Internists, Gastroenterologist (digestive)


4001 Worth St
3rd Floor
Dallas, TX 75246
Locations and availability (3)

Education ?

Medical School Score Rankings
The University of Texas Southwestern (1959)
  • Currently 4 of 4 apples
Top 25%

Awards & Distinctions ?

Associations
American Board of Internal Medicine

Affiliations ?

Dr. Polter is affiliated with 3 hospitals.

Hospital Affilations

Score

Rankings

  • Baylor University Medical Center
    3500 Gaston Ave, Dallas, TX 75246
    • Currently 4 of 4 crosses
    Top 25%
  • Baylor Specialty Hospital
    3504 Swiss Ave, Dallas, TX 75204
    • Currently 1 of 4 crosses
  • Dallas County Hospital District
  • Publications & Research

    Dr. Polter has contributed to 15 publications.
    Title Stimulated Active Potassium Secretion in a Patient with Colonic Pseudo-obstruction: a New Mechanism of Secretory Diarrhea.
    Date November 2005
    Journal Gastroenterology
    Excerpt

    BACKGROUND & AIMS: Secretory diarrhea is caused by inhibition of intestinal active sodium absorption and stimulation of active chloride secretion. The resulting increase in fecal sodium salts causes an isotonic increase in fecal water output. Abnormalities in potassium transport are not known to be a cause of secretory diarrhea. The aim of our report is to describe a patient with secretory diarrhea that was mediated by excess intestinal secretion of potassium. METHODS: A 78-year-old woman developed colonic pseudo-obstruction, complicated by severe diarrhea and hypokalemia. Her stools were collected quantitatively on 11 occasions and analyzed for electrolyte concentrations. Rectosigmoid potential difference was measured. RESULTS: The diarrheal fluid had a very high potassium concentration (130-170 mEq/L) and a very low sodium concentration (4-15 mEq/L). Stool potassium losses were as high as 256 mEq/day (normal, 9 mEq/day), and fecal sodium losses were never higher than 13 mEq/day. Potential difference between colonic lumen and a peripheral reference electrode was -14 mV (lumen side negative). CONCLUSIONS: Fecal potassium salts were the exclusive driving force for severe secretory diarrhea in a patient with colonic pseudo-obstruction. The high fecal output of potassium was due to stimulation of active colonic potassium secretion, possibly because of changes in autonomic nervous system activity and distention of the colon in association with colonic pseudo-obstruction. The extremely low fecal excretion of sodium indicates that active sodium absorption was not inhibited. This case study reveals an ion transport mechanism of secretory diarrhea that has not been previously appreciated.

    Title Daniel Earl Polter, Md: a Conversation with the Editor. Interview by William Clifford Roberts.
    Date October 2005
    Journal Proceedings (baylor University. Medical Center)
    Title Hepatic Failure As the Presenting Manifestation of Malignant Lymphoma.
    Date December 2001
    Journal Clinical Lymphoma
    Excerpt

    Fulminant hepatic failure carries a high mortality regardless of etiology. Liver transplantation may be lifesaving. Hepatic invasion by malignant lymphoma is a rare cause of liver failure, but one that is potentially responsive to treatment. Lymphoma (non-Hodgkin's or Hodgkin's) should be included in the differential diagnosis of fulminant hepatic failure so that liver transplantation is avoided and appropriate therapy can be instituted. The findings and clinical course of 4 patients with liver failure due to hepatic lymphoma, who were referred to our institution for liver transplant evaluation, are presented and discussed. Medical records, imaging studies, and histological material were examined. Review of the literature revealed less than 40 cases of lymphoma presenting as fulminant hepatic failure. The diagnosis of malignant lymphoma may be difficult. The presenting symptoms and signs are indistinguishable from other causes of fulminant hepatic failure. Early liver biopsy with adequate tissue and immunologic studies is mandatory for diagnosis. This condition may be reversible and may respond to chemotherapy if the diagnosis is made prior to multiorgan system failure. The presence of malignant lymphoma is considered a contraindication to liver transplantation, although firm data are lacking.

    Title Malignant Histiocytosis in a Patient Presenting with Hepatic Dysfunction and Peliosis Hepatis.
    Date March 1995
    Journal The American Journal of Gastroenterology
    Excerpt

    In this article, we report the case of a 36-yr-old patient presenting with manifestations of portal hypertension, hepatic dysfunction, and fever who proved to have peliosis hepatis on liver biopsy. A thorough work-up revealed no obvious etiology. At autopsy, malignant histiocytosis of the liver and bone marrow was diagnosed. This case represents the first report of the association of peliosis hepatis with this rare histiocytic neoplasm and exemplifies the need for persistence in the search for malignancy, particularly hematological malignancy, in the patient with unexplained peliosis. The clinical similarity of peliosis hepatis associated with hematological malignancy and bacillary peliosis is also discussed.

    Title Liver Transplant in Complete Situs Inversus: a Case Report.
    Date September 1993
    Journal Surgery
    Excerpt

    BACKGROUND. Several technical solutions have been proposed for patients with situs inversus (SI) needing liver transplantation. This report describes the hepatic replacement in a patient with complete SI with dextrocardia. In the only other reported patient with complete SI the donor right lobe was placed over the vertebral column and the stomach to align the donor cava with that of the recipient. METHODS. A 45-year-old woman with complete SI, suffering from Laënnec's cirrhosis with frequent upper gastrointestinal hemorrhages, underwent transplantation in June 1991. The recipient weighed 48.2 kilograms and was 155 centimeters tall. The donor weighed 77.3 kilograms and was 188 centimeters tall. The weight of the native liver was 1934 grams, and the donor liver weighed 1595 grams. RESULTS. At hepatectomy of the native liver an intact vena cava was left behind. Donor liver was rotated 90 degrees to the left, making the donor left lobe point into the left iliac fossa and the donor right lobe fall into the recipient hepatic fossa. Donor infrahepatic vena cava was sewn end-to-side to the recipient vena cava. Suprahepatic vena cava was oversewn. Donor and recipient hila were well aligned, allowing a standard arterial reconstruction and a choledocholedochostomy. Patient's recovery was uneventful with no problems during the following 6 months. CONCLUSIONS. The proposed technique for a patient with complete SI and dextrocardia offers several advantages: no need to downsize the donor in comparison with the recipient; no need for cutdown of the liver; no risk of kinking of the venous outflow; hepatic hila are aligned; and it allows for a standard arterial and biliary reconstruction. We recommend this technique as a procedure of choice for patients with SI and an intact vena cava.

    Title Laser Photocoagulation for the Treatment of Acute Peptic-ulcer Bleeding. A Randomized Controlled Clinical Trial.
    Date July 1987
    Journal The New England Journal of Medicine
    Excerpt

    We tested the hypothesis that therapeutic endoscopy using the Nd:YAG (neodymium:yttrium-aluminum-garnet) laser would benefit patients with acute peptic-ulcer bleeding. Over 43 months, 174 patients with active bleeding (n = 32) or stigmata of recent bleeding (n = 142) due to peptic ulcers were randomly assigned during endoscopy to either standard treatment with laser photocoagulation or therapy without photocoagulation. There were no significant differences in a number of outcomes between the group treated with laser photocoagulation and the control group. Continued bleeding or rebleeding was observed in 22 percent of the laser-treated group and in 20 percent of the control group. Urgent surgery was necessary in 16 percent of the laser-treated patients and in 17 percent of the controls. Laser-treated patients spent a mean of 41 hours in the intensive care unit, and controls spent a mean of 32 hours. The mean hospital stay was 12 days in the laser-treated group and 11 days in the control group. One death occurred in each group. When patients with active bleeding were analyzed separately, there was no significant difference in outcome, even though laser photocoagulation stopped active bleeding in 88 percent of cases. Among patients with visible vessels, rebleeding occurred in 5 of 14 (36 percent) who received laser treatment and 2 of 15 (13 percent) who did not. Laser treatment precipitated bleeding in four patients and duodenal perforation in one. We conclude that Nd:YAG-laser photocoagulation does not benefit patients with acute upper gastrointestinal bleeding from peptic ulcers.

    Title Hydrostatic Balloon Dilators--fair or Foul.
    Date November 1986
    Journal Journal of Clinical Gastroenterology
    Title Percutaneous Endoscopic Gastrostomy--to Push or Pull. A Prospective Randomized Trial.
    Date October 1986
    Journal Gastrointestinal Endoscopy
    Excerpt

    A prospective randomized study was undertaken to evaluate the Ponsky-Gauderer and Sachs-Vine types of gastrostomy kits. The techniques, complications, morbidity, and mortality with each type of device are compared. Both devices are found to compare favorably to the traditional surgically placed gastrostomy.

    Title Nonsurgical Management of Lye-induced Antral Stricture with Hydrostatic Balloon Dilation.
    Date August 1986
    Journal Gastrointestinal Endoscopy
    Title Preliminary Experience with Hydrostatic Balloon Dilation of Gastric Outlet Obstruction.
    Date June 1986
    Journal Gastrointestinal Endoscopy
    Excerpt

    In treating a group of 15 patients with gastric outlet obstruction, 12 (80%) had good to excellent relief of symptoms. Two patients required surgical intervention. One patient has symptoms that were persistent but mild enough to forego surgery. Balloon dilation offers an alternative to the surgical management of gastric outlet obstruction.

    Title Beneficial Effect of Cholestyramine in Sclerosing Cholangitis.
    Date October 1980
    Journal Gastroenterology
    Excerpt

    Cholestyramine exerted a beneficial effect on the course of a patient with sclerosing cholangitis associated with ulcerative proctitis. Over a 6.5-yr period, discontinuation of cholestyramine resulted in episodes of RUQ pain and/or appearance of abnormalities in liver tests. Readministration of the resin was followed by disappearance of symptoms and normalization of test resuls. The mechanism of the beneficial effect of cholestyramine was not elucidated.

    Title Colonoscopy in Diagnosis and Polypectomy.
    Date July 1976
    Journal Texas Medicine
    Title Effect of Long Term Anticholinergic Therapy on Gastric Acid Secretion, with Observations on the Serial Measurement of Peak Histalog Response.
    Date September 1970
    Journal Gastroenterology
    Title Anaerobic Bacteria As Cause of the Blind Loop Syndrome. A Case Report with Observations on Response to Antibacterial Agents.
    Date August 1968
    Journal Gastroenterology
    Title Colocutaneous Fistula After a Peg.
    Date
    Journal Gastrointestinal Endoscopy

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