0000000000371464
AUTHOR
Dirk Hartmann
Endometriose des Colon transversum
HISTORY A 65-year-old woman with no complaints came to our hospital for a colonoscopy because of a family history of a colorectal carcinoma. Because of postmenopausal complaints she had been undergoing estrogen therapy for the past five years. INVESTIGATIONS Colonoscopy revealed a 2 x 2 cm polyp like structure with central tissue proliferation in the transverse colon. Neither chromoendoscopy with indigocarmine nor multiple biopsies indicated an adenomatous glandular proliferation. Miniendosonography revealed the image of a tumour located in the muscularis propria. DIAGNOSIS AND CLINICAL COURSE: As a malign process could not definitely be excluded, a colon segment resection was carried out b…
A phase I/II multicentric trial of gemcitabine and epirubicin in patients with advanced pancreatic carcinoma
Potential synergistic interaction between gemcitabine (GEM) and epirubicin (EPI) in pancreatic cancer have been described previously. The maximum-tolerated dose in this trial was GEM 1000 mg m(-2) and EPI 45 mg m(-2). Median time to progression was 5.1 months and median survival time 7.4 months. This combination appears well tolerated and shows promising clinical activity.
Inkarzeration eines Pankreassteinfragmentes im distalen Pankreasgang nach Therapie durch extrakorporale Stoßwellenlithotripsie (ESWL)
A partial or total absence of stones in pancreaticolithiasis therapy can be reached by using ESWL. We report on a patient who happened to get an incarceration of a fragment in the distal pancreatic duct after having been treated by ESWL without a previous sphincterotomy to the ductus Wirsungianus. This emphasizes the recommendation to carry out a papillotomy of the pancreatic main duct before applying ESWL to pancreatic stones.
Diagnostik eines hochmalignen B-Zell-Lymphoms des Dünndarms mit der Kapselendoskopie
Wireless capsule endoscopy is a new diagnostic procedure to detect diseases of the small bowel, in particular in patients with obscure gastrointestinal bleeding. We report on a 76-year-old patient who presented at our hospital with signs of gastrointestinal bleeding and hypochromic anaemia. Bidirectional endoscopy, push enteroscopy, angiography as well as small bowel barium enema rendered no pathologic findings. Wireless capsule endoscopy demonstrated a polypous space in the cantral area of the small bowel. Subsequent intraoperative endoscopy revealed a subtotal stenosing tumour of the upper jejunum which was resected. Based on the histology a high-grade B-Cell lymphoma was diagnosed. The p…
Does Cytokeratin7/20 immunoreactivity help to distinguish Barrett's esophagus from gastric intestinal metaplasia? Results of a prospective study of 75 patients
Barrett's esophagus is a recognized risk factor for the development of esophageal dysplasia and carcinoma. Unfortunately, gastric incomplete intestinal metaplasia arising in Short Segment Barrett's esophagus can be indistinguishable histologically on hematoxylin/eosin stains. Distinct patterns of CK 7 and CK 20 immunohistochemical expression have been demonstrated to be both highly sensitive and specific for Barrett's esophagus, but have not been found in gastric metaplasia. The aim of our study was to test whether immunostaining with CK 7/20 helps to distinguish between Barrett's epithelium and gastric incomplete metaplasia. Cases of long segment Barrett's esophagus, short segment Barrett'…
Incomplete Conventional Colonoscopy: Magnetic Resonance Colonography in the Evaluation of the Proximal Colon
Background and Study Aims: The purpose of this study was to evaluate dark-lumen magnetic resonance (MR) colonography prospectively in patients with incomplete conventional colonoscopy. Patients and Methods: Thirty-two patients with incomplete conventional colonoscopy underwent same-day dark-lumen MR colonography on the basis of a standard protocol. The depiction of colorectal diseases was assessed in the following colon segments: cecum, ascending colon, transverse colon, descending colon, sigmoid colon, and rectum. The reasons for incomplete colonoscopy included high-grade stenosis in 26 patients (four with occlusive cancer, 12 with fibrotic stenosis based on recurrent sigmoid diverticuliti…
ERCP and MRCP in the Differentiation of Pancreatic Tumors
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.
Long-Segment Early Squamous Cell Carcinoma of the Proximal Esophagus: Curative Treatment and Long-Term Follow-Up after 5-Aminolevulinic Acid (5-ALA)-Photodynamic Therapy
Photodynamic therapy (PDT) is an established treatment for the ablation of dysplastic Barrett's epithelium and early esophageal carcinoma, but no data have been published on curative 5-aminolevulinic acid (5-ALA)-PDT for long-segment early esophageal cancer with infiltration of the upper sphincter. We describe successful curative treatment of an unusual early long-segment squamous cell carcinoma (uT1a,N0) of the proximal esophagus (18 - 28 cm aborally), with three sessions of 5-ALA-PDT. Endoscopic and endosonographic follow-up macroscopically showed a complete remission of the tumor, proven by biopsy showing total histological ablation. After a follow-up period of 23 months, there has been …
Effect of intravenous application of esomeprazole 40???mg versus pantoprazole 40???mg on 24-hour intragastric pH in healthy adults
BACKGROUND: It has been demonstrated that therapy with proton pump inhibitors reduces recurrence of bleeding following initial endoscopic treatment of bleeding peptic ulcers. AIM: This study compared the effects of esomeprazole 40 mg and pantoprazole 40 mg on intragastric acid control. Both substances were administered intravenously as 15-min infusion and as bolus injection. METHODS: Healthy men and women volunteers were enrolled in this single-center, open, randomized, three-way crossover study. After administration of esomeprazole 40 mg and pantoprazole 40 mg intravenously as 15-min infusion, and pantoprazole 40 mg intravenously as bolus injection, continuous 24-h intragastric pH monitori…
Capsule Endoscopy versus Push Enteroscopy in Patients with Occult Gastrointestinal Bleeding
Background Wireless capsule endoscopy is a new method enabling non-invasive diagnostic endoscopy of the entire small intestine. In this study we prospectively examined the diagnostic precision of capsule endoscopy compared with push enteroscopy in patients with occult gastrointestinal bleeding. Methods Between July 2001 and October 2002 we examined 48 patients with suspected disorders of the small intestine using capsule endoscopy. 33 patients with obscure bleeding (19 men, 14 women, mean age 58 +/- 23 years) were prospectively examined using capsule endoscopy and push enteroscopy. Results On average, the patients had been suffering from chronic gastrointestinal bleeding for 30 +/- 36 (1-12…
Colorectal Polyps: Detection with Dark-Lumen MR Colonography versus Conventional Colonoscopy
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 …
Colorectal Polyps
Publisher Summary Colorectal cancer (CRC) remains the second leading cause of cancer death for both women and men with more than 130,000 newly diagnosed cases and 50,000 deaths each year in the United States alone. Most colon cancers develop from nonmalignant colonic adenomas or polyps over a comparatively long time period ranging between 24 and 60 months. Reflecting this adenomatous pathogenesis of most colorectal cancers, polyp screening with subsequent polypectomy is used to constitute an effective approach for decreasing the incidence of this malignant tumor. Thus, colorectal screening for polyps may be considered one of the most promising preventive measures in medicine. Most available…