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Biomedical subjects

A H Zalev

Publications and source records attributed to A H Zalev.

17 recordsLinked to original sources
PubMed1992

Crohn's disease of the proximal small intestine: radiologic findings in 55 patients.

Radiographs of the upper gastrointestinal tract and the small bowel of 55 patients were reviewed to identify changes associated with proximal enteric Crohn's disease. Five patients had gastroduodenitis, 18 duodenitis, 14 jejunitis and 18 jejunoileitis. Nineteen had previously undergone ileocecal resection. The terminal ileum was spared in 11 of the 36 patients who had not undergone ileocecal resection; of these, 9 had jejunoileitis, 1 jejunitis and 1 jejunitis secondary to colitis with colojejunal fistulas. In just over 80% of the patients with jejunal disease and all the patients with primary jejunal disease in whom the terminal ileum was spared, the condition developed before the patients reached 30 years of age. Duodenal disease was not associated with any particular age group, and duodenitis was invariably a "skip" lesion in patients with disease of the terminal ileum. The diagnosis of proximal enteric Crohn's disease depended on the presence of one or more characteristic lesions in the jejunum or terminal ileitis associated with a duodenal or jejunal abnormality. Ulceration occurred in 88% of the patients with a diseased terminal ileum but was less common in patients with a diseased duodenum (occurring in 43%), jejunum (in 53%) or proximal ileum (in 57%). Fistulas in the terminal ileum complicate ulceration in 10% to 26% of patients, and sinuses complicate ulceration slightly more often, but proximal enteric fistulas or sinuses occurred in only four (7%) of the patients described here.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Crohn's disease of the small intestine with polypoid configuration.

We describe three patients with Crohn's disease of the small intestine with a polypoid configuration. In two patients, the polypoid masses were the only radiologic abnormalities and were suggestive of jejunoileal lymphoma and terminal ileal adenomas. The diagnosis of Crohn's disease was established only at laparotomy. In the third patient, a polypoid mass simulating a sessile adenoma was seen along with other typical features of ileitis and was recognized preoperatively as a manifestation of the ileitis. The resected ileal segments of all three patients showed mural thickening, luminal narrowing and distortion, and mucosal ulceration and fissuring. The asymmetry of the mural thickening and the resultant luminal narrowing simulated sessile polyps to which mucosal ulceration and fissuring gave a lobulated appearance.

Adolescent↗
PubMed1991

Double-contrast hypotonic duodenography after enteroclysis.

The authors describe a technique for obtaining a double-contrast hypotonic duodenogram after a small-bowel enema examination. They have used this technique successfully in patients with unexplained gastrointestinal bleeding and to assess duodenal involvement in patients with Crohn's disease.

Adolescent↗
PubMed1990

Linitis plastica of the alimentary tract and scrotum.

We present a unique case of diffuse linitis plastica involving the gastrointestinal tract and the scrotal skin of a 63-year-old man. The radiologic and pathologic features of this entity are discussed together with a review of the pertinent literature.

Adenocarcinoma, Scirrhous↗
PubMed1989

Shigella colitis with radiological and endoscopic correlation: case report.

We report a patient with acute colitis secondary to Shigella flexneri infection. Radiologic and endoscopic studies were obtained during and after the patient's clinical recovery. Hypotonic air contrast barium enemas were helpful in evaluating the severity and extent of the disease proximal to the segment viewed by flexible sigmoidoscopy. They showed pseudopolyposis, which has not been previously reported in the acute phase, and other mucosal abnormalities which persisted long after clinical recovery.

Colitis↗
PubMed1989

Carcinoma of the fallopian tube presenting as renal failure: case report.

We describe a patient with carcinoma of a fallopian tube initially presenting with oliguric renal failure. Urinary tract symptoms are uncommon as a result of this rare tumor, and renal failure due to bilateral ureteral obstruction by nodal metastases has not been reported previously as a complication.

Acute Kidney Injury↗
PubMed1989

The total fundoplication gastroplasty: surgical procedure and radiologic appearance.

The total fundoplication gastroplasty (TFG) consists of a combination of an esophagus-lengthening Collis gastroplasty and suturing of the gastric fundus to the esophagus and neo-esophagus to produce a stable intra-abdominal segment together with a complete Nissen fundoplication tailored in length to control reflux and avoid overcompetence. We studied 50 patients at least three months after TFG with an upper gastrointestinal examination and a tube esophagogram. Tube esophagography enhances distension of the esophagus and esophagogastric junction and eliminates the barium pool often seen in the distal esophagus in double-contrast esophagography. With this technique we were better able to understand the radiologic anatomy of the esophagogastric junction following TFG. Tube esophagography provided additional radiologic information in the five patients (10%) with preoperative peptic strictures of the esophagus. We describe the surgical and radiologic anatomy of the TFG, the technique of postoperative radiographic examination, and the postoperative problems we have encountered.

Adolescent↗
PubMed1988

Fine-needle aspiration biopsy of an islet cell tumour simulating pancreatic carcinoma.

The importance of distinguishing between malignant islet cell tumour and pancreatic carcinoma is emphasized in this report of a 57-year-old woman who presented with an epigastric mass. Clinically and radiologically it was diagnosed as a pancreatic adenocarcinoma. A fine-needle aspiration biopsy specimen obtained under ultrasonic guidance showed tumour cells suggestive of an islet cell tumour. Immunostaining and electron microscopy were performed on the aspirate. The tumour cells stained positive with antibodies to keratin, glucagon and gastrin; ultrastructural examination revealed neurosecretory granules, confirming the diagnosis of an islet cell tumour. Angiography was performed to assess the possibility of debulking the mass. This case demonstrates the value of immunohistochemistry and electron microscopy on fine-needle aspiration biopsy specimens of the pancreas to differentiate islet cell tumours, which are potentially curable, from pancreatic adenocarcinomas, which carry a 5-year survival rate of less than 2%.

Adenocarcinoma↗
PubMed1988

Radiologic treatment of a patient with the "steakhouse syndrome": case report.

A method of treating the "steakhouse syndrome" (esophageal obstruction due to meat impaction), employing air insufflation via a nasoesophageal tube with esophageal hypotonia, is described as applied in one patient. The technique is a modification of tube esophagography and can be attempted when the combination of an effervescent agent and a hypotonic drug has been unsuccessful.

Aged↗
PubMed1987

A comparative assessment of tube esophagography with double-contrast esophagography in the detection of reflux esophagitis.

We undertook a prospective study comparing the sensitivities of double-contrast and tube esophagography in 34 patients with gastroesophageal reflux and compared our findings with those at endoscopy. Neither test detected changes accurately in mild inflammation; however, they both became more sensitive as the severity of esophagitis increased. The sensitivity of both tests increased from 0% in grade 2 to 86% in grade 4 esophagitis. The tube esophagogram demonstrated inflammatory changes better than the double-contrast esophagogram in only 18% of the 34 patients, all with grade 3 or 4 esophagitis, despite the elimination of the barium pool in the distal esophagus and improved distension of the esophagogastric junction. Endoscopy is still the most reliable means of diagnosing and grading esophagitis.

Adolescent↗
PubMed1986

Recurrent hepatoma with CT, MRI, and angiographic correlation.

Two patients who underwent successful resections for uninodular hepatomas in non-cirrhotic livers were readmitted with late recurrences. Both had multiple imaging procedures prior to treatment including computed tomography, magnetic resonance imaging, and angiography. I recommend periodic ultrasonography and alphafetoprotein assay in the follow-up of patients who have had a hepatoma resected and I indicate when additional imaging methods are required.

Adult↗
PubMed1985

Reliability of amniotic fluid volume estimation from ultrasonograms: intraobserver and interobserver variation before and after the establishment of criteria.

This study assesses levels of intraobserver and interobserver agreement for the determination of decreased and normal amniotic fluid volumes, both before and after the development of criteria. Good to excellent levels of agreement were obtained. Agreement may be higher after the development of criteria and may be higher for more experienced ultrasonographers.

Amniotic Fluid↗