Gastroenterology
Dr. med. Martin Brennenstuhl & Dr. med. Reinhold Wagner
The division covers all areas of clinical gastroenterology, hepatology and gastroenterological oncology. Besides standard diagnostics and therapy of illnesses of the esophagus, stomach, small intestine, colon, bile tracts, liver and pancreas special focuses lie on the area of interventional endoscopy and the diagnostics and therapy of oncological patients. In this context we can offer a highly specialized care close to home and emergency endoscopy around the clock.
Therapy planning for oncological patients takes place in close and interdisciplinary consultation with the inhouse oncology (Dr. Raßmann, Dr. Dietzfelbinger, Dr. Hubmann) within the scope of regular in-session tumor boards at the Klinik Dr. Robert Schindlbeck (for example in cooperation with the pathology Starnberg and radiation therapy Weilheim) as well as at the Klinikum München-Bogenhausen and further structured cooperations for specific questions or rare procedures.
In detail following procedures are performed inhouse:
Gastroenterological diagnostics includes:
laboratory chemical examinations, breath tests, lactose intolerance quick testing
ultrasound examinations:
The ultrasound examination of the abdominal organs is performed with state-of-the-art equipment of its reference class. This allows an expansion of diagnostics in terms of contrast media enhanced sonography, elastography, as well as color flow mapping Doppler and duplex sonography of the abdominal vessels. Organ biospies are performed low-risk under sonographic control with a specific puncture sonic head.
Endoscopy:
- gastroscopy, coloscopy, ERCP
- Push enteroscopy, push-and-pull enteroscopy
- Flexible endosonography with radial and longitudinal head including elastography, KM sonography, color duplex for the evaluation of the esophagus, stomach, duodenum, pancreas, rectum, especially during the local staging and the follow-up care of oncological results, highest sensivity towards chronic pancreatitis, pseudocysts and choledocholithiasis, pararectal abscesses, clarification of obscure constrictions or submucosal processes within the gastrointestinal tract.
- Capsule endoscopy of the small intestine
- In cooperation: pH metry, HD manometry/impedance measurement, incontinence diagnostics, PTCD, TACE, radio frequency ablation of metastases or Barrett SH, MRCP, MR enteroclysis, virtual coloscopy
Endoscopic examinations are performed according to the patients’ wishes without premedication or in (analgo)sedation with the administration of oxygen. Here the cardiovascular system is under constant surveillance (RR/pulse, ECG, pulse oximetry). Sedation guidelines are closely monitored, if required an anesthesist is consulted.
The examinations are performed with modern high resolution digital video endoscopy equipment, if needed as (virtual) chromoendoscopy (i-scan / endoscopic colouring of the mucuous membranes of the gastrointestinal tract). The convenient new endoscopy of the clinic is on current status and in service since 2011 and additionally features a digital X-ray-DL-device.
The endoscopic equipment is cleaned and tested following present hygiene regulations using latest technology. Only disposable product applications are used for this procedure.
The phsycian performing the endoscopy and the assisting staff attend advanced trainings visiting courses and conferences several times a year.
Therapeutic procedures:
- Hemostasis (injection therapy, clipping, endoclot, fibrin glue, elastic band ligation, sclerotherapy)
- Expansion of obstructions at the esophagus, pylorus, colon and rectum as well small intestine (for example Crohn disease), achalasia treatment
- Esophagus varicose vein and hemorrhoid banding
- Polyp ablation including mucotomy
- Argon-plasma-coagulation (angiodysplasia, GAVE syndrome)
- Stenting of all kinds (including metal stent)
- Therapeutic ERCP: papillotomy with gallstone extraction, bile duct and pancreas drainages.