[Rare causes of cholestasis in ERC/PTC]. / Seltene Cholestaseursachen in der ERC/PTC.

Using case reports, attention is drawn to rare causes of cholestasis the clarification of which by ERC/PTC and by endoscopic therapy, if necessary, will clearly shown the usefulness of this method. The picture of an unusual choledocholith, the extraction of a "suture stone", the case of a Mirizzi syndrome, a cholecystocolic fistula, a cystic dilatation of the choledochus with Caroli's syndrome and status after choledochojejunostomy, the extraction of an ascarid from the papilla at biliary pancreatitis as well as the detection of a biliobronchial fistula resulting from an unsound hepaticojejunostomy are examples to underline the diagnostic usefulness of the ERC/PCT including its therapeutic capabilities and consequences in contrast to other methods, such as x-ray, ultrasound or computertomography.

[Diagnostic and therapeutic problems of primary non-Hodgkin lymphoma of the stomach]. / Diagnostische und therapeutische Probleme des primären Non-Hodgkin-Lymphoms des Magens.

The primary extranodal manifestation of the non-Hodgkin-lymphomas above all concerns the stomach. An essential problem is the low, exactly positive rate of biopsy. As a rule the non-Hodgkin-lymphoma is diagnosed on the surgical specimen. During 5 years we treated 11 patients with non-Hodgkin-lymphoma, this corresponds to 3.85% of our malignant tumours of the stomach. The anamnesis is uncharacteristic, the endoscopic picture is multiform, penetration and haemorrhage are relatively frequent to be observed. Only in 1 patient of 11 by means of multifarious biopsies the diagnosis could be ascertained preoperatively. At stage I the surgical therapy is sufficient, for all other stages the combination of operation and poly-chemotherapy is the therapy of choice.

[Experiences in the treatment of esophageal achalasia with pneumatic dilatation]. / Erfahrungen bei der Behandlung der Osophagusachalasie mit der pneumatischen Dilatation.

The results of the pneumatic cardia dilation in 17 patients are reported, which were yielded by means of a cardia dilation performed in doses. In this case an anaesthesia could be renounced. The pneumatic dilation performed in such a way proved as a risk-poor and effective method which loads the patient only insignificantly, is easily to be performed and has a large range of indication.

[Experiences with a methodologic variant of fiberoptic sclerosing of esophageal varices]. / Erfahrungen mit einer methodischen Variante der fiberendoskopischen Osophagusvarizensklerosierung.

43 patients with acute bleeding oesophageal varices were treated by means of endoscopic sclerotherapy using a modified fiber-endoscopic technic by either intravasal or combined intra- and paravasal injections. The results obtained in this group were compared with a group of 30 patients who had been treated conservatively--above all using a Sengstaken tube. According to previous experiences the method proved sufficient. In the sclerotherapy group there were by far less recurrent variceal haemorrhages (22 episodes of haemorrhages in 35 per cent of the patients) than in the control group, and during an average observation time of 16 months 18 per cent of the patients died. On the other hand, in the group treated conservatively, there were 44 episodes of haemorrhages in 60 per cent of the patients and 66.6 per cent of the patients died within 13 months. The results are compared with the results in literature and they suggest that, apart from the decrease of the frequency of haemorrhagic recidivations the sclerotherapy may have a favourable influence on the survival time of patients with liver cirrhosis. These findings, however, must still be confirmed by long-term results.

[Endoscopic papillotomy in East Germany]. / Endoskopische Papillotomie (EPT) in der DDR.

Through a survey 751 patients, in whom an endoscopic papillotomy (EPT) had been tried, were registered to the end of 1981. EPT was technically successful in 695 cases (92,5%). Control investigations were available for 650 patients, the aim of therapy being achieved in 594 cases (91,4%). The main indication was choledocholithiasis, 90,2%--among them 10% with gallbladder in situ--followed by benign papillary stenosis without stones (5,9%), carcinoma of the Vaterian papilla (3,2%) and rare indications such as ascaridiasis, choledochocele and stones of the pancreatic duct (0,7%). 53 patients suffered from more serious complications (7,6%), 18 had to be operated on (2,6%), and 7 patients died due to EPT (1%). The results are in agreement with those of other statistics from various countries.

[Experiences in fiber-endoscopic removal of foreign bodies from the intestinal tract]. / Erfahrungen bei der fiberendoskopischen Fremdkörperentfernung aus dem Intestinaltrakt.

It is reported on the complication-free fiber-endoscopic extraction of foreign bodies in 8 cases, of these 7 times from the upper intestinal tract and then, taking into consideration literature, the indication spectre to the endoscopic approach is mentioned. An immediate attempt to extraction should be performed above all in all sharp and pointed things on account of increased danger of perforation. An additional waiting for longer than 8 days after incorporation we consider little reasonable, since a spontaneous passage at this moment is unlikely. Small-calibrated perforating lesions of the stomach, the possible poverty of symptoms is emphasized apparantly heal without any sequels after extraction. Finally is referred to the prevention of an unnecessary laparotomy, when the therapeutic fiber endoscopy is reasonably used.