W Maier

Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde

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S. Block

Universität Ulm

Peter Malfertheiner

Otto-von-Guericke University Magdeburg

Gerd Jürgen Ridder

University of Freiburg

B Meier

University Hospital of Bern

Schumacher Ka

Universität Ulm

Stephan Windecker

University Hospital of Bern

CC Boedeker

Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde

MW Büchler

University of Amsterdam

Eric Boersma

Erasmus University Rotterdam

William Wijns

Ollscoil na Gaillimhe – University of Galway

Cooperative Institutions

Universität Ulm

University of Freiburg

Universitäts-HNO-Klinik Heidelberg

University Medical Center Freiburg

Universitätsklinik für Hals-, Nasen- und Ohrenheilkunde

University Hospital of Bern

University of Bern

Chirurgische Universitätsklinik Heidelberg

Heidelberg University

Freie Universität Berlin

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Identification of pancreas necrosis in severe acute pancreatitis: imaging procedures versus clinical staging.

Gut (1986)

S. Block W Maier R. Bittner Markus W. Büchler Peter Malfertheiner

One hundred and five of 395 patients with acute pancreatitis were surgically treated in our clinic from 1981 to 1984. Ninety three of these patients were examined with contrast enhanced computed tomography and/or ultrasound and were clinically assessed according to Ranson's objective criteria before operation. At operation, 77 patients showed necrotising pancreatitis and 16 showed biliary acute interstitial pancreatitis. Ninety per cent of the cases with extensive and 79% of those with minor necroses of the pancreas had been demonstrated with contrast enhanced computed tomography. Ultrasound failed to be diagnostic in 24% of the patients due to meteorism; the sensitivity of the diagnostic studies for pancreatic necrosis was 73% regardless of the extent of the process. Using the early objective signs, seven patients with acute interstitial pancreatitis were classified as having a severe attack, whereas 30 patients with necrotising pancreatitis were categorised as mild attacks. We conclude that the contrast enhanced computed tomography is an aid in deciding on conservative or surgical treatment in a case of acute pancreatitis. Ultrasound does not appear to be an adequate method for determining pancreatic necrosis. The early objective signs fail to sufficiently identify the necrotising form of acute pancreatitis.

10.1136/gut.27.9.1035

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Citations (172)

Experimentelle Untersuchungen zur echographischen Frühestmanifestation der inzipienten Pankreatitis und Pankreasnekrose

RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren (1988)

W Maier

The earliest echographic manifestations of developing pancreatitis or pancreatic necrosis were studied experimentally in five dogs (Beagles). Fifteen minutes after induction of pancreatitis the pancreas was removed and accurately corresponding histological and sonographic serial sections were prepared. Pancreatic necrosis up to 25% was not apparent sonographically. 50% pancreatic necrosis manifested various echo patterns (low echoes, focal hyperechogenicity). 75% and 100% pancreatic necrosis showed characteristic sonographic appearances of focal-nodular hyperechogenicity on an hypo-echogenic background. The study has shown that sonography is a highly sensitive method for recognizing even the earliest stages of acute necrotizing pancreatitis.

Echogenicity

Pancreatic Disease

10.1055/s-2008-1048395

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Citations (1)

Cerebral computed tomography of ethylene glycol intoxication

Neuroradiology (1983)

W Maier

Ethylene Glycol Poisoning

Neuroradiology

10.1007/bf00347839

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Citations (30)

[Ct-morphology and exocrine function in chronic pancreatitis].

PubMed (1983)

Peter Malfertheiner W Maier A Walliser M.W. Büchler H. Ditschuneit

A quantitative correlation between computer-tomographic (CT) findings and exocrine pancreatic function following secretin-ceruletide stimulation was performed in 48 patients with chronic pancreatitis; thereby a significant correlation between the degree of morphological changes in CT and the stage of functional impairment was found (r = 0,7841, p less than 0,001). Bicarbonate secretion/h showed the strongest correlation to CT findings (r = -0,7193, p less than 0,001) within the single functional parameters. CT showed a limited sensitivity (50%) in detecting chronic pancreatitis in cases with a slight functional impairment (stage 1). Morphological signs as calcifications, pancreatic duct ectasia were constantly coupled with a severe degree of functional impairment, whereas enlargement and cysts were found throughout the different functional stages.

Secretin

Ectasia

Functional impairment

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Citations (7)

An neurotensinoma of the head of the pancreas. Demonstration by ultrasound and computed tomography.

PubMed (1982)

W Maier Schumacher Ka H Etzrodt I. Arlart

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Citations (3)

[Radiation exposure of the staff during angiography and percutaneous transluminal angioplasty].

PubMed (1992)

Ludwig Bogner H Czempiel H. Gfirtner H. Gohlke Lössl Hj

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Citations (0)

Computed Tomography in Chronic Pancreatitis

Springer eBooks (1986)

W Maier

10.1007/978-3-642-71128-2_24

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Citations (4)

[The value of computed tomography in the localization of parathyroid adenomas].

PubMed (1990)

A. Goldmann W Maier Mara A. Schonberg

Value (mathematics)

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Diagnostik der nekrotisierenden Pankreatitis: Vergleich von Kontrastmittel-CT und Ultraschall in einer klinischen Studie

DMW - Deutsche Medizinische Wochenschrift (2008)

S. Block W Maier C. Clausen MW Büchler Peter Malfertheiner

Contrast-enhanced computed tomography and (or) sonography was carried out preoperatively in 93 patients undergoing operation for the treatment of severe acute pancreatitis. 77 patients presented with necrotising pancreatitis and 16 with interstitial oedematous pancreatitis predominantly due to biliary causes. The surgical principle involved necrotomy, continuous post-operative bursal lavage or biliary sanitation and (or) pancreas drainage in the case of interstitial oedematous pancreatitis. Sensitivity of contrast-enhanced CT in necrotising pancreatitis was 85%, in localised necrosis 79%, and in extensive necrosis 89.5%. Sonography was negative in 24% of patients and in 37% of those with severe necrotising processes due to extensive masking by intestinal gas. If successful, its sensitivity was 73% only. Thus, sonography is unsuitable for the diagnosis of severe, especially necrotising, pancreatitis; it should be used for confirming the diagnosis and for monitoring the course of mild pancreatitis. Contrast-enhanced CT is indicated for suspected cases involving the necrotising form of the disease, where extensive pancreatic necrosis is registered with high reliability. Controls are advisable for cases with localised pancreatitis.

Pancreatic Disease

10.1055/s-2008-1068912

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Citations (20)

[The clinical use of a new contrast medium injector for computed tomography].

PubMed (1990)

W Maier

High contrast

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