[The pathological endoscopic pancreatogram diagnostic value of radiomorphological changes (author's transl)]. / Das pathologische endoskopische Pankreatogramm: Wertigkeit der röntgenmorphologischen Veränderungen.

The specificity of abnormal radiomorphological patterns in the endoscopic retrograde pancreatogram (ERCP) has been studied. Out of 3,000 ERCPs 381 contained pathological findings in the pancreatic duct, all of which was subsequently checked by histology. Comparison of the radiomorphologic data and the histologic abnormalities has revealed that ductal abnormalities are not specific to the underlying pancreatic disease. There are, however, changes in the radiomorphologic appearance which, owing to their greater incidence, may be regarded as characteristic to some pathologic process. Solitary stenosis or complete obstruction indicate the presence of tumour, nonsegmental extended dilatation points to papillary stenosis, filling of cavities reveals cysts, while diffuse abnormalities occur most frequently in chronic pancreatitis. Opacification of the bile ducts may yield complementary data, although their specificity is not absolute either. Nonsegmental stenosis of the intrapancreatic bile duct indicate chronic inflammation, while irregular narrowing supports the diagnosis of pancreatic tumours. Arc-shaped dislocation of the bile duct is frequently observed in response to cysts, stenosis confined to the ampullary segment and associated with dilated biliary system are characteristic findings in papillary stenosis. Thus the diagnostic value of the abnormal pancreatogram may be enhanced by simultaneous study of the biliary morphology

[Endoscopic retrograde cholangiopancreatography in the differential diagnosis of chronic pancreatitis and pancreatic cancer (author's transl)]. / Differentialdiagnostischer Wert der endoskopischen retrograden Cholangiopankreatographie bei chronischer Pankreatitis und Pankreastumoren.

The endoscopic retrograde cholangiopancreatography (ERCP) findings in 30 patients with chronic pancreatitis and 25 cases of pancreatic cancer are presented in this report. The diagnosis was confirmed in every case by surgery or at autopsy. ERCP was found to be a reliable means of differentiating between pancreatic cancer and chronic pancreatitis in most cases. Multiple lesions are typical of chronic pancreatitis. In solitary lesions a diagnosis can be reached only by consideration of the pancreatographic findings in conjunction with the clinical picture.

[Diagnostic features of the abnormal endoscopic pancreatogram (author's transl)]. / Differentialdiagnostischer Wert des pathologischen endoskopischen Pankreatogramms.

Features of 75 abnormal pancreatograms are analysed. Radiomorphology is conferred with surgical or postmortem findings in all cases. None of the anatomical alterations was found to be specific for any given diseases entity, some consistency was verified however. Solitary stenosis suggests cancer. Diffuse alterations point to chronic pancreatitis. Cave filling is a likely sign of cyst or pseudocyst. Since, however, these features are nonspecific, the diagnosis must be based on clinical data as well.

Diagnostic value of endoscopic retrograde cholangio-pancreatography in biliodigestive anastomoses.

Endoscopic retrograde cholangio-pancreatography performed in patients with bilodigestive anastomosis may furnish not only reliable radiograms revealing abnormal morphology of the two duct system but allows also endoscopic investigation of the stoma, which is often of equal diagnostic value in such patients. The size of the anastomosis is of crucial importance in such complications as cholangitis and secondary bile stone formation. In a significant portion of patients with biliodigestive anastomoses, i.e. in 75% of the present patient material, a morphologic abnormality could be demonstrated offering in many if not most cases the possibility of a surgical correction and eventual cure of the symptoms.

[The double-pyelon kidney with special regard to the transport function (author's transl)]. / Uber die Doppelnieren mit besonderer Rücksicht auf die Funktion des Transportsystems

The double-pyelon kidney, i.e. the total or partial duplication of the urinary transport system may involve both diagnostic and therapeutic difficulties. Observations are presented on the strength of 398 cases with total or partial duplication of the upper urinary tract. The incidence rate was 0.7 percent. The various types of duplication are presented with the diagnostic and therapeutic features involved. Transport function is discussed in detail as investigated under ideal physiologic conditions: during excretory urography under the amplifier screen. Aiming at early detection of the congenital anomaly and specification of the appropriate management, a urologic check-up is suggested even with mild presenting symptoms. Special emphasis is given to the consistent day-time enuresis in children over 3 years old, as a possible sign of ectopic ureter. Both children and parents are saved much unpleasantness by early detection, proper management and considerate surgery.

[Effect of urinary transport function on the development of kidney calculi]. / Uber die Auswirkung der Harntransportfunktion auf die Nierensteinbildung

The formation of renal calculus is, according to the currently accepted view, a polyetiological process whose most important components are the composition of the urine and urinary stasis. The second of these factors is discussed. The importance of anatomical lesions is indicated by the finding of a hindrance of flow in 66 of the 100 patients operated for renal calculus. The stasis may, however, have some functional cause, too. X-rays revealed two types of hypomotility: a temporary, or in certain parts constant, lack of contractions and sluggish contractions of normal frequency. Temporary lack or sluggishness of contraction promotes calculus formation because the physiological pyelo-calicous reflux which occurs in three quarters of the intact cases is lacking. These refluxes counteract sedimentation and together with the orthostatic emptying are the most effective factors preventing the retention of calculus nuclei.