent on the level of alcohol consumption or the degree of fibrosis.

Adult↗
PubMed1980

[Portal hypertension in chronic hepatitis (author's transl)].

Portal hypertension as the basis of threatening complications determines the subsequent fate of many patients with chronic inflammatory diseases of the liver. Normal values are exceeded considerably already in chronic hepatitis, but critical levels of pressure--with respect to the danger of bleeding from oesophageal varices--are only attained when cirrhotic remodelling is complete. With the aid of laparoscopic transhepatic manometry (LTM), we measured the levels of pressure in the branches of the portal vein and the hepatic vein in 23 patients suffering from chronic hepatitis (CH). In patients with chronic persistent hepatitis (CPH), the pressure in the portal vein was 17,7, in the hepatic vein 12,3 mm Hg (n = 4). In a group of 15 patients presenting with chronic aggressive hepatitis (CAH) with marked remodelling extending to cirrhosis, the average pressures were 19,9 and 11,8 mm Hg respectively; in four patients with CAH and, as yet, only slight fibrosis, the corresponding figures were 18,8 and 11,0 mm Hg respectively. In view of the recorded incidence of bleeding in 42 patients with complete hepatic cirrhosis, the early detection and intensive treatment of CH is of particular importance.

Adult↗