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Biomedical subjects

R Hippéli

Publications and source records attributed to R Hippéli.

14 recordsLinked to original sources
PubMed1990

Diffuse esophageal intramural pseudodiverticulosis and nutcracker esophagus in a 54-year-old man.

Esophageal intramural pseudodiverticulosis, which was first described by Mendl et al. in 1960, is characterized by multiple small flask-shaped outpouchings in the esophageal wall. The pseudodiverticula represent dilated excretory ducts of deep mucous glands in the esophagus. The etiology of this rare condition is unknown. Hiatal hernias, gastroesophageal reflux, esophageal strictures, candida esophagitis, herpes esophagitis, diabetes mellitus, and chronic alcoholism have been found associated with intramural pseudodiverticulosis. We report the second case of esophageal hypermotility in intramural pseudodiverticulosis.

Diverticulum, Esophageal↗
PubMed1982

[Technique and problems of transaxillary angiography of the distal aorta and its branches].

The primary approach to angiography of the distal aorta and its branches is transfemoral catheterization. Whenever this approach is contraindicated, the transaxillary way is an alternative of full value. The comparatively somewhat higher risk can be reduced to an acceptable minimum by the knowledge of damaging mechanisms and careful postangiographic control. The decrease of the angle between left subclavian artery and aortic arch in older patients renders the approach to the descending aorta more difficult and is the most frequent reason for failures. Since an ideal technique for managing this problem does not yet exist a review of some of the hitherto published suggestions is given, completed by experience of our own.

Aged↗
PubMed1981

[The significance of individual angiographic features in the evaluation of hypovascular renal lesions. Part I (author's transl)].

Fifty malignant and 50 benign renal lesions, with an hypovascular pattern, were classified into four groups on the basis of their vascular morphology. Three of these groups consisted of circumscribed masses distinguished as avascular lesions, lesions with peripheral vascularity and lesions with central vascularity. The fourth group consisted of diffuse or multicentric hypovascular lesions, which were also space-occupying. This grouping confirmed that histologically similar processes can produce widely differing vascular patterns and that they were therefore found in all groups (polymorphy). On the other hand, masses of different aetiology could show practically identical vascular patterns (isomorphy). In order to reduce errors in the diagnosis of hypovascular lesions, the value of individual features was analysed. Part I of this paper deals with the angiographic changes within the tumour. An analysis of the frequency of various phenomena in malignant and benign lesions (total index) permitted conclusions concerning their diagnostic value.

Angiography↗
PubMed1981

[The evaluation of angiographic features in the diagnosis of poorly vascularised renal lesions--part II (author's transl)].

Problems arise in the diagnosis of poorly vascularised lesions of the kidney in about 5% of angiograms. Particularly serious is the misdiagnosis of a poorly vascularised malignant lesions as a benign tumour. The value of various angiographic appearances has been assessed in a series of problem cases consisting of 50 malignant and 50 benign lesions. It was confirmed that there is no individual sign which is exclusive to either of these categories. An attempt was also made to judge the value of various signs in this differentiation. An appreciation of the lack of specificity of the various appearances is quite as important as an understanding of their relative significance in the diagnosis of poorly vascularised renal lesions.

Diagnosis, Differential↗
PubMed1981

[Contribution of radiology to the postoperative after care of patients with colorectal tumors].

The prognosis of local recurrences after surgery for colorectal cancer is better than in recurrences of many other tumor sites. Since in most cases secondary tumor growth takes place as local recurrence and distant metastases are infrequent, there is a good chance of detecting the recurrence early in a curable state. This offers good conditions for a radical second operation. Following excision of tumors, double-contrast enema permits a very detailed assessment of the anastomosis, allowing detection of small local recurrences and recognition of postoperative changes or sequelae of delayed healing at the site of the anastomosis. Following amputation of the rectum, computed tomography permits better control of the presacral space than other conventional radiodiagnostic procedures. In both situations, however, integration of both methods is necessary in a consequent time schedule of clinical follow-up with suitable intervals.

Aftercare↗
PubMed1980

[Lipoma of the liver (author's transl)].

A patient with a lipoma of the liver is described; the accuracy of sonography, scintigraphy, computer tomography and angiography in the pre-operative diagnosis is discussed. Computer tomography appears to be the method of choice for the recognition of this very rare tumour, in view of the characteristic attenuation produced by fatty tissue.

Angiography↗
PubMed1979

[Delayed healing of colonic anastomoses after tumour resection (author's transl)].

Local tumour recurrences at colonic anastomoses in an early, curable stage are rarely missed by double contrast enema. On the other hand, the variable appearances caused by inflammatory lesions, which delay healing of the anastomosis, are often misinterpreted as recurrences. Early post-operative investigation with a water-soluble contrast medium is therefore important. Small and transient leaks at the suture line may cause intramural inflammatory lesions with a variety of symptoms and may be confused with local recurrences. They are due to delayed healing at the anastomosis and will only be interpreted correctly if there is regular radiological follow-up.

Colonic Neoplasms↗
PubMed1979

[Rational combined X-ray examination of gallbladder and stomach (author's transl)].

X-ray examination of patients with upper abdominal symptoms has been performed up to now mostly as a sequence of separate procedures; instead, an integrated procedure is recommended: a plain film of the upper abdomen should be taken first; a routine oral cholecystogram in the lying position 12 hrs after intake of the contrast medium should be omitted-instead the gallbladder should be visualized fluoroscopically with the patient remaining in the standing position or lying, and films should be taken during visualization. X-ray examination of the stomach and duodenum may follow immediately thereupon, eventually as well during pharmacologically induced hypotony. Then a fatty meal may be given in order to stimulate contraction of the gallbladder; if spasmolytics have been given before, contraction however might be hampered. The diagnostic significance of fatty meals applied as a routine procedure in X-ray diagnosis of gallbladder function is considered to be limited; on the other hand this procedure may improve the diagnosis of the morphological situation.

Biliary Tract Diseases↗
PubMed1979

[Radiologic diagnosis of benign and malignant changes occurring at anastomoses following resection of colonic cancer (author's transl)].

Following resection of carcinoma of the colon, local recurrence at the site of the anastomosis must be expected in about 10%. Recurrence diagnosed early can be resected in 50%. Double contrast technique has proven to be most helpful in early diagnosis of recurrence. Therefore, radiographic follow-up examination, in adequate time intravals permit an early differentiation between lesions due to recurrence and due to the surgical procedure or prolonged healing of the anastomosis. Close cooperation with clinical follow-up, especially by endoscopy and biopsy, guarantees reliably good care of patients after resection of cancer of the colon or rectum.

Colectomy↗
PubMed1978

[Multiple phaeochomocytomas (author's transl)].

Multiple phaeochromocytomas represent a polytopic form of chromaffin tumours. The tumours may arise simultaneously or sequentially in chromaffin tissue, particularly in the retroperitoneal space. Malignancy can only be assumed if there are metastases to organs which do not contain chromaffin tissue. Their origin may be regarded as a dysontogenetic event. The clinical picture is dominated by the excretion of catecholamines. Laboratory tests are therefore used to determine the suspicion of the presence of a chromaffin tumour. A patient with an eight-year history is described, who had had four operations and in whom, by radiology or surgery, seven phaeochromocytomas had been found. The value of various radiological methods is discussed. The most informative method is arteriography; in view of the possibility of multiple tumours, aortography should be carried out in the first instance.

Adrenal Gland Neoplasms↗
PubMed1978

[Investigation of the small bowel using an intubation method (author's transl)].

Small bowel contrast examinations by an intubation method were carried out in our hundred patients suspected of having small bowel disease. The method described by Sellink was used and the time and expenditure for carrying out the procedure was monitored. The effect of changes in the method on side effects and quality of the results were observed. Although the technique requires rather more time and effort, the side effects are minimal once it has been properly worked out and there are definite diagnostic gains compared with conventional methods of investigating the small bowel. The increased information available justifies the use of the intubation technique not only for selected problems, but as the primary method of examination of the small bowel.

Adolescent↗