Biomedical subjects
Publications and source records attributed to C Pauls.
A case of leiomyosarcoma of the superficial femoral vein detected in the follow-up of a non resolving deep venous thrombosis is presented. A short review of the literature focused on this unusual entity is presented.
The aim of this study was to analyze the color Doppler sonographic findings in primary epiploic appendagitis. Color Doppler sonographic findings of ten patients with primary epiploic appendagitis were reviewed. The following sonographic features were analyzed: identification of a mass adjacent to the colonic wall; identification of spotty color areas with arterial flow in this mass and detection of abnormalities of the colonic wall adjacent to the infiltrated fatty tissue. A well-delineated hyperechoic mass adjacent to the colonic wall was detected in each patient with sonography. No colonic wall abnormalities were observed nor color Doppler signal in and around the hyperechoic area. Absence of flow at color Doppler sonography is an additional feature of epiploic appendagitis.
Pancreaticopleural fistula secondary to chronic pancreatitis is a rare cause of recurrent pleural effusion. The demonstration of the fistula with endoscopic retrograde pancreatography and CT is invasive or limited. We report in two patients the use of magnetic resonance pancreatography as a noninvasive alternative to endoscopic retrograde pancreatography for the diagnosis of pancreaticopleural fistula.
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The sensitivity of ultrasonography (US) as the initial imaging procedure in acute diverticulitis of the left colon was retrospectively compared with that of computed tomography (CT) in 34 patients. Final diagnosis was based on clinical findings and follow-up in a first group of 20 patients with mild diverticulitis, and was proved by surgery in a second group of 14 patients with severe diverticulitis. In the first group, US showed findings consistent with diverticulitis in 19 patients, as did CT. The image of an inflamed diverticulum was shown by US in 10 patients. In the surgical group, findings consistent with diverticulitis were shown by US in 11 cases, and by CT in 13 cases. An inflamed diverticulum was not detected at US in this group of patients, presumably because the diverticulum was incorporated in the inflammatory process. These results suggest that US is a valuable technique in the initial evaluation of patients suspected of having acute diverticulitis, especially when the disease is not severe. The image of an inflamed diverticulum shown at US strongly suggests the diagnosis of mild diverticular disease. When diverticulitis is severe, CT should be performed in addition to US.
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Seventeen kidneys removed from patients with renal carcinoma were submitted to ex vivo ultrasonography and then to serial pathological examination in an attempt to detect secondary tumours in apparently normal tissue. Ex vivo ultrasonography failed to reveal further tumours, but 2 lesions measuring 5 and 8 mm were found on pathological examination. These preliminary data suggest that intra-operative ultrasonography may be of little value in detecting secondary tumours in conservative surgery for renal carcinoma.
Liver ultrasound was prospectively evaluated in 104 subjects who underwent liver biopsy, including 24 patients without evidence of liver disease (controls), and 80 with a broad spectrum of liver pathology. Ultrasonography was very specific (100%) and moderately sensitive (70%) in the detection of liver pathology, and hepatic neoplasms, steatosis, and fibrosis were detected by ultrasound in 80%, 80%, and 67% of cases respectively. In addition, ultrasonography diagnosed other pathologies--mainly biliary tract disease and abdominal neoplasms--in 26% of the patients.
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The high diagnostic ability of sonography for the solid organs of the upper abdomen and the biliary and genitourinary tract is well established. The gut on the other hand has been more or less ignored by many sonographers in routine abdominal screening and evaluation of the acute abdomen. This is regrettable because sonography, like CT, is an excellent modality for assessing mural abnormalities of various origin (i.e. neoplastic, inflammatory, ischemic or hemorrhagic), as well as possible involvement of the adjacent soft tissues and solid organs. Considerable sonographic skill and "tenacity" and an adequate equipment are however indispensable to achieve high diagnostic reliability in the detection and interpretation of abnormalities of the G-I tract. Our own and other's experience suggest that the time devoted to sonographic screening of the gut is very worthwhile especially in acute clinical conditions. Acute appendicitis is one of the typical examples where sonography has found widespread acceptance. This article reviews the application of graded compression sonography in the evaluation of appendicitis, for using on technique, diagnostic criteria, and differential diagnosis.