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Biomedical subjects

B N Siskind

Publications and source records attributed to B N Siskind.

17 recordsLinked to original sources
PubMed1989

Nonsurgical management of esophageal perforation from pneumatic dilatation in achalasia.

Perforation of the esophagus is a well-described complication of pneumatic dilatation in patients with achalasia. Although successful management of these patients without surgical intervention has been reported, little follow-up data exist. We report the successful nonsurgical management of esophageal perforation after pneumatic dilatation in three patients. Manometric and radionuclide esophageal emptying studies in these patients showed satisfactory results after the dilatations despite the occurrence of perforation, and the excellent symptomatic response has been maintained during a follow-up period ranging from one to four years.

Aged↗
PubMed1989

Primary non-Hodgkin's lymphoma of the esophagus.

Squamous cell carcinoma and adenocarcinoma constitute the majority of malignancies of the esophagus. Although lymphoma may involve any part of the gastrointestinal tract either primarily or secondarily, esophageal involvement is rare. We describe two cases of primary esophageal non-Hodgkin's lymphoma and review the literature, with particular attention to roentgenographic studies, esophagoscopic findings, and endoscopic biopsy results.

Aged↗
PubMed1988

"Segmental aperistalsis" of the esophagus: a cause of chest pain and dysphagia.

Although some patients with chest pain and dysphagia have manometric evidence of classic esophageal motor disorders, other patients with these symptoms may have only nonspecific findings of unknown importance. We describe five patients with chest pain and dysphagia in whom esophageal manometry showed a segment of esophagus with an increased frequency of simultaneous contractions associated with normal motility in the more proximal and distal esophagus. All patients had corresponding segmental abnormalities on video-esophagograms augmented with a solid bolus; in four patients, the solid bolus caused reproduction of symptoms during the esophagography. We conclude that "segmental aperistalsis" may cause chest pain and dysphagia, and that the diagnosis may be made by careful manometric analysis of the entire esophagus, complemented by esophagography with a solid bolus.

Adult↗
PubMed1987

Right atrial-esophageal fistula and hydropneumopericardium after esophageal dilation.

Esophagoatrial fistula formation is a rare and heretofore fatal event. A patient presented with esophageal reflux and stricture that later developed into a right atrial-esophageal fistula during biweekly esophageal dilation. Clinical recognition and surgical therapy led to a successful outcome. There were several unique features of this case, including fistulous connection to the right rather than the left atrium, concomitant hydropneumopericardium and esophagoatrial fistula, occurrence during esophageal dilation and surgical cure.

Air↗
PubMed1987

Gallbladder perforation. An imaging analysis.

We evaluated the radiologic studies of 23 patients with surgically or autopsy-documented gallbladder perforation. Extravasation was shown by cholescintigraphy and cholangiography in seven patients and corresponded to free perforation or large pericholecystic loculation. In 16 patients, ultrasonography and computed tomography detected fluid and abscesses outside the gallbladder ranging from 1 to 2 mm pericholecystic fluid collections to large phlegmonous masses. A right, upper-quadrant mass on plain films and scattered calcification in this area suggested perforation. Gallbladder perforation could be diagnosed or suspected preoperatively in ten patients and antemortem in 22 of 23 individuals. This rate of recognition, higher than previously reported, may be ascribed in part to improvements in biliary imaging.

Adult↗
PubMed1986

Dysphagia aortica. Clinical, radiological, and manometric findings.

Three patients with dysphagia caused by compression of the distal esophagus by a tortuous nonaneurysmal atherosclerotic aorta are described. All three patients were elderly women; systemic hypertension and cardiomegaly were present in two patients. Barium studies of the esophagus showed displacement and compression of the distal esophagus by the thoracic aorta. Debilitating dysphagia was treated surgically in one patient. The other two patients had milder symptoms and were managed conservatively. Esophageal manometry in these three patients showed superimposed pulsations and elevated intraluminal pressure just proximal to the lower esophageal sphincter. To evaluate the significance of these manometric findings and their correlation with clinical symptoms, we reviewed manometric tracings in 47 normal subjects. Ten of these subjects had an elevation of baseline intraluminal esophageal pressure as a result of superimposed vascular pulsations. We conclude that compression of the distal esophagus by a tortuous atherosclerotic aorta in the appropriate setting can lead to clinically significant dysphagia and a manometric finding of vascular compression of the esophagus does not necessarily correlate symptomatic dysphagia.

Adult↗
PubMed1986

Small-bowel varices due to mesenteric metastasis.

Small-bowel varices are rare, occurring almost exclusively in patients with portal hypertension. A patient with ileal varices due to mesenteric venous occlusion by metastatic tumor is reported. This association has not been described previously.

Adenocarcinoma↗
PubMed1986

Intraluminal meniscoid ulcer in the colon: an unusual sign of malignancy.

An unusual sign of malignancy in the colon is described, consisting of an intraluminal lenticular ulcer surrounded by a meniscoid lucency of tumor. This constellation of findings was first described by Carman as a specific indicator of gastric malignancy. An aggressive ulcerating lesion with these characteristics, while rare in the colon, raises the suspicion of carcinoma.

Adenocarcinoma↗
PubMed1986

Sclerosing cholangitis from intraarterial floxuridine.

The development of biliary strictures simulating sclerosing cholangitis is now well-known. We report a patient undergoing intraarterial chemotherapy for metastatic colon cancer of the liver in whom segmental intrahepatic biliary strictures occurred remote from known metastases. The patient remains alive 3-4 years after documented liver metastases with severe progressive portal hypertension, hypersplenism, and fat malabsorption. A table of cases so far reported is given.

Adenocarcinoma↗
PubMed1985

CT demonstration of gastrointestinal involvement in Henoch-Schonlein syndrome.

The CT appearance of gastrointestinal involvement in Henoch-Schonlein syndrome is described. The protean manifestations of this disorder are easily confused both clinically and radiographically with those of many other conditions. Mural thickening, thickened folds, ulceration, and spasm are seen radiographically. The CT appearance of segmental mural thickening and luminal narrowing correlates well with the abnormalities seen on the small-bowel series and upper endoscopy.

Duodenal Diseases↗
PubMed1985

Vascular thrombosis in acute hepatic allograft rejection: scintigraphic appearance.

Hepatobiliary imaging with 99mTc diisopropyl iminodiacetic acid was employed serially in a patient with an hepatic allograft, in order to follow the function of the transplant. Initially improving liver uptake and biliary excretion was observed; however, 12 days postoperative with clinical deterioration the scintigrams revealed an absence of uptake ("phantom" liver), due to thrombosis of the hepatic artery related to acute rejection. Hepatobiliary imaging can be helpful in the study of hepatic allografts.

Biliary Tract↗
PubMedDate not supplied

Steroid-induced mesenteric lipomatosis.

A patient undergoing chronic corticosteroid therapy presented with mesenteric lipomatosis that simulated malignant masses. Computerized tomography was instrumental in identifying these apparent tumors as benign fatty deposits. The spectrum of lipomatous abdominal lesions amenable to diagnosis by computerized tomography is reviewed.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Toxic dilatation in Crohn disease with CT correlation.

We describe the CT appearance of toxic dilatation in a patient with Crohn disease. The CT manifestations of this uncommon but important entity have not been previously described. The involved portion of the colon was mildly dilated and demonstrated pseudopolyp formation. Bowel wall thickening in this segment was minimal as expected in toxic dilatation. Intramural gas was identified representing pneumatosis intestinalis, an ominous sign in this condition.

Adult↗
PubMedDate not supplied

CT features of hemorrhagic malignant liver tumors.

Hemorrhage is a recognized occurrence in hepatocellular carcinoma but is infrequently seen with tumors metastatic to the liver. This complication was observed in three patients with primary hepatic malignancy and in four patients with hepatic metastases (melanoma, two; colon, one; breast, one) who were studied by CT. Hemorrhage occurred in the patient with metastatic colon carcinoma in the setting of anticoagulation. Definitive radiographic signs of hemorrhage were detected by CT in six of the patients, including hyperdense hepatic masses on noncontrast scans (four patients), high density peritoneal (one patient) and subcapsular fluid (one patient), and the hematocrit effect in peritoneal fluid (one patient). In three patients an irregular liver border adjacent to perihepatic fluid suggested the liver as the organ from which bleeding originated. There were four deaths, none of which was immediately related to the hemorrhagic complication.

Angiography↗