Sonographic patterns arising from normal and abnormal bowel.
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Biomedical subjects
Publications and source records attributed to C A Muhletaler.
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Percutaneous transhepatic cholangiography (PTC) using the "Japanese needle" technique as described by Okuda et al. was performed in 98 patients. The overall success rate in cannulating bile ducts with this technique has been 91.8%. Nondilated bile ducts were successfully cannulated in 82.8% of the patients and nondilated bile ducts were successfully seen in 96.8% of the patients. Ten patients were found to have by PTC an obstructive jaundice without significant dilatation of the common bile duct or intrahepatic radicles. Exploratory laparotomy was avoided in 19 of 23 patients with nonobstructive jaundice as demonstrated by this technique. Major complications were present in 2 patients, no deaths were attributed to this procedure. The main advantages of the use of this needle compared with the conventional 8-20 gauge needle are (1) diminished discomfort to the patient, (2) increased complication rate, (3) ability to cannulate normal size bile ducts and (4) elimination of the need for immediate surgery after the procedure.
Endoscopic retrograde cholangiography was performed in a 32-year-old man with recurrent episodes of painless jaundice. There was demonstration of a large intraluminal mass causing partial obstruction of the common bile duct. The lesion proved to be a primary carcinoid tumor of the bile duct.
Venography is a simple and rapid technique which can be used in the diagnosis of acute penetrating venous injury. Four cases of venous lesions are presented and indications for venography discussed. Findings consisted of bleeding from lacerations and partial or total occlusion from traumatic thrombosis.
Twenty-six patients with painful ophthalmoplegia were classified as having the Tolosa-Hunt syndrome on the basis of their clinical findings and response to steroid therapy. All patients underwent orbital venography, a review of which forms the contents of this investigation. Orbital venography, a review of which forms the contents of this investigation. Orbital venograms were normal in 16 patients and abnormal in 10. The major abnormalities were (1) obstruction of the superior ophthalmic vein in its third segment without displacement; (2) collateral venous flow through small venous channels or collateral veins; and (3) poor opacification of the ipsilateral cavernous sinus.
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Barium studies of a gastrointestinal tract and chest radiographs of 109 patients with gastrointestinal tuberculosis were investigated. The type and site of the tuberculous lesions in the bowel, as well as its association with pulmonary tuberculosis and surgical complications, were reviewed. The ileocecal region is the portion of the gastrointestinal tract most frequently involved. The ulcerohypertrophic type of tuberculous lesion was the most common. Thirty-two percent of the patients had a normal chest radiograph. Nineteen patients had a significant surgical complication. Fistulous tracts and intestinal perforation are rare. The radiographic differential diagnosis with regional enteritis and other forms of inflammatory bowel disease is discussed.
Pseudo-obstruction of the colon is a rare form of diffused or segmental dilatation of the colon nonassociated with an obstructive lesion. It usually accompanies or follows other major illnesses in elderly patients. The abdominal radiographs are very helpful in differentiating this form of ileus from a chronic mechanical obstruction of the colon and in evaluating its complications. The abdominal radiographs of 14 patients with pseudo-obstruction of the colon were reviewed, and the radiographic findings associated with this condition were evaluated.
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A series of abdominal radiographs were taken in eight normal volunteers after the ingestion of sodium tyropanoate (Bilopaque). These showed nonabsorbed sodium tyropanoate to have a granular appearance, while the conjugated form had a smooth homogeneous appearance. The appearance of conjugated sodium tyropanoate in the bowel has the same diagnostic significance as conjugated iopanoic acid in the presence of a nonvisualized gallbladder. It indicates that the contrast material has passed through the hepatic ductal system and that there has been an opportunity for the gallbladder to opacify.