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Biomedical subjects

A M McLean

Publications and source records attributed to A M McLean.

27 records · Page 2Linked to original sources
PubMed1983

Chronic erosive gastritis--a recently recognized disorder.

We have reviewed the clinical manifestations, endoscopic findings, pathology, and upper gastrointestinal x-rays in 10 patients with chronic erosive gastritis, a disorder that was rarely recognized before the use of double-contrast upper gastrointestinal radiology and endoscopy. The characteristic x-ray appearance is that of a series of 3 to 11-mm nodules, some with central collections of barium, that are distributed along rugal folds and usually extend into the antrum. The endoscopic appearance is similar: small erythematous nodules with shallow central erosions. The pathology differs from that seen in peptic ulcer disease. There are few polymorphonuclear leukocytes and a predominance of plasma cells in the inflammatory infiltrate. Seven of our patients presented with epigastric pain similar to that of peptic ulcer disease; four of these also had anorexia and weight loss. In two other patients anorexia and weight loss were the only symptoms. One patient was asymptomatic. All nine symptomatic patients responded to antacid treatment. However, repeat x-rays demonstrated persistence of the nodules, although the central erosions usually disappeared. The etiology is unknown. Chronic erosive gastritis appears to be a distinct entity different from peptic ulcer disease.

Adult↗
PubMed1982

The relationship between hypoalbuminaemia and the radiological appearances of the jejunum in tropical sprue.

Hypoalbuminaemia has been implicated as a possible cause of the radiological abnormalities of the small intestine in tropical sprue. Barium follow-through examination was performed in 35 southern Indian patients with documented tropical sprue, and jejunal width and fold pattern abnormalities were compared with those of a local age-matched control group. Although hypoalbuminaemia was present in 66% of patients with tropical sprue, in only one case was an increase in jejunal calibre associated with a serum albumin concentration below 27 g/l, the threshold below which jejunal dilatation occurs in hypoalbuminaemia alone. These findings suggest that other factors, such as the extent of the mucosal injury, are likely to be more important than hypoalbuminaemia in producing jejunal dilatation in this condition. Abnormalities of fold pattern occurred more frequently than increase in jejunal calibre and appear to be a more sensitive indicator of disease.

Adolescent↗
PubMed1982

Chronic erosive gastritis--clinical and radiological features.

Chronic erosive gastritis has been regarded as an unusual, ill-defined condition of unknown etiology. We report a retrospective study of 40 patients in whom this diagnosis was made relating radiologic findings to patients' age, symptomatology and possible etiologic factors. The condition is more common than previously suspected and requires careful technique combining double contrast and graded compression to demonstrate fine mucosal abnormalities. The radiologic appearance is of mucosal mounds measuring 3-11 mm in diameter with central barium collections and numbering from 3-27 per examination. Antral involvement occurred in 90% of patients, with diffuse involvement of both antrum and body in 58%. Several linear erosions measuring up to 15 mm in length were also demonstrated. Chronic erosive gastritis is most severe and symptomatic between 40 and 60 years, becoming sub-clinical in the elderly. Symptoms mimic those of a peptic ulcer or gastric neoplasm and are more severe the more extensive the disease. Gastric irritants, virus infection and Crohn's disease were possible etiologic factors in some patients in this study.

Adult↗
PubMed1981

Computed tomography in patients with an abdominal mass: effective and efficient? A controlled trial.

In 28 of 53 patients with a palpable abdominal mass computed tomography (CT) was used as the initial imaging technique, and conventional imaging was used in the remaining 25 patients. The diagnosis was established more quickly in the CT group, and the period of inpatient investigation was shorter. The cost of imaging investigations was higher for the CT group, but this difference was small when compared with the difference in cost of inpatient stay. CT seems accurate in the investigation of a palpable abdominal mass and particularly useful in excluding a pathological cause. The need for the latter is emphasised by the fact that no lesion could be found in 23 of the 53 patients.

Abdominal Neoplasms↗
PubMed1981

Radiologic features of the jejunum in hypoalbuminemia.

Although hypoalbuminemia is a recognized cause of jejunal dilatation, the level of serum albumin at which this occurs and its relation to the extent of jejunal dilatation in celiac disease have not been clearly established. Barium follow-through examination was performed in 12 patients with hypoalbuminemia, in 21 patients with celiac disease, some of whom had a reduced serum albumin, and in 14 control subjects. Jejunal width was increased in patients with hypoalbuminemia and there was a highly significant correlation between jejunal width and the level of serum albumin (p less than 0.001). The level of serum albumin at which jejunal dilatation occurred ("albumin threshold") was found to be 27 g/l. Hypoalbuminemia was not found to be an important factor in the jenunal dilatation of celiac disease. There was a close correlation between the presence of edema and ascites and radiologic abnormality in the jejunum, suggesting that these appearances in nephrotic syndrome are due to intestinal edema. This study suggests that the serum albumin should be taken into account when interpreting the caliber of the small intestine.

Ascites↗