S Guth
University of Hamburg
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Medizinische Klinik | 2010
S Guth; Carola Gocke; Jürgen Gebhardt; Wolfgang Schwenk; Jörg Caselitz; Christoph M. Bamberger
BACKGROUND Lymphangioma is an uncommon tumor, an intraperitoneal lymphangiolipoma is exceedingly rare. These tumors are principally benign, but lead to complications due to their size and localization. CASE REPORT A 46 year old male patient presented for a regular medical check up. Apart from a hearing loss 2006 and 2008 he reported no previous or chronic diseases. An extensive health examination had been performed two years ago and had been without pathological results. Abdominal ultrasound revealed a large polycystic lesion in the right middle and lower abdomen, approximately 12x10x7 cm in size. There was no vascularisation in the septae. In MRI, the tumor appeared cystic as well without communication to the intestinal wall. Laboratory values including echinococcus serology was without pathological results. An explorative laparotomy was done with right hemicolectomy and subsequent ileotransversostomy. Histologically, a lymphangiolipoma was diagnosed, as well as a chronic appendicitis and chronic lymphangitis of the ileocolic lymph nodes. Postoperatively, the patient recovered without any complications. CONCLUSION Lymphangiomas, especially lymphangiolipomas, are an extremely rare differential diagnosis of intraabdominal cystic tumors. Potential complications included ileus, intussusception or an immuring growth. Abdominal ultrasound can reveal important pathological findings even in symptom- free patients.ZusammenfassungHintergrund:Lymphangiome, speziell Lymphangiolipome sind extrem seltene Tumoren im Mesenterium. Es sind benigne Raumforderungen mit vorwiegender Manifestation in der Kindheit, die aber aufgrund ihrer Größe, eines ummauernden Wachstums und ihrer Rezidivneigung häufiger zu Problemen führen können.Fallbeschreibung:Ein 46-jähriger Patient stellte sich beschwerdefrei zu einer internistischen Vorsorgeuntersuchung vor. Bis auf zwei Hörstürze 2006 und 2008 war die Vorgeschichte leer. Eine umfassende Voruntersuchung 2 Jahre zuvor war ohne auffälligen Befund geblieben. In der abdominellen Sonographie fiel eine große (ca. 12x10x7 cm) cystische mehrfach septierte Raumforderung mit echofreiem Inhalt ohne Vaskularisation im rechten Mittel- und Unterbauch auf. Ein umfassendes internistisches Routinelabor incl. Echinococcusserologie (der Patient war Jäger) war unauffällig. Auch in der abdominellen MRT zeigte sich eine zystisch-liquide Raumforderung ohne Vaskularisation der Septen, eine Verbindung zum Darm oder zu anderen Organen war nicht nachweisbar. Es erfolgte die explorative Laparatomie mit Hemicolektomie rechts und Anlage einer Ileotransversostomie. Die Histologie ergab die Diagnose eines Lymphangiolipoms, einer chronischen Appendicitis sowie einer chronischen Lymphadenitis der ileocolischen Lymphknoten ohne Hinweis für Malignität oder Spezifität. Der postoperative Verlauf war unkompliziert.Schlussfolgerung:Das Lymphangiom bzw. die Subspezifität Lymphangiolipom ist eine seltene Differentialdiagnose cystischer intraabdomineller Tumoren. Mögliche Komplikationen sind Ileus, Invaginationen und auch ein ummauerndes Wachstum. Abdomineller Ultraschall erhebt in der Vorsorge wichtige Befunde auch bei beschwerdefreien Patienten.AbstractBackground:Lymphangioma is an uncommon tumor, an intraperitoneal lymphangiolipoma is exceedingly rare. These tumors are principally benign, but lead to complications due to their size and localization.Case Report:A 46 year old male patient presented for a regular medical check up. Apart from a hearing loss 2006 and 2008 he reported no previous or chronic diseases. An extensive health examination had been performed two years ago and had been without pathological results. Abdominal ultrasound revealed a large polycystic lesion in the right middle and lower abdomen, approximately 12x10x7 cm in size. There was no vascularisation in the septae. In MRI, the tumor appeared cystic as well without communication to the intestinal wall. Laboratory values including echinococcus serology was without pathological results. An explorative laparotomy was done with right hemicolectomy and subsequent ileotransversostomy. Histologically, a lymphangiolipoma was diagnosed, as well as a chronic appendicitis and chronic lymphangitis of the ileocolic lymph nodes. Postoperatively, the patient recovered without any complications.Conclusion:Lymphangiomas, especially lymphangiolipomas, are an extremely rare differential diagnosis of intraabdominal cystic tumors. Potential complications included ileus, intussusception or an immuring growth. Abdominal ultrasound can reveal important pathological findings even in symptom- free patients.
Medizinische Klinik | 2011
S Guth; Carola Gocke; Jürgen Gebhardt; Wolfgang Schwenk; Jörg Caselitz; Christoph M. Bamberger
BACKGROUND Lymphangioma is an uncommon tumor, an intraperitoneal lymphangiolipoma is exceedingly rare. These tumors are principally benign, but lead to complications due to their size and localization. CASE REPORT A 46 year old male patient presented for a regular medical check up. Apart from a hearing loss 2006 and 2008 he reported no previous or chronic diseases. An extensive health examination had been performed two years ago and had been without pathological results. Abdominal ultrasound revealed a large polycystic lesion in the right middle and lower abdomen, approximately 12x10x7 cm in size. There was no vascularisation in the septae. In MRI, the tumor appeared cystic as well without communication to the intestinal wall. Laboratory values including echinococcus serology was without pathological results. An explorative laparotomy was done with right hemicolectomy and subsequent ileotransversostomy. Histologically, a lymphangiolipoma was diagnosed, as well as a chronic appendicitis and chronic lymphangitis of the ileocolic lymph nodes. Postoperatively, the patient recovered without any complications. CONCLUSION Lymphangiomas, especially lymphangiolipomas, are an extremely rare differential diagnosis of intraabdominal cystic tumors. Potential complications included ileus, intussusception or an immuring growth. Abdominal ultrasound can reveal important pathological findings even in symptom- free patients.ZusammenfassungHintergrund:Lymphangiome, speziell Lymphangiolipome sind extrem seltene Tumoren im Mesenterium. Es sind benigne Raumforderungen mit vorwiegender Manifestation in der Kindheit, die aber aufgrund ihrer Größe, eines ummauernden Wachstums und ihrer Rezidivneigung häufiger zu Problemen führen können.Fallbeschreibung:Ein 46-jähriger Patient stellte sich beschwerdefrei zu einer internistischen Vorsorgeuntersuchung vor. Bis auf zwei Hörstürze 2006 und 2008 war die Vorgeschichte leer. Eine umfassende Voruntersuchung 2 Jahre zuvor war ohne auffälligen Befund geblieben. In der abdominellen Sonographie fiel eine große (ca. 12x10x7 cm) cystische mehrfach septierte Raumforderung mit echofreiem Inhalt ohne Vaskularisation im rechten Mittel- und Unterbauch auf. Ein umfassendes internistisches Routinelabor incl. Echinococcusserologie (der Patient war Jäger) war unauffällig. Auch in der abdominellen MRT zeigte sich eine zystisch-liquide Raumforderung ohne Vaskularisation der Septen, eine Verbindung zum Darm oder zu anderen Organen war nicht nachweisbar. Es erfolgte die explorative Laparatomie mit Hemicolektomie rechts und Anlage einer Ileotransversostomie. Die Histologie ergab die Diagnose eines Lymphangiolipoms, einer chronischen Appendicitis sowie einer chronischen Lymphadenitis der ileocolischen Lymphknoten ohne Hinweis für Malignität oder Spezifität. Der postoperative Verlauf war unkompliziert.Schlussfolgerung:Das Lymphangiom bzw. die Subspezifität Lymphangiolipom ist eine seltene Differentialdiagnose cystischer intraabdomineller Tumoren. Mögliche Komplikationen sind Ileus, Invaginationen und auch ein ummauerndes Wachstum. Abdomineller Ultraschall erhebt in der Vorsorge wichtige Befunde auch bei beschwerdefreien Patienten.AbstractBackground:Lymphangioma is an uncommon tumor, an intraperitoneal lymphangiolipoma is exceedingly rare. These tumors are principally benign, but lead to complications due to their size and localization.Case Report:A 46 year old male patient presented for a regular medical check up. Apart from a hearing loss 2006 and 2008 he reported no previous or chronic diseases. An extensive health examination had been performed two years ago and had been without pathological results. Abdominal ultrasound revealed a large polycystic lesion in the right middle and lower abdomen, approximately 12x10x7 cm in size. There was no vascularisation in the septae. In MRI, the tumor appeared cystic as well without communication to the intestinal wall. Laboratory values including echinococcus serology was without pathological results. An explorative laparotomy was done with right hemicolectomy and subsequent ileotransversostomy. Histologically, a lymphangiolipoma was diagnosed, as well as a chronic appendicitis and chronic lymphangitis of the ileocolic lymph nodes. Postoperatively, the patient recovered without any complications.Conclusion:Lymphangiomas, especially lymphangiolipomas, are an extremely rare differential diagnosis of intraabdominal cystic tumors. Potential complications included ileus, intussusception or an immuring growth. Abdominal ultrasound can reveal important pathological findings even in symptom- free patients.
Phlebology | 2018
Alexander T Kropp; A Ludwig Meiss; Angelika E Guthoff; Eik Vettorazzi; S Guth; Christoph M. Bamberger
Objective Venous stasis is a risk factor for venous thromboembolism. We aimed to determine the efficacy of forceful foot exercises for actuation of the calf muscle pump to counteract stasis. Methods We examined 20 seated healthy subjects. The peak systolic velocity at the level of the popliteal vein was assessed by Doppler ultrasound. Results The mean peak systolic velocity measurements (in cm/s) were as follows: baseline = 5.6; ankle plantar flexion with toe flexion = 91.0; toe touch heel lift = 107.4; ankle dorsiflexion with toe extension = 193.6; isolated flexion of all toes = 118.8; ankle plantarflexion with 100 and 250 Newton forefoot force = 89.9 and 154.5, respectively. Conclusion All exercises achieved significant increases in peak systolic velocity compared to baseline. Ranking showed that forceful ankle dorsiflexion, plantarflexion with 250 Newtons and forceful flexion of all toes yielded the highest mean peak systolic velocity values (193.6, 154.5, and 118.8 cm/s, respectively).
Ultrasound International Open | 2016
S Guth; E. Windler; U. Leise; Christoph M. Bamberger
Ultrasonography has become available to most physicians in primary care. Increasingly hepatic steatosis becomes a chance finding, which has been shown to be associated with cardiovascular risk factors, surrogates of vascular disease, and vascular events. This study tries to answer the question whether it is justified to recommend a cardiovascular workup in response to the incidental finding of hepatic steatosis in asymptomatic healthy individuals. The data of 259 healthy women and 561 men aged 19–93 years, who consecutively underwent a primary preventive check-up, were retrospectively analyzed. Ultrasonography for diagnosis of hepatic steatosis, determination of the maximal intima media thickness (IMT) and plaques of the carotid arteries was performed by a single certified physician according to conventional criteria. Hepatic steatosis was found in 28.3% men and 7.7% women. In 88% the steatosis was judged to be mild. These individuals differed from those without hepatic steatosis in body mass index, ALAT, GGT, HbA1c, fasting glucose, triglycerides, HDL and lipoprotein(a). The IMT was higher and plaques were more prevalent. In logistic regression analysis hepatic steatosis was a highly significant predictor of the presence of an IMT>0.8 mm or carotid plaques besides age and sex. This was also the case in analyses including BMI, or multiple risk factors, which added only lipoprotein(a) as a predictor. The incidental diagnosis of hepatic steatosis is a strong indicator for the presence of cardiovascular risk factors and even signs of developing atherosclerosis. Thus, the recommendation of further cardiovascular workups seems appropriate.
Medizinische Klinik | 2010
S Guth; Carola Gocke; Jürgen Gebhardt; Wolfgang Schwenk; Jörg Caselitz; Christoph M. Bamberger
BACKGROUND Lymphangioma is an uncommon tumor, an intraperitoneal lymphangiolipoma is exceedingly rare. These tumors are principally benign, but lead to complications due to their size and localization. CASE REPORT A 46 year old male patient presented for a regular medical check up. Apart from a hearing loss 2006 and 2008 he reported no previous or chronic diseases. An extensive health examination had been performed two years ago and had been without pathological results. Abdominal ultrasound revealed a large polycystic lesion in the right middle and lower abdomen, approximately 12x10x7 cm in size. There was no vascularisation in the septae. In MRI, the tumor appeared cystic as well without communication to the intestinal wall. Laboratory values including echinococcus serology was without pathological results. An explorative laparotomy was done with right hemicolectomy and subsequent ileotransversostomy. Histologically, a lymphangiolipoma was diagnosed, as well as a chronic appendicitis and chronic lymphangitis of the ileocolic lymph nodes. Postoperatively, the patient recovered without any complications. CONCLUSION Lymphangiomas, especially lymphangiolipomas, are an extremely rare differential diagnosis of intraabdominal cystic tumors. Potential complications included ileus, intussusception or an immuring growth. Abdominal ultrasound can reveal important pathological findings even in symptom- free patients.ZusammenfassungHintergrund:Lymphangiome, speziell Lymphangiolipome sind extrem seltene Tumoren im Mesenterium. Es sind benigne Raumforderungen mit vorwiegender Manifestation in der Kindheit, die aber aufgrund ihrer Größe, eines ummauernden Wachstums und ihrer Rezidivneigung häufiger zu Problemen führen können.Fallbeschreibung:Ein 46-jähriger Patient stellte sich beschwerdefrei zu einer internistischen Vorsorgeuntersuchung vor. Bis auf zwei Hörstürze 2006 und 2008 war die Vorgeschichte leer. Eine umfassende Voruntersuchung 2 Jahre zuvor war ohne auffälligen Befund geblieben. In der abdominellen Sonographie fiel eine große (ca. 12x10x7 cm) cystische mehrfach septierte Raumforderung mit echofreiem Inhalt ohne Vaskularisation im rechten Mittel- und Unterbauch auf. Ein umfassendes internistisches Routinelabor incl. Echinococcusserologie (der Patient war Jäger) war unauffällig. Auch in der abdominellen MRT zeigte sich eine zystisch-liquide Raumforderung ohne Vaskularisation der Septen, eine Verbindung zum Darm oder zu anderen Organen war nicht nachweisbar. Es erfolgte die explorative Laparatomie mit Hemicolektomie rechts und Anlage einer Ileotransversostomie. Die Histologie ergab die Diagnose eines Lymphangiolipoms, einer chronischen Appendicitis sowie einer chronischen Lymphadenitis der ileocolischen Lymphknoten ohne Hinweis für Malignität oder Spezifität. Der postoperative Verlauf war unkompliziert.Schlussfolgerung:Das Lymphangiom bzw. die Subspezifität Lymphangiolipom ist eine seltene Differentialdiagnose cystischer intraabdomineller Tumoren. Mögliche Komplikationen sind Ileus, Invaginationen und auch ein ummauerndes Wachstum. Abdomineller Ultraschall erhebt in der Vorsorge wichtige Befunde auch bei beschwerdefreien Patienten.AbstractBackground:Lymphangioma is an uncommon tumor, an intraperitoneal lymphangiolipoma is exceedingly rare. These tumors are principally benign, but lead to complications due to their size and localization.Case Report:A 46 year old male patient presented for a regular medical check up. Apart from a hearing loss 2006 and 2008 he reported no previous or chronic diseases. An extensive health examination had been performed two years ago and had been without pathological results. Abdominal ultrasound revealed a large polycystic lesion in the right middle and lower abdomen, approximately 12x10x7 cm in size. There was no vascularisation in the septae. In MRI, the tumor appeared cystic as well without communication to the intestinal wall. Laboratory values including echinococcus serology was without pathological results. An explorative laparotomy was done with right hemicolectomy and subsequent ileotransversostomy. Histologically, a lymphangiolipoma was diagnosed, as well as a chronic appendicitis and chronic lymphangitis of the ileocolic lymph nodes. Postoperatively, the patient recovered without any complications.Conclusion:Lymphangiomas, especially lymphangiolipomas, are an extremely rare differential diagnosis of intraabdominal cystic tumors. Potential complications included ileus, intussusception or an immuring growth. Abdominal ultrasound can reveal important pathological findings even in symptom- free patients.
Ultraschall in Der Medizin | 2016
S Guth; M Höpfner; C Gocke; A Guthoff
Ultraschall in Der Medizin | 2016
S Guth; C Gocke; A Guthoff; J Gebhardt; Cm Bamberger
Ultraschall in Der Medizin | 2014
S Guth; J Gebhardt; Cm Bamberger
Ultraschall in Der Medizin | 2014
S Guth; J Gebhardt; A Guthoff; C Gocke; Cm Bamberger
Ultraschall in Der Medizin | 2013
S Guth; A Guthoff; J Gebhardt; Cm Bamberger