Diagnosis and conservative treatment of congenital disorders of endocrine system in Hannover Medical School (MHH)

About the department

The Department of Gastroenterology, Hepatology and Endocrinology at the Hannover Medical School offers the full range of services in these medical fields. The department specializes in both diagnostics and treatment of diseases of the gastrointestinal tract, liver, endocrine glands, metabolic disorders and diabetes mellitus. Special attention is paid to the treatment of gastrointestinal cancers: esophageal, stomach and bowel tumors, neuroendocrine tumors, liver and bile duct tumors. The department has state-of-the-art diagnostic equipment for high-precision examinations, including endoscopic devices. Medical care is provided both on an inpatient and outpatient basis. The patients' health is in the safe hands of a competent team of doctors with an impressive clinical experience and excellent treatment results. The department is headed by Prof. Dr. med. Heiner Wedemeyer.

The department's gastroenterologists carry out comprehensive examinations of the digestive system, including functional and endoscopic tests. The department most often admits patients with inflammatory bowel disease (Crohn's disease and ulcerative colitis), gastritis, stomach ulcers, gastroesophageal reflux disease, diverticular disease, bowel and stomach polyps, internal haemorrhage, bowel obstruction and other pathologies. In most cases, doctors use carefully thought out drug regimens for treatment. They are often supplemented with diet therapy. Sometimes endoscopic therapeutic procedures are required, for example, to remove polyps, stop intragastric hemorrhage, and eliminate stenoses in the organs of the digestive system.

Particular attention is paid to gastrointestinal oncology, namely the treatment of tumors of the esophagus, stomach and bowel, neuroendocrine tumors, tumors of the liver and bile ducts. Both diagnostics and treatment of patients with such diseases is carried out in close cooperation with oncologists, radiologists, radiation therapists, chemotherapists, general and abdominal surgeons. The department's specialists believe that only the development of the most effective and sparing treatment regimen will allow the patient to get rid of cancer, and therefore they regularly hold interdisciplinary tumor boards. Small tumors at the early stages are removed using endoscopic techniques, while surgical procedures for advanced gastrointestinal cancers are performed in the Department of General and Abdominal Surgery. After cancer treatment, patients are strongly encouraged to undergo regular follow-up examinations to prevent or early detect recurrence.

The team of the department's doctors is deservedly proud of their excellent results in the treatment of liver diseases. They most often deal with the treatment of autoimmune liver diseases (primary biliary cholangitis, primary sclerosing cholangitis, autoimmune hepatitis), vascular lesions of the liver (Budd–Chiari syndrome, Osler–Weber–Rendu syndrome), infectious liver diseases (viral hepatitis), as well as metabolic liver disorders. The specialists also have sufficient experience in the treatment of rare liver pathologies: porphyria, hemochromatosis, Wilson's disease, alpha-1-antitrypsin deficiency, etc. The range of services in the field of hepatology is complemented by the provision of medical care for patients with liver cirrhosis and portal hypertension, as well as their complications.

In addition, the department employs competent endocrinologists whose task is to detect and treat diseases of the pituitary gland, thyroid gland, parathyroid glands and adrenal glands, as well as male and female hypogonadism. The medical facility provides the treatment of type 1 and type 2 diabetes mellitus. The therapeutic options in this field include drug therapy using hypoglycemic drugs, insulin therapy, lifestyle modification, including adherence to diet, avoidance of unhealthy habits, etc. The department's medical team develops comprehensive treatment programs individually for each patient. The specialists in the field of endocrine, abdominal, transplant surgery and nuclear medicine can be involved in the treatment process. As a rule, the examination is carried out on an outpatient basis, and the treatment can be carried out on an outpatient or inpatient basis, depending on the complexity of the clinical case.

The department's main clinical focuses include:

• Diagnostic services
  • Ultrasound diagnostics
    • Native sonography and color Doppler sonography
    • Rectal endosonography
    • Contrast-enhanced ultrasound scanning (also using radiofrequency techniques)
    • Ultrasound-guided fine-needle aspiration biopsy
    • Duplex sonography
    • Ultrasound elastography
    • Innovative methods of ultrasound diagnostics (3D, 4D techniques)
  • Endoscopic diagnostics
    • Gastroscopy
    • Colonoscopy
    • Rectoscopy
    • Endoscopic retrograde cholangiopancreatography
    • Percutaneous liver biopsy
    • Transjugular liver biopsy
    • Endosonography
    • Capsule endoscopy
    • Balloon-assisted enteroscopy
    • Functional diagnostics (intragastric pH-metry, esophageal manometry, anorectal manometry)
• Therapeutic services
  • Ultrasound therapy
    • Ultrasound-guided removal of pathological fluid accumulations (for example, abscess, ascites, pleurisy): puncture, drainage, flushing, instillation of antibiotics
    • Ultrasound-guided removal of liver, kidney and spleen cysts (sclerotherapy, puncture, washing)
    • Ultrasound-guided removal of neoplasms (radiofrequency ablation, microwave ablation)
  • Endoscopic therapy
    • Colonoscopy with polypectomy
    • Elimination of stenoses and obstructions in the gastrointestinal organs using bougienage and balloon dilation
    • Percutaneous endoscopic gastrostomy
    • Percutaneous endoscopic jejunostomy
    • Removal of large polyps with endoscopic mucosal resection
    • Endoscopic treatment of achalasia cardia
    • Endoscopic treatment of Zenker's diverticulum
    • Endoscopic treatment of Barrett's esophagus
    • Cholangioscopy for the treatment of bile duct stenosis and obstruction
    • Radiofrequency ablation for bile duct tumors
    • Biliary stent placement
    • Drainage of pseudocysts and necrectomy (therapy for severe forms of pancreatitis)
    • Minilaparoscopy
• Other medical services