Diagnosis of duodenal stenosis in Hospital Oberberg Waldbrol

About the department

The Department of Gastroenterology and Hepatology at the Hospital Oberberg Waldbrol offers all the possibilities of modern medicine for high-precision diagnostics and effective treatment of gastrointestinal diseases. The department provides drug treatment and endoscopic treatment for patients with diseases of the stomach, esophagus, small intestine, large intestine, rectum, liver, gallbladder, bile ducts, and pancreas. A treatment regimen is elaborated individually for each patient based on the clinical data obtained during comprehensive diagnostics. The department is proud of its state-of-the-art endoscopy rooms, where patients undergo all available examinations and therapeutic procedures in this field. The specialists most often perform gastroscopy and colonoscopy. Many medical services are provided to patients on an outpatient basis. The department has 34 beds. The competent team of the department's doctors treats about 1,500 inpatients and more than 1,000 outpatients annually. The doctors strictly follow the clinical protocols and recommendations of professional societies, taking care of maximum patient comfort during the entire therapeutic process. The department is headed by Dr. med. Hartmut Kristahl.

The department's specialists have vast experience in gastroscopy. This endoscopic procedure allows doctors to visually assess the condition of the mucous membrane of the upper gastrointestinal tract (stomach, esophagus, and duodenum). The department's doctors successfully perform gastroscopy for tissue sampling for a further histologic examination. In addition, this endoscopic manipulation is an effective and minimally invasive method for stomach polyp removal. The department's doctors also successfully use gastroscopy to arrest gastrointestinal bleeding, remove foreign bodies from the upper gastrointestinal tract, or eliminate esophageal and pyloric stenosis. For patients to avoid pain and discomfort during gastroscopy, the specialists use sedation. The duration of the procedure takes only 5-10 minutes, but if therapeutic interventions are required, it may take more time.

Another frequently used diagnostic and treatment method in the department is colonoscopy. This endoscopic procedure is used to assess the condition of the mucous membrane of the colon and rectum using a special flexible device with a built-in camera (colonoscope). A colonoscopy is used to take tissue samples from a suspicious area for follow-up examination. It is also the main screening method for colon cancer (one of the most common and life-threatening types of oncology). The procedure is also successfully used in the department for therapeutic purposes, such as the removal of colon polyps and small colon tumors in the early stages, the arrest of internal bleeding, and the elimination of stenosis. Sedation or local anesthesia may be used for pain management during a colonoscopy. The procedure usually lasts 20-30 minutes.

The department's range of medical services also includes endoscopic retrograde cholangiopancreatography (ERCP). Endoscopic and X-ray devices are used during the examination. The procedure is indicated for patients with suspected bile duct stones, bile duct stenosis, bile duct obstruction, bile duct tumors, or pancreatic tumors. Doctors approach the pancreatobiliary organs by inserting a flexible endoscope with a camera built into it through the oral cavity. The endoscope passes through the esophagus and stomach into the duodenum, entering the hepatopancreatic ampulla (junction of the orifices of the common bile duct and the pancreatic duct). The doctor then introduces a thin probe at the end of the endoscope into the desired anatomical area, injecting a contrast agent, which generates highly precise images on the screen of the X-ray device. If, during diagnostic endoscopic retrograde cholangiopancreatography, the department's specialists detect gallstones, bile duct stenosis, or other pathological changes, they mostly immediately carry out the necessary therapeutic manipulations. ERCP is performed under sedation, so pain is excluded.

The department's main clinical focuses include:

• Diagnostic options
  • Endoscopic examinations
    • Gastroscopy to examine the stomach, esophagus, and duodenum
    • Colonoscopy to examine the large intestine
    • Endoscopic retrograde cholangiopancreatography (ERCP) to examine the gallbladder, bile ducts, and pancreas
    • Small bowel capsule endoscopy
    • Endosonography of all parts of the gastrointestinal tract, including the bile ducts, pancreas, and liver, including targeted ultrasound-guided puncture biopsy
  • Ultrasound examinations
    • Classical abdominal ultrasound and Doppler ultrasonography of the blood vessels in the abdominal cavity
    • Contrast-enhanced ultrasound examinations
    • Liver elastography
    • Contrast-enhanced liver ultrasound
  • Functional diagnostics
    • Esophageal manometry
    • Esophageal pH monitoring and impedance measurement
    • Breath tests for suspected lactose and fructose intolerance
    • 13C-urea breath test for Helicobacter pylori infection
• Therapeutic options
  • Gastroscopy to remove stomach polyps and small stomach tumors in the early stages, arrest gastrointestinal bleeding, remove foreign bodies from the upper gastrointestinal tract, and eliminate esophageal and stomach stenosis or stricture
  • Colonoscopy to remove colon polyps and small colon tumors in the early stages, arrest gastrointestinal bleeding, remove foreign bodies from the colon, and eliminate colon stricture
  • Endoscopic retrograde cholangiopancreatography (ERCP) to remove gallstones, implant, replace, or remove stents in cases of stenoses, and remove small tumors in the early stages
  • Percutaneous transhepatic cholangiography with internal and external bile duct drainage procedures
  • Botulinum toxin injections for esophageal achalasia
• Other diagnostic and treatment methods

Photo of the doctor: (c) Klinikum Oberberg GmbH