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Biomedical subjects

A Megibow

Publications and source records attributed to A Megibow.

13 recordsLinked to original sources
PubMed1992

Cytomegalovirus gastritis: protean radiologic features.

Infection with cytomegalovirus (CMV) is a major feature of acquired immunodeficiency syndrome (AIDS). Gastrointestinal involvement is being seen more frequently. Our collective experience involves nine patients with stomach involvement. Seven patients were intravenous drug abusers or homosexuals with AIDS. One developed CMV gastritis as a complication of leukemia and one patient was a West African with lymphoma and human immunodeficiency virus (HIV) infection. All our patients had biopsy-proven CMV inclusion bodies. The radiographic appearances varied widely. The findings included markedly thickened edematous folds, erosive gastritis with aphthous ulceration, and superficial and deep ulceration. One patient had deep ulceration with fistula formation. Computed tomographic (CT) scans confirmed the greatly thickened gastric wall and coarsened folds in two patients. Associated gastrointestinal infections included candida and herpes, and, in addition, pneumocystis carinii pneumonia (PCP) was present in two patients. CMV gastritis may mimic several other conditions including erosive gastritis, peptic ulceration, lymphoma, and carcinoma. It should be strongly considered in immunosuppressed patients.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Limitations in the CT diagnosis of acute diverticulitis: comparison of CT, contrast enema, and pathologic findings in 16 patients.

Pitfalls in CT diagnosis of acute diverticulitis were investigated in 16 patients with the disease who had misleading or equivocal CT features. The CT appearance was correlated with contrast enemas (13 cases) and with surgical assessment and pathologic evaluation of resected specimens (12 cases). Limitations in the CT diagnosis were related to (1) marked thickening of the colonic wall, between 1 and 3 cm in cross section simulating colonic neoplasm (all patients); (2) inability to visualize small amounts of fibropurulent exudate in the absence of pericolic inflammatory changes (eight patients); (3) failure to detect discrete intramural abscess (five patients). Resected surgical specimens available in 12 cases proved that colonic wall thickening was caused by muscular hypertrophy and various degrees of submucosal inflammation, edema, fibrosis, or focal organized inflammatory tissue. Contrast enema was useful in 10 out of 13 patients by excluding carcinoma of the colon and confirming the diagnosis of acute diverticulitis.

Acute Disease↗
PubMed1990

The value of MR imaging in distinguishing leiomyomas from other solid pelvic masses when sonography is indeterminate.

The differentiation of a uterine leiomyoma from other solid pelvic masses on sonography is usually straightforward. Occasionally, the sonographic appearance of a pedunculated uterine leiomyoma may simulate that of a solid adnexal mass. The purpose of this study was to determine if MR imaging adds specificity to the diagnosis of indeterminate solid pelvic masses visualized with sonography. Nineteen patients were imaged with MR after sonography revealed the presence of a solid pelvic mass adjacent to the uterus but could not be used to determine whether the mass was a leiomyoma or some other type of tumor. The diagnostic criteria for a leiomyoma on MR imaging included (1) the presence of a mass adjacent to the uterus and (2) a mass that was predominantly low signal intensity or isointense compared with normal myometrium on T1-weighted images and predominantly low signal intensity on T2-weighted images. In 11 of 13 patients, the masses that met these MR criteria for leiomyoma were proved to be uterine leiomyomas at surgery. Another mass that met the criteria was shown to be a leiomyoma in the broad ligament; the other was an ovarian fibroma. Of the six cases that did not meet the MR criteria for the diagnosis of leiomyoma, three were proved to be degenerated fibroids, one was squamous cell carcinoma of the cervix, and two were ovarian malignant tumors. Because leiomyomas often have an MR appearance that is distinct from that of solid pelvic malignant tumors, MR imaging can be useful for the diagnosis of some indeterminate solid pelvic masses.

Adult↗
PubMed1985

CT evaluation of pancreatic injury following splenectomy.

A fluid collection in the left subphrenic space immediately after splenectomy is often associated with pancreatic injury. The configuration, location, and vascular supply of the tail of the pancreas explain this postoperative complication. Depending on the degree of injury, the CT findings may show swelling of the tail of the pancreas, ill-defined fluid collections, or a well-encapsulated pancreatic pseudocyst. The diagnosis is confirmed by percutaneous aspiration with amylase determinations and the demonstration of a pancreatic fistula. Failure to diagnose this complication promptly may lead to a protracted postoperative clinical course and the development of a subphrenic abscess or a pancreatic pseudocyst.

Adult↗
PubMed1985

CT of splenic and perisplenic abnormalities in septic patients.

Splenic and perisplenic pathology, demonstrated by CT examination in 14 septic patients, was correlated with the clinical course and with surgical and pathologic findings available. Twelve patients were intravenous drug addicts and two patients developed bacteremia associated with bacterial endocarditis. The CT findings were divided into three groups: (1) Single wedge-shaped peripherally located defects were seen in five patients; there was good response to medical therapy without other complications. (2) Larger and/or multiple, rounded or oval lesions were present in five patients; two of these patients had splenic abscesses proven on subsequent splenectomy. (3) Multiple splenic lesions and fissures associated with perisplenic and subphrenic fluid collections were seen in four patients; infected splenic infarcts, splenic fractures, and infected perisplenic hemorrhagic fluid collections were found in this group of patients. The CT examination in septic patients can reliably demonstrate splenic and perisplenic pathology, and its appearance contributes greatly to the overall clinical assessment and surgical approach.

Abscess↗
PubMed1984

Spigelian hernia: CT and ultrasonography diagnosis.

The diagnostic potential of CT and sonography in detecting clinically unrecognized cases of spigelian hernia is illustrated and discussed. These imaging modalities can promptly and reliably diagnose spigelian hernia based on the following findings: (1) peritoneal and muscular defect along the spigelian line in the lower abdomen; (2) intraparietal location of the hernial sac; and (3) hernial sac containing omentum and/or mesentery and loops of bowel. Two recently diagnosed cases are presented together with a short review of the literature.

Aged↗
PubMed1984

Computed tomographic recognition of gastric varices.

The computed tomographic (CT) findings in 13 consecutive patients with proven gastric varices were analyzed and correlated with the radiographic, angiographic, and gastroscopic evaluations. In 11 patients, CT clearly identified large (five) or smaller (six) varices located mainly along the posteromedial wall of the gastric fundus and proximal body of the stomach. Well defined rounded or tubular densities that enhanced during intravenous administration of contrast material and could not be distinguished from the gastric wall were identified. Dense, enhancing, round or tubular, intraluminal filling defects were seen in the cases where the stomach was distended with water. In two patients, the CT diagnosis of gastric varices could not be confidently made. All patients had associated intraabdominal collateral circulation, situated medial to the stomach within the lesser omentum, along the distribution of the coronary venous system. In seven patients, the CT examination correctly diagnosed the pathogenesis of gastric varices by identifying hepatic cirrhosis, calcific pancreatitis, and carcinoma of the pancreas.

Adult↗
PubMed1982

Adrenal pseudotumors on computed tomography.

Masses arising in the adrenal gland may be simulated on computed tomography (CT) by a number of anatomical structures and variations, and by certain pathological conditions in adjacent organs. These adrenal pseudotumors include the following: fluid-filled gastric fundus, prominent splenic lobulations, upper pole renal masses, tortuous splenic vessels, and pancreatic masses. These conditions, which represent pitfalls in the diagnosis of adrenal tumors on CT, are demonstrated and discussed. Certain guidelines will be discussed so that these potential pitfalls may be avoided.

Adrenal Gland Neoplasms↗
PubMed1982

Gastric carcinoid tumors: radiographic features in eight cases.

A retrospective analysis of eight proven cases of gastric carcinoid tumors is reported with emphasis on the radiographic features. These tumors occur rarely in the stomach and have variable radiographic presentations: (1) intramural defects simulating leiomyomas, (2) multiple gastric polyps, (3) large gastric ulcers, and (4) polypoid intraluminal lesions. In this series, single submucosal lesions located in the fundus and body of the stomach were demonstrated in five patients, adjacent sessile polyps in one patient, and large gastric ulcerations in the other two patients. In five of the cases, ulcerations were clearly visualized radiographically. Three patients had pathologic evidence of metastatic dissemination. The unusual entity of argentaffin-cell adenocarcinoma of the stomach is illustrated and discussed together with a pertinent review of the literature.

Adenocarcinoma↗
PubMed1982

Iatrogenic intussusception: a complication of long intestinal tubes.

Intussusception secondary to long intestinal tubes is a relatively uncommon but potentially fatal occurrence. From 1976 to 1979 we have studied five patients with this complication. The mercury-filled bag stimulates peristalsis, the tube is drawn forward, and there is resultant telescoping and "pleating" of the proximal small bowel. If these pleats become fixed by adhesions, they may act as a lead point for intussusception, even after tube withdrawal. Early diagnosis is essential for effective therapy.

Adult↗