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Results for “PERITONEOSCOPY”

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At least 415 records · Page 23Linked to original sources

PubMed1980

Endoscopic diagnosis of primary cancer of the liver.

1. 247 cases clinically suspected of primary cancer of the liver were peritoneoscoped during the period of 1970-1978. 2. Peritoneoscopy alone made a correct diagnosis of primary cancer of the liver in 93%. It made an error in diagnosis in 7%. It missed the diagnosis of primary cancer of the liver in 2%. If combined with guided direct vision liver biopsy, the accuracy is almost 100%. 3. It is safe procedure and is an accurate way of ruling out the diagnosis of clinically suspected primary cancer of the liver.

Humans↗

PubMed1980

[Conservative treatment of traumatic splenic rupture in childhood (author's transl)].

In childhood there exists a considerable risk of overwhelming sepsis after splenectomy with a high mortality rate. To prevent this complication conservative treatment of traumatic splenic rupture should be attempted. Peritoneoscopy is an important diagnostic aid and facilitates the indication for conservative treatment. If laparotomy is necessary, splenorraphy is often possible. The authors' experiences are reported.

Child↗

PubMed1981

[Ultrasonography in the diagnosis of fatty liver (author's transl)].

Diagnostic relevance of ultrasonography was studied prospectively and controlled by peritoneoscopy and biopsy. 310 cases were investigated, 126 of these had fatty infiltration of the liver between 5% and 95%, which was diagnosed correctly in 92% of the cases by ultrasonography on the basis of increased reflexes. The incidence of correct diagnoses was 95% resp. 100% in cases with more than 10% resp. 50% fatty infiltration of the liver. Thus, diagnosis of fatty liver can be achieved with high sensitivity (fat infiltration of more than 10% may be recognized) and high specificity (only 4.35% false positives) by ultrasonography. Ultrasonography is a simple, non-invasive, and fast method suited for screening and follow-up in this condition.

Adult↗

PubMed1984

[Benign recurring intrahepatic cholestasis--a case report].

The diagnosis of benign recurrent intrahepatic cholestasis was made in a 40 year old female. Seven episodes of jaundice persisting up to 6 months in lengths lead to 3 laparotomies, numerous peritoneoscopies and needle biopsies of the liver. Elevation of conjugated serum bilirubin and alkaline phosphatase levels and histopathological confirmation of intrahepatic cholestasis without cholangitis were the main characteristics during the episodes of cholestatic jaundice. However, hepatic histology and liver function were normal in remission periods. Drug induced cholestasis was ruled out by careful history. A sister also suffered from 4 episodes of intrahepatic cholestasis. The etiology of the disease is probably of a genetic origin. The pathogenesis remains unclear. There is no specific treatment to prevent or shorten the occurrence of cholestatic episodes. The patients are advised to avoid pregnancy and oral contraceptives, since both will induce icteric phases.

Adult↗

PubMed1984

[Localized fibrous malignant peritoneal mesothelioma in an operated patient with massive hemorrhage to the peritoneal cavity].

We reported an operated patient with localized peritoneal mesothelioma. The patient was a 39-year-old man who had occasionally complained of left hypochondralgia for 5 years before admission. Progressive anemia due to hemorrhage into the peritoneal cavity was noted after admission. Peritoneoscopy revealed the bleeding to be located between the left lobe of the liver and the anterior wall of the stomach. On the 22nd hospital day, surgery was performed and a fist-sized tumor was resected. Microscopically, it was fibrous malignant type of the peritoneal mesothelioma. Chemotherapy was performed 3 times after the operation, and the patient is living and well 1 year and 8 months postoperatively.

Adult↗

PubMedDate not supplied

Treatment of advanced ovarian carcinoma with a combination of hexmethylmelamine, cyclophosphamide, methotrexate, and 5-fluorourcil (hexa-CAF) in patients with and without previous treatment.

Forty patients with stage III or IV epithelial ovarian tumors were treated with a combination of hexamethylmelamine, cyclophosphamide, methotrexate, and 5-fluorouracil. Fourteen of 37 evaluable patients had recieved previous treatment. Three of these 14 previously treated patients responded; no complete remissions were achieved and more severe toxicity was seen compared with the 23 previously untreated patients. In the latter group of patients, seven partial remissions and five complete remissions documented by peritoneoscopy and laparotomy were achieved. It is concluded that the combination of hexamethylmelamine, cyclophosphamide, methotrexate, and 5-fluorouracil is not useful as second-line chemotherapy but can be considered suitable for remission induction in previously untreated patients.

Aged↗

PubMed1982

Clinical presentation and biochemical abnormalities in black (Zulu) patients with cirrhosis in Durban.

A retrospective was designed to analyse the mode of presentation, clinical signs and haematological and biochemical abnormalities in 225 consecutive Black (Zulu) patients who were admitted to a general medical ward between the years 1970 and 1981 and in whom cirrhosis was later diagnosed. The most common presenting complaint was swelling of the body (60% of the patients), followed by abdominal pain (32%) and episodes of bleeding, mainly from the gastrointestinal tract (19%). On examination, hepatomegaly was encountered in 66% of the patients, with moderate to massive enlargement in 40%. Ascites was detected in 56%, with tense abdominal distension in 34%. Jaundice was present in 38% and emaciation, mental disturbance and splenomegaly in over 25%. Spider naevi (found in 2 patients) and Dupuytren's contracture (found in 1) were very rare. Thrombocytopenia and a high ESR were common. Over 90% of patients had low albumin and high globulin concentrations (albumin less than 20 g/dl and globulin greater than 60 g/dl in 25%). Bilirubin and alkaline phosphatase levels and the prothrombin index were found to be within normal limits in 32%, 24% and 52% of cases respectively. Histologically the lesion was most commonly micronodular (73%) with variable deposits of fat and iron. Peritoneoscopy was the most useful special investigation in the diagnosis of cirrhosis, leading to a correct diagnosis in 77% of cases. In conclusion, the clinical signs, biochemical abnormalities and histological features suggest that the factors causing cirrhosis in the community studied are mixed; it may result from the combined effects of alcohol abuse, malnutrition and chronic viral (e.g. hepatitis B) infections.

Abdomen↗

PubMed1982

[Peliosis hepatis. A clinical status inventory].

Peliosis hepatis is a rare condition, recognizable by macroscopical view. It is characterized by multiple blood-filled cystic spaces in the liver parenchyma. According to 49 out of 152 more recent case reports (1951-1981/82) its spontaneous occurrence is frequently associated with malignant and toxic processes. However, in about 70% peliosis may be induced by the action of certain drugs, especially by 17 alpha-alkylated steroids. Usually peliosis is found by chance at autopsy or peritoneoscopy, as the clinical picture does not provide sufficient conclusive criteria to allow a definite diagnosis. The striking macroscopical appearance contrasts to the dispute on the as yet unestablished natural history. As most important complication spontaneous intraabdominal bleeding can occur in occasional cases. On the other hand, the patients predominantly die of their underlying diseases and not of a peliosis hepatis.

Adenoma↗

PubMedDate not supplied

[Hepatic biopsy in acute leukemia].

In 25 patients with acute leukemia that presented chantes in liver function tests, 29 liver biopsies were done by percutaneous needle or peritoneoscopy and directed needle, to determine the nature of the lesion. In one case leukemic infiltration was found; 16 patients showed nonspecific lesions, one, granulomatous hepatitis, one, viral hepatitis; one showed no changes in the biopsy. In these twenty cases the treatment was not modified, the survival time was from 15 to 57 months (median 25 months), and 14 an still in remission. Five patients (20%) showed drug-induced hepatitis; in these it was necessary to modify to chemotherapy, the survival time in four cases was 2 to 9.6 months (median 4.8 months) and one is still in remission after 36 months of treatment. It is concluded that hepatic biopsy may be very useful in evaluating the undesirable effects of treatment of acute leukemia and in making therapeutic decisions. The risks of this procedure and the contraindications are similar in patients with acute leukemia and those with other diseases.

Acute Disease↗

PubMed1980

[Congenital hepatorenal polycystic disease with unusual long survival (author's transl)].

The authors report a case of hepatorenal polycystic disease discovered in the course of a routine physical examination. The patient was asymptomatic and the progression of the disease was extremely low. The existence of the disorder, however, was confirmed in the autopsy. Although hepatorenal polycystic disease is a relatively common clinical finding, the rareness of this condition in patients of advanced age and its occasionally asymptomatic form are pointed out. Clinical and prognostic characteristics of the two types of the disease (infantile and adult) are mentioned too. Physical examination and pyelography are the most import exploratory methods; other procedures such as echography, scanning and peritoneoscopy are complementary techniques. Lastly, the need to establish an early diagnosis in order to avoid unappropiated surgical maneuvers is stressed.

Aged↗

PubMed1978

[Studies on development of viral hepatitis with HBs antigenemia (author's transl)].

47 cases of viral hepatitis with HBs antigenemia, who were diagnosed by peritoneoscopy and biopsy, were studied. 41 cases were males, and 6 cases were females. The onset ages were mostly in 25--29 years old. The histories of blood transfusion were found in only 4.3%. On the other hand, the families clustered with HBs antigen were found in 68%. Recidivums were often seen (76%), and yet the intervals between recidivum were short (the neighborhood of 8 months). The transaminases at the recidivums were not so high (200 units or thereabout). 20 cases whom biopsies were performed more than twice, were studied histologically. 14 cases were prognessive. 5 were stationary. 1 was improved. In all of progressive cases, sublobular hepatic necrosis was seen. But in other cases, sublobular necrosis was not seen. After this sublobular necrosis, various distortion of the lobule architecture was appeared, and some of them progressed to liver cirrhosis. As to GOT and GPT, GPT was dominant before sublobular neerosis, but GOT was liable to be dominant after sublobular necrosis. Peritoneoscopically, peculiar red spots were found on liver surfaces at the time of sublobular necrosis.

Adult↗

PubMed1981

Restaging of patients with ovarian carcinoma.

Sixty-four patients, 34 with no clinical evidence of disease (NED) and 30 with clinical evidence of disease (ED), were submitted to restaging with peritoneoscopy plus diaphragmatic inspection, peritoneal cytology, and lymphography. Eleven patients (32.2%) in the NED group and 25 (83.3%) in the ED group had positive restaging findings. The 3 diagnostic procedures, in combination, are important in establishing occult disease and therefore in the planning of further treatment.

Female↗

PubMed1994

[Peritoneal mesothelioma: long-course ascites as the only clinical manifestation].

The mesothelioma is a rare tumor, especially in its peritoneal location (20%). Most of these cases are related to an exposition to asbestos long time age. We present a patient with long-evolution ascites and without any other clinical manifestations. The study of the ascitic fluid, the imaging techniques and the peritoneoscopy did not allow the diagnosis in the first place. Only after one year of follow-up and when the patient recalled, in a directed interrogation, her occupational contact with asbestos thirty years age, the diagnosis could be established.

Ascites↗

PubMed1994

[Nonoperative treatment for simple hepatic injury: an analysis of 77 cases].

In this study, 77 of 82 hepatic injury cases were selected for conservative therapy. The hepatic injuries in all these 77 cases were originally graded as type I or Type II by reviewing the history of trauma, abdominal paracentesis, B-mode ultrasonography, peritoneoscopy, X-ray pneumoperitoneography, and serum GPT measurement. Patients were all resuscitated by fast volume expansion, blood transfusion recovered from intraabdominal bleeding, nasogastric tube decompression added by chinese herbs. Three patients died of compound internal organ injuries, respiratory failure and DIC, the remaining 74 (96.1%) were cured.

Adolescent↗

PubMedDate not supplied

A new laparoscopic method for implantation of peritoneal catheters.

The placement of peritoneal catheters by non-surgeons was facilitated by a percutaneous laparoscopic technique ("Y-tec"). We have developed a catheter implantation system that is simpler to use, is less expensive initially and per procedure, and provides greatly enhanced peritoneal visualization. The core of the system is a 4 mm diameter Verres needle, which has a protective spring loaded obturator. This fits within a stainless steel cannula, which is in turn surrounded by a disposable peel away sheath. This entire unit is inserted into the peritoneal cavity through the rectus muscle after blunt dissection. Pneumoperitoneum is optional. The Verres needle is removed and peritoneoscopy is performed with a 5 mm Storz laparoscope. This is withdrawn, followed by the steel cannula, leaving the peel away sheath. The catheter is inserted through this, over a stylet. The sheath is then peeled off and the catheter sutured and tunneled in the usual fashion. This method uses the safest mode of blind peritoneal entry and permits thorough peritoneal inspection, even without insufflation. The needle and cannula are reusable, which minimizes cost. The technique is simple, and early results with inexperienced operators are encouraging.

Catheters, Indwelling↗

PubMed1977

False-positive liver scan caused by anomalous quadrate lobe and right portal branch.

A case of early cirrhosis exhibiting a discrete scan defect along the inferomedial margin of the liver near the hilum is described. Peritoneoscopy and percutaneous transhepatic portography disclosed that the quadrate lobe had a tongue like protrusion increasing activity below the hilum on the scan and a dilated right portal branch which divided near the superior mesenteric vein entered the liver at the porta hepatis.

Adult↗

PubMed1996

Hepatitis C virus infection in chronic liver disease in Natal.

The aim of this cross-sectional seroprevalence study was to determine the prevalence of antibodies to hepatitis C virus (HCV) (anti-HCV) in patients with cirrhosis, hepatocellular carcinoma (HCC) and chronic active hepatitis (CAH) attending a referral hospital in a hepatitis B virus (HBV)-endemic area in South Africa. One hundred and ten patients with suspected cirrhosis, 44 with suspected HCC and 6 with chronic hepatitis were initially included. The diagnoses were confirmed in 77 patients with cirrhosis (histologically or macroscopically at peritoneoscopy), 33 patients with HCC (histologically or elevated alpha-fetoprotein levels plus focal lesion on hepatic imaging) and 6 patients with CAH (histologically) without antinuclear antibodies. All patients were tested for anti-HCV with the Abbott second-generation enzyme immunoassay combined with a supplemental neutralisation assay, and hepatitis B surface antigen (HBsAg). Anti-HCV seroprevalence for cirrhosis, HCC and CAH were 18/77 (23%), 8/33 (24%) and 2/6 (33%) respectively. HBsAg was detected in serum in 16 (21%), 15 (46%) and 1 (17%) patient respectively. Only 1 patient (with cirrhosis) was positive for both anti-HCV and HBsAg. Of those who were anti-HCV-positive, 4/18 (22.2%) cirrhotics, none with HCC and 1/2 (50%) with CAH, had previously received blood transfusions, resulting in a cumulative frequency of 5/28 (18%). Our results indicate that HCV is an important aetiological agent in the pathogenesis of chronic liver disease in our patients. In the majority of patients (82%), the infection was not transfusion-related. Thus, screening of blood donors for anti-HCV would not prevent the majority of cases of chronic liver disease secondary to HCV. It appears as if HCV and HBV have different modes of transmission in southern Africa.

Adolescent↗

PubMed1977

Tuberculous peritonitis.

The records of 40 patients with tuberculous peritonitis treated at Charity Hospitals in Louisiana were reviewed. Thirty-nine patients were Negroes and 24, males. The average age was 36.5 years, with 22 of the patients being between the ages of 20 and 39 years. The most common symptoms were fever, abdominal pain, weight loss and abdominal swelling. The most frequent physical signs were abdominal tenderness, fever and ascites. Diagnosis was made by laparotomy in 24, peritoneoscopy in two, paracentesis in eight, autopsy in four and upon elective hernial repair in two. Four had a previous history of extra-abdominal tuberculous, four were known to have extra-abdominal tuberculosis at the time of diagnosis and four were found to have extra-abdominal tuberculous after the diagnosis of tuberculous peritonitis had been established. The follow-up interval averaged six and one-half years. Six patients died prior to discharge, and six patients died after discharge, none of the latter deaths was established as being due to tuberculosis. Twenty-two patients were alive at the end of the follow-up interval.

Adult↗