0000000000134457
AUTHOR
Henning E. Adamek
showing 21 related works from this author
Management of Esophageal Perforations after Therapeutic Upper Gastrointestinal Endoscopy
1997
Esophageal perforation is one of the most dreaded complications in therapeutic gastrointestinal endoscopy. We assessed the frequency of esophageal perforation after endoscopic procedures in a highly specialized endoscopy unit and compared clinical outcomes in patients undergoing either surgical or conservative management.From January 1985 to June 1996, 1011 instrumental endoscopic procedures (dilatation and bougienage) were performed in our department. The computerized complication database was searched to identify all patients with esophageal perforation during this same period, and their records were reviewed.Seventeen esophageal perforations (1.7%) occurred in the course of 1011 procedur…
A negative rapid urease test is unreliable for exclusion of Helicobacter pylori infection during acute phase of ulcer bleeding
2003
Abstract Background. The reliability of the rapid urease test has not been proven in patients with peptic ulcer bleeding. Some studies show bad diagnostic results with the rapid urease test for gastrointestinal bleeding. Aims. To evaluate the efficacy of the rapid urease test in patients with bleeding gastric or duodenal ulcers. Patients and methods. A total of 96 patients with acute peptic ulcer bleeding without proton pump inhibitor or antibiotic therapy within the last 14 days before bleeding were included into the study. During index endoscopy, specimens for histological and rapid urease test were obtained from the antrum and corpus mucosa of the stomach. Patients were also investigated…
Magnetic resonance cholangiopancreatography
2002
With the introduction of endoscopic retrograde cholangio-pancreatography in the early 1970s, gastroenterologists have a lot of diagnostic options in the biliopancreatic system to their disposal. Meanwhile, magnetic resonance cholangiopancreatography (MRCP) has become a competitive replacement for diagnostic ERCP with the advantage of avoiding complications related to endoscopic techniques. Mounting evidence suggests that both MRCP and MRI (magnetic resonance imaging) have a profound influence of diagnostic algorithms in a variety of hepatobiliary and pancreatic diseases.
Magnetic Resonance Imaging in Gastroenterology: Time to Say Good-bye to All That Endoscopy?
2000
Magnetic resonance imaging (MRI) has been described as the most important development in medical diagnosis since the discovery of the roentgen ray more than 100 years ago. The effectiveness of MRI has been extended to make it applicable in a wide variety of gastrointestinal disorders. The attention of gastroenterologists is currently focusing on pancreaticobiliary and bowel diseases. Magnetic resonance cholangiopancreatography (MRCP) has become a competitive alternative to diagnostic endoscopic retrograde cholangiopancreatography in a variety of hepatobiliary and pancreatic diseases. Magnetic resonance enteroscopy has the potential to become the preferable method for evaluating the entire s…
ERCP and MRCP in the Differentiation of Pancreatic Tumors
2004
The introduction of endoscopic retrograde cholangiopancreatography (ERCP) in the early 1970s provided gastroenterologists with a number of diagnostic as well as therapeutic possibilities for examining biliopancreatic systems. In the meantime, magnetic resonance cholangiopancreatography presents a non-invasive alternative to diagnostic ECRP providing the advantage of a lower rate of possible complications. This article addresses the two methods presently available for differentiating pancreatic tumors. The objective of this article is to describe the advantages and disadvantages as well as the possibilities inherent in both methods.
Minilaparoscopy versus conventional laparoscopy in the diagnosis of hepatic diseases
2001
Minilaparoscopy (ML) is being used increasingly in the diagnosis of liver disease. This is a prospective study of the accuracy and safety of ML compared with conventional laparoscopy (CL) in the diagnostic workup of liver disease.One hundred four patients with suspected liver disease were randomized either to undergo CL (n = 50) or ML (n = 54). CL was performed with a standard Storz laparoscope (Ø 11 mm, Storz GmbH, Tuttlingen, Germany) according to accepted guidelines. For ML a 1.9-mm small-diameter optical telescope was used (Richard Wolf GmbH, Knittlingen, Germany). In all cases, an attempt was made to obtain a liver biopsy specimen.Laparoscopy could successfully be performed in 100 of 1…
Arthralgia as an early extraintestinal symptom of Whipple's disease. Report of five cases.
1997
Five patients with Whipple's disease all suffered from arthralgia for a long time (15 years in one case) before developing gastrointestinal or other symptoms. In all patients, arthralgia was seronegative, and there was no evidence of joint destruction. Arthralgias were symmetric and migrating. Whipple's disease is part of the differential diagnosis of enteropathic arthralgia. Thereby, the polymerase chain reaction can be a helpful tool to prove Whipple's disease in difficult differential diagnosis.
Wireless Capsule Endoscopy in a Patient with Obscure Occult Bleeding
2002
A case of obscure/occult bleeding in a 39-year old man with a 7-year history of chronic fatigue and iron-deficiency anemia is presented here. Esophagogastroduodenoscopy, push enteroscopy, ileocolonoscopies, and a magnetic resonance imaging small-bowel follow-through did not reveal any abnormalities. Multiple inflammatory lesions with fibrin-covered ulcers and petechial bleeding in the area of the lower jejunum and ileum were diagnosed only with capsule endoscopy. One ulcer located near the ileocecal valve was then biopsied during a repeat ileocolonoscopy, and the histology showed signs of Crohn's enteritis. The further treatment approach was changed, with medical treatment being initiated a…
Management of retained bile duct stones: a prospective open trial comparing extracorporeal and intracorporeal lithotripsy.
1996
Abstract Background: Endoscopic management of common bile duct stones has become the approach of choice, especially in patients with high surgical risk. Problems are encountered if there are large stones or a duct stenosis. For these difficult stones, shock wave technology serves as an alternative to surgical intervention. Methods: A total of 125 patients with common bile duct stones in whom conventional endoscopic treatment had failed were selected and treated either by extracorporeal piezoelectric lithotripsy (ESWL, n=79) or intracorporeal electrohydraulic lithotripsy (EHL, n=46). The average age of our patients was 70 years. Results: In the ESWL group visualization of the stones by ultra…
Long-term results (7 to 10 years) of endoscopic papillotomy for choledocholithiasis. Multivariate analysis of prognostic factors for the recurrence o…
1998
Abstract Background: The long-term outcome after endoscopic papillotomy is poorly defined. The aim of this study was to determine the long-term results of this method in the treatment of common duct calculi and to determine which prognostic factors are associated with the relapse of biliary symptoms. Methods: Between 1985 and 1988, 223 consecutive (149 women, mean age 67.9 years) patients underwent endoscopic papillotomy for duct stones; 127 had already undergone cholecystectomy or underwent this operation during the same hospitalization. Follow-up data were obtained retrospectively from the patients and patients' relatives and general practitioners. Results: The procedure was successful in…
Colorectal Polyps: Detection with Dark-Lumen MR Colonography versus Conventional Colonoscopy
2005
To prospectively compare dark-lumen magnetic resonance (MR) colonography with conventional colonoscopy in the detection of colorectal polyps.Local ethical committee approval and informed consent were obtained. One hundred consecutive patients (56 men, 44 women; mean age +/- standard deviation, 67.7 years +/- 14.7; range, 25-82 years) who were referred for conventional colonoscopy from January 2003 to January 2004 underwent MR colonography and conventional colonoscopy after standard precolonoscopic bowel cleansing. Colonoscopy was performed immediately after MR colonography. For MR colonography, the colon was filled with approximately 2000 mL of tap water. Imaging was performed with a 1.5-T …
Choledochocele imaged with magnetic resonance cholangiography.
2000
Choledochal cysts are rare developmental malformations of the biliary tree. Percutaneous and endoscopic ultrasound, as well as endoscopic retrograde cholangiopancreatography, are recommended diagnostic tools. Magnetic resonance cholangiography may also contribute to the workup and treatment plan of patients with choledochal cysts. We report a 25-yr-old white woman with episodic nausea and moderate epigastric dyscomfort. Magnetic resonance cholangiography showed a rather spherical, cyst-like, fluid-filled structure in continuity with the prepapillary segment of the common bile duct, thus making a choledochocele (type III choledochal cyst) likely. The patient was treated by endoscopic sphinct…
Impact of Gallbladder Status on the Outcome in Patients with Retained Bile Duct Stones Treated with Extracorporeal Shockwave Lithotripsy
2002
BACKGROUND AND STUDY AIMS The use of endoscopic therapy in combination with lithotripsy techniques has become increasingly common in patients with complicated common bile duct stones. In many units, although this is controversial, cholecystectomy is then performed, because of possible subsequent cholecystitis and recurrence of choledocholithiasis. The aim of this study was to investigate whether gallbladder status influences the long-term outcome in patients after extracorporeal shockwave lithotripsy (ESWL) of common bile duct stones. PATIENTS AND METHODS Recruited for the study were 120 patients with an average age of 68 years (range 28 - 86). They were selected from 137 consecutive patien…
Pancreatic cancer detection with magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography: a prospective contro…
2000
Summary Background Magnetic resonance cholangiopancreatography (MRCP) is a non-invasive and increasingly used procedure in cases involving biliary and pancreatic diseases. However, the accuracy of MRCP in differential diagnosis between pancreatic cancer and chronic pancreatitis has never been documented in a large prospective controlled study. Methods 124 patients were recruited for the study, selected from 141 consecutive patients with an average age of 55 years (range 19–80) who presented to our department between February, 1996, and January, 1998, with a strong clinical suspicion of pancreatic cancer. MRCP images were interpreted by a radiologist and a gastroenterologist who were unaware…
A prospective evaluation of magnetic resonance cholangiopancreatography in patients with suspected bile duct obstruction.
1998
Background—The value of magnetic resonance cholangiopancreatography (MRCP) is under debate.Aims—To assess the diagnostic accuracy of MRCP and endoscopic retrograde cholangiopancreatography (ERCP) and to determine whether MRCP may help to prevent unnecessary interventional procedures.Methods—Eighty six patients with suspected common bile duct obstruction who presented between January and December 1996 were enrolled. Twenty six were excluded due to anatomical reasons or because MRCP or ERCP could not be performed successfully. Results of MRCP were interpreted by two radiologists and a gastroenterologist unaware of clinical diagnosis. Final diagnosis was determined by ERCP and histopathologica…
Long term follow up of patients with chronic pancreatitis and pancreatic stones treated with extracorporeal shock wave lithotripsy
1999
BACKGROUNDThere have been conflicting reports as to whether pancreatic ductal drainage achieved by endoscopy and lithotripsy improves the clinical outcome of patients with chronic pancreatitis.AIMSTo determine the clinical outcome in patients with chronic pancreatitis who received extracorporeal shock wave lithotripsy (ESWL), and were followed up for two to eight years.METHODSEighty patients with severe chronic pancreatitis and endoscopically unretrievable obstructive stones underwent ESWL with a piezoelectric lithotripter between 1989 and 1996. Clinical status, relief of symptoms, further endoscopic or surgical interventions, and mortality were defined.RESULTSForty three (54%) patients wer…
Value of magnetic-resonance cholangio-pancreatography (MRCP) after unsuccessful endoscopic-retrograde cholangio-pancreatography (ERCP).
1997
Background and Study Aims: The present study tries to evaluate the success rate of MRCP when two attempts by experts to perform ERCP in a center failed. Patients and Methods: From March 1996 to December 1996 thirteen patients fulfilled the inclusion criteria. The MR cholangiopancreatograms were acquired using commercially available software in a clinical MR scanner (Magnetom Expert 1T-Scanner, Siemens, Erlangen, Germany). MRCP utilized heavily T2-weighted turbo-spin echo sequences with fat supression (HASTE). Maximum intensity projection (MIP) of the pancreatic duct and biliary tree was then carried out. Additionally, T1-weighted sequences were obtained using the breath-hold technique. Resu…
Endoscopic therapy of adenomas of the papilla of Vater. A retrospective analysis with long-term follow-up.
2001
Abstract Aims. To compare the efficacy and the complication rate between endoscopic snare resection of adenomas of Vater's papilla and endoscopic palliation. Methods. In a retrospective, non randomized manner, we compared long-term results of our endoscopic strategies in 36 patients with histologically confirmed adenoma of Vater's papilla submitted either to local endoscopic snare resection (n=18) or to simple endoscopic palliation (n=18), respectively. Results. Between 1985 and 1998 results were reviewed. Median age was 76.5 (range 42–89) years in the palliation, and 64.0(23–89) years in the endoscopic snare resection group. Median duration of follow-up was 33 (6–135) and 75.0 (27–123) mon…
Clinical comparison of extracorporeal piezoelectric lithotripsy (EPL) and intracorporeal electrohydraulic lithotripsy (EHL) in difficult bile duct st…
1995
Today, nearly 90% of common bile duct stones are extracted endoscopically. Problems are encountered if there are large stones or a duct stenosis. Extracorporeal piezoelectric lithotripsy (EPL) as well as intracorporeal electrohydraulic lithotripsy (EHL) serve as an alternative to surgical intervention for those few patients in whom endoscopic measures have failed. A total of 35 patients with common bile duct stones in whom conventional endoscopic treatment had failed were selected on the condition that stone visualization through ultrasound was possible and that the papilla was within easy reach of the endoscope. Patients fulfilling the inclusion criteria were randomly treated either by EPL…
Mucinous cystadenomas and intraductal papillary mucinous tumors of the pancreas in magnetic resonance cholangiopancreatography.
2000
Background and Study Aims: In mucin-producing tumors of the pancreas, diagnosis using endoscopic retrograde cholangiopancreatography (ERCP) is limited to cystic formations that communicate with the main pancreatic duct. Magnetic resonance cholangiopancreatography (MRCP) is a new, sophisticated method which is currently under evaluation. The authors describe the usefulness of MRCP in diagnosis of mucin-producing tumors. Patients and Methods: Six patients with mucin-producing tumors were investigated using MRCP and ERCP. Imaging was compared with surgery and histopathological examinations. Results: Three patients were found to have mucinous cystadenomas (MC), two patients had intraductal papi…
Prospective, randomized, single-center trial comparing 3 different 10F plastic stents in malignant mid and distal bile duct strictures.
2003
Abstract Background: The aim of this study was to determine whether patency rates differ with respect to the material, design, and surface texture of 3 different plastic stents. Methods: A total of 120 patients (median age 70.5 years; interquartile range 62-78 years) with malignant mid or distal bile duct strictures, seen between March 1996 and May 1999, were prospectively randomized to receive a 10F polyurethane stent, a Teflon Tannenbaum stent, or a hydrophilic hydromer-coated polyurethane stent. The primary study outcome measure was the interval between stent insertion and the first episode of clogging (or the presence of jaundice at death without stent exchange). All 3 types of stent we…