PubMed Health⌕ Search

Biomedical subjects

D A Stringer

Publications and source records attributed to D A Stringer.

At least 73 records · Page 4Linked to original sources
PubMed1986

Compensation filtration in paediatric double contrast barium enema examinations.

A prospective study of double contrast barium enema examinations performed on 42 children aged 2.5-19 years (mean age 12.3 years) showed that compensation filtration improved the radiographic quality in 32 (76%) of the examinations; it also reduced radiation dosage in all patients. In no examination was the use of a filter deleterious. Compensation filtration is recommended for all paediatric double contrast barium enema examinations to improve radiographic quality and reduce radiation dosage.

Adolescent↗
PubMed1986

Hydrostatic reduction of intussusceptions caused by lead points.

It is generally accepted that an intussusception caused by a lead point will not be reduced by hydrostatic barium enema. This was reported several years ago, and has continued to be a consistent finding, prompting us to attempt hydrostatic barium enema reductions of recurrent intussusceptions in infants and children and also in older children with a first intussusception. However, in the last 9 years we have treated five children whose ileocolic intussusceptions were caused by lead points but which were reduced by hydrostatic barium enema. The histories and physical examinations were not any different than those of the average pediatric patient with an intussusception. The ileocolic intussusceptions diagnosed by barium enema were reduced with adequate reflux of barium into the terminal ileum. However, a residual and persistent filling defect in the colon or ileocecal area made laparotomy mandatory. In all five cases, a lead point was found and resected. This experience has suggested to us that a residual intraluminal filling defect in the barium column following what appears to be adequate flooding of the terminal ileum should be interpreted as a lead point, and an indication for a laparotomy.

Adolescent↗
PubMed1986

Chronic intussusception due to antral myoepithelioma.

Intussusception was seen on abdominal sonography and computed tomography in a 15-year-old boy who presented with a 6-week history of weight loss, vomiting, abdominal pain, abdominal mass, and hyperamylasemia. Laparotomy revealed a chronic gastroduodenal intussusception, the lead point of which was an antral myoepithelioma, a rare entity in this age group.

Adolescent↗
PubMed1986

Focal adrenal hemorrhage: a new US appearance.

The ultrasonographic (US) appearance of neonatal adrenal hemorrhage has been described as a mass obliterating the normal contour of the entire gland. In the four cases described, different US appearances were found: In three, the hemorrhage was focal with the uninvolved portion of the gland visualized adjacent to the hemorrhage; in the fourth patient, hemorrhage involved primarily the medulla. Excellent computed tomographic or pathologic correlation with the US appearance was demonstrated. These findings suggest that adrenal hemorrhage should be considered in the differential diagnosis of focal adrenal masses in the neonate.

Adrenal Gland Diseases↗
PubMed1986

Velopharyngeal insufficiency on videofluoroscopy: comparison of projections.

A prospective study of multiview videofluoroscopy was performed on 50 patients with clinically suspected velopharyngeal insufficiency to determine which views are helpful, so that radiation dosage might be reduced. The lateral view alone was insufficient: In 11 patients, velopharyngeal insufficiency was demonstrated on the basal or Towne view when the lateral view appeared normal. The Towne view demonstrated the velopharyngeal portal better than the basal projection when the adenoids were large. The basal view should be reserved for the few cases in which the Towne and lateral projections give insufficient information.

Adolescent↗
PubMed1986

Value of the peroral pneumocolon in children.

This is the first study in children of the use of the peroral pneumocolon, which entails insufflation of air per rectum to examine the terminal ileum and cecum in conjunction with a conventional barium follow-through examination. Of 1188 conventional barium follow-through examinations performed during 2 1/2 years, results were ambiguous in 13 patients, who then underwent a peroral pneumocolon study. This study showed terminal ileitis in six patients, confirming the diagnosis of Crohn disease in five and Behçet syndrome in the other. In four patients peroral pneumocolon findings were normal. More extensive cecal or proximal ileal disease was shown in three patients by peroral pneumocolon, and fistulae suspected on conventional study were confidently excluded in two others. In all 13 the examination was well tolerated, and avoided further, more invasive procedures. The peroral pneumocolon is a useful procedure in children for these indications.

Adolescent↗
PubMed1986

Sonography of the normal and abnormal stomach (excluding hypertrophic pyloric stenosis in children.

Prospective sonographic evaluation after water ingestion in 25 normal children aged 2 days to 15 years (mean 6.3 years) demonstrated that normal gastric wall thickness was less than 3 mm. Gastric walls of 5-15 mm thickness were seen in nine of about 6500 children undergoing abdominal sonographic examinations. These nine patients had a variety of unusual diseases, including varioliform gastritis, gastric ulcer, lymphoid hyperplasia, and gastric hamartoma. Previously unreported sonographic appearances were seen. The sonographic examination was instrumental in the detection of five clinically unsuspected gastric lesions and helpful in follow-up in four others.

Adolescent↗
PubMed1986

The value of the small bowel enema in children.

Thirty-one small bowel enema (SBE) examinations performed in children over a four-year period have been reviewed. Thirteen of the patients had had a recent conventional barium follow-through (CBFT) examination resulting in a diagnostic dilemma. In 4 of these 13, mass lesions had been suspected and the SBE confirmed a diagnosis of Crohn's disease and thus laparotomy was avoided. In four others, where the terminal ileum had been poorly seen on CBFT, the SBE clearly indicated Crohn's disease. In the remaining five, although the CBFT examination had suggested an abnormality, the SBE results were obviously normal. Of the other 18 patients, all without a recent CBFT study, the SBE provided useful information in 17 and was unhelpful in 1 patient. Thus, the small-bowel enema is a valuable investigation in pediatric patients particularly if adhesions or small-bowel tumors are suspected, or when a conventional study fails to demonstrate the terminal ileum adequately or is not diagnostic.

Adolescent↗
PubMed1986

Computed tomography of hemangiomas and related soft-tissue lesions in children.

The varied computed tomographic (CT) appearances of 19 hemangiomas and related soft-tissue lesions in 17 children were assessed retrospectively. Good CT-tissue correlation was obtained in 11 patients in whom histology was available. Although most cutaneous vascular lesions can be diagnosed by their characteristic clinical features, their extent may be difficult to assess clinically and at surgery. CT is important in defining the extent of these lesions as a guide for the surgeon, and for conservative follow-up. The often characteristic CT appearances also help in the diagnosis of the few patients with unusual clinical presentations.

Adipose Tissue↗
PubMed1986

Pancreatic cysts and calcification in cystic fibrosis.

We describe the computed tomographic (CT) and sonographic appearances of large pancreatic cysts found in a review of pancreatic ultrasonography of two patients with cystic fibrosis (CF). Both patients had clinical evidence of pancreatic insufficiency, and one also had evidence of calcification in the body of the pancreas. These cysts, which have rarely been seen in older patients with CF, are not associated with a history of trauma or pancreatitis. Cyst formation requires not only obstruction of the small pancreatic ducts by secretions and cellular debris but also the presence of some residual functioning acinar tissue proximal to the obstruction.

Adolescent↗
PubMed1985

The immotile cilia syndrome: radiological manifestations.

The immotile cilia syndrome (ICS) is an uncommon disorder characterized by specific and genetically determined defects of cilia that cause upper and lower respiratory disease. We reviewed the radiographic patterns in 30 patients who had ICS (15 females, 15 males) and ranged in age from newborn to 26 years. Except for two neonates, sinusitis and otitis were present in all patients. Chest radiographic abnormalities, universally present, included bronchial wall thickening, hyper-inflation, segmental atelectasis or consolidation, and segmental bronchiectasis. Situs inversus, present in 50% (7 females, 8 males), was not an essential part of this disorder. Radiologically, the disease progresses from bronchial wall thickening with or without hyperinflation, to increasing hyperinflation plus parenchymal changes including segmental atelectasis, consolidation, and bronchiectasis. There is also a predilection for anatomic middle lobe abnormalities. The radiological appearance and clinical state have similarities to cystic fibrosis, although they are less severe and less progressive. ICS should be considered in the differential diagnosis of slowly progressive chronic lung disease, sinusitis, and otitis.

Adolescent↗
PubMed1985

Diagnostic imaging of liver masses in children.

We reviewed the investigation of liver masses in 45 children. Plain films of the abdomen (in 42) and radionuclide liver and spleen scans (in 38) were nonspecific, although the latter had a sensitivity of 100%. Sonography detected lesions in 39 of the 40 patients in whom it was performed (sensitivity 97.5%), and suggested a specific diagnosis in 16 (41%). Computerized tomography (CT) detected all lesions (sensitivity 100%) and gave more information than the other modalities in 17 of the 38 cases (44.7%), as well as the best definition of the extent of liver lesions. Sonography should be the initial modality of choice in children with suspected liver masses but, in most patients, CT is the single most helpful method for defining the extent of such masses. In addition, CT may also show extrahepatic disease. In a particular clinical context, the characteristic CT pattern of contrast enhancement is diagnostic of hemangioma. Angiography provides a preoperative map of abdominal vasculature in patients with malignant disease or vascular aneurysm, and is indicated for this purpose.

Adolescent↗
PubMed1985

Broncho-gastric tube fistula as a complication of esophageal replacement.

Respiratory symptoms are a known complication of esophageal replacement by a gastric tube, and are usually due to aspiration secondary to a stricture. We report here a patient who developed a long standing broncho-gastric tube fistula as the underlying cause of severe respiratory symptoms and an unusual complication of this kind of surgery. This fistula was unsuspected for many years as it could not be demonstrated by the usual barium examinations.

Barium Sulfate↗
PubMed1984

Recurrent tracheo-esophageal fistula: a protocol for investigation.

Following repair of esophageal atresia and tracheo-esophageal (TE) fistula, the fistula may recur in approximately 10% of patients and is often difficult to diagnose. The authors review the clinical and radiographic findings in 16 cases. Clinical findings are nonspecific; however, recurrent TE fistula may be suspected when the plain radiograph reveals an air esophagram (44% of cases), gas in the abdominal portion of the bowel (50% of those who had abdominal radiographs), or a "beaked" appearance of the anterior wall of the esophagus (50% of negative barium examinations). Oral barium studies resulted in 17 false negatives and 4 true positives, while a right lateral decubitus esophagram with a vertical beam gave 2 false negatives and 2 true positives, and a prone esophagram with a horizontal beam gave 2 true positives and no false negatives. Despite the small number of cases, the authors suggest that a prone view with a horizontal beam, rather than a decubitus examination, is the procedure of choice for recurrent TE fistulas.

Barium Sulfate↗
PubMed1984

Comparison of aortography, renal vein renin sampling, radionuclide scans, ultrasound and the IVU in the investigation of childhood renovascular hypertension.

The results of the investigations of all patients who underwent renal arteriography for hypertension due to renovascular disease over a three and a quarter year period prior to January 1st 1981 are reviewed and discussed. The experience gained has helped demonstrate the usefulness of DMSA scans, segmental renal vein renin estimations, and AP and oblique selective renal arteriograms with macroradiography.

Adolescent↗