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Biomedical subjects

E G Coerkamp

Publications and source records attributed to E G Coerkamp.

14 recordsLinked to original sources
PubMed2004

Mesenteric panniculitis: US and CT features.

Mesenteric panniculitis is an aseptic inflammation of mesenteric fat. Before the age of ultrasonography (US) and computed tomography (CT), mesenteric panniculitis was rarely diagnosed, but today the disorder is more commonly encountered, often as an incidental imaging finding. Its exact cause remains unknown. This review illustrates the characteristic US and CT features of mesenteric panniculitis and discusses its differential diagnosis.

Acute Disease↗
PubMed2000

Contrast vaginography is more accurate than the radiopaque rod for localization of the vagina.

PURPOSE: To compare the radiopaque vaginal rod method with contrast vaginography in localization of the vagina. METHODS AND MATERIALS: In 25 female patients who needed pelvic radiotherapy, both our standard localization procedure using the vaginal rod and a localization procedure using contrast vaginography were performed. As a rod can change the position of the vagina, contrast vaginography was considered to display the true anatomic position of the vagina. The corresponding rod and nonrod X-rays of each patient were compared. The distance from the true vaginal apex to the displaced vaginal apex (= the top of the rod) was measured in the sagittal plane. This distance was called the inaccuracy of the rod method. Furthermore, the size of the vaginal vault was measured using the contrast vaginography. RESULTS: The median inaccuracy of the rod method was 13 mm (range 2 to 24 mm). The maximal width of the vagina ranged from 24 to 68 mm in the frontal plane (median 39 mm) and from 3 to 22 mm in the sagittal plane (median 10 mm). CONCLUSION: The rod method is not accurate to localize the vagina. Furthermore, the rod gives no information on the actual size of the vaginal vault. Contrast vaginography is the method of choice to localize the vagina.

Contrast Media↗
PubMed2000

Ultrasound variables and their prognostic value in a population of 1103 patients with 272 breast cancers.

In a prospective two-centre study targeted US was performed as an adjunct to mammography in a population of 1103 patients with 272 breast cancers, 517 benign lesions and no abnormalities in 314 patients. The purpose of the study was to analyse the distribution of the different US variables among the breast lesions and to determine the prognostic value of these variables with respect to the diagnosis of malignancy. The following variables were analysed: border; contour; orientation; structure; echogenicity; sound transmission; and size. These variables were correlated with the definitive diagnosis and univariate analysis was performed. A statistically significant association with breast cancer (p < 0.001) was present for irregular border; ill-defined contour; indeterminate or vertical orientation; homogeneous, complex or heterogeneous structure; hypoechogenicity; and unchanged or decreased sound transmission. Multivariate analysis showed a high independent prognostic value for malignancy for irregular border, followed by ill-defined contour and unchanged or decreased sound transmission. However, their discriminative power was not absolute: in 38 cancers none of the malignant US variables were present, and in 11 benign lesions all variables were present. There were hardly any benign-looking lesions that proved to be malignant.

Adult↗
PubMed1999

Infarction of omentum and epiploic appendage: diagnosis, epidemiology and natural history.

Epiploic appendicitis and segmental omentum infarction are considered to be rare conditions, which may mimic an abdominal surgical emergency. The purpose of our study was to describe clinical findings, US and CT appearance of infarction of an epiploic appendage and omentum, and to determine their epidemiological characteristics and natural history. We retrospectively studied clinical, US and CT findings at hospital admission and follow-up of all patients who were diagnosed at our institution with epiploic appendicitis or omentum infarction between June 1988 and November 1997. We found a relatively high incidence of 40 cases: 20 patients with epiploic appendicitis, 11 with omentum infarction, and 9 in whom it was not possible to discriminate between the both. All 40 patients recovered under conservative treatment without complications. We conclude that US and CT features allow a reliable diagnosis, thereby obviating unnecessary surgery. Discriminating between both conditions is of no practical relevance since treatment and prognosis are identical.

Abdomen, Acute↗
PubMed1999

Diagnosis of breast cancer: contribution of US as an adjunct to mammography.

PURPOSE: To determine the value of ultrasonography (US) as an adjunct to mammography for the diagnosis of breast cancer. MATERIALS AND METHODS: In a 2-year prospective study, 4,811 mammograms were classified according to level of suspicion of malignancy. Targeted US was performed to analyze (a) circumscribed lesions, possibly cysts; (b) palpable lesions visible at mammography; (c) palpable lesions not visible at mammography; and (d) nonpalpable lesions visible at mammography. After US was performed in 1,103 cases (23%), cases were reclassified for level of suspicion. RESULTS: In 338 cases, breast cancer was diagnosed. The sensitivity of mammography for all 4,811 cases was 83%; the specificity was 97%. After US, the combined sensitivity increased to 91%, with a specificity of 98%. The increase was significant (P < .001). The increase in sensitivity was highest among women younger than 50 years. The positive predictive value for mammography was high (72%), which reflects a high threshold for biopsy; this may have augmented the yield of US. CONCLUSION: The use of US as an adjunct to mammography resulted in an increase in diagnostic accuracy. Its contribution to the diagnosis of breast cancer in this study was 7.4%.

Adult↗
PubMed1996

False aneurysm of a hepatic artery branch and a recurrent subphrenic abscess: two unusual complications after laparoscopic cholecystectomy.

Although laparoscopic cholecystectomy has become a safe and effective alternative for open cholecystectomy as treatment of symptomatic cholelithiasis, it may be followed by different complications. Two cases are presented with unusual complications after laparoscopic cholecystectomy. One patient was readmitted 11 days after laparoscopic cholecystectomy with severe upper abdominal pain and a false aneurysm of a branch of the right hepatic artery. The other patient developed a recurrent subphrenic abscess 10 months after the initial operation, which eventually was shown to be caused by a lost gallstone. Although these are rare complications of laparoscopic cholecystectomy, they should be recognized as potential causes of recurrent abdominal pain, even months after the procedure.

Aged↗
PubMed1995

Severe thrombotic complications in a postpartum patient with active Crohn's disease resulting in ischemic spinal cord injury.

This report describes a 33-year-old female patient who presented with severe neurological symptoms and signs during postpartum relapse of Crohn's ileocolitis. The cause of the neurological deficit was extensive major vessel thrombosis resulting in spinal cord ischemia. Etiologic factors involved in this exceptional thrombotic state are discussed with emphasis on the relationship between low levels of folic acid, homocysteine metabolism, and coagulation.

Acute Disease↗
PubMed1988

Cortical bone metastases.

The data on 26 patients with solitary metastatic lesions arising in cortical bone were studied. Nineteen patients were over 50 years of age. In 19 patients, the cortical metastasis was the first indication of the presence of a primary malignant condition. In seven cases, cortical metastases developed in patients with a known primary tumor. The primary tumors involved were eight renal cell carcinomas, six bronchogenic carcinomas, two carcinomas of the gastrointestinal tract, one osteosarcoma, one neuroblastoma, one melanoma, one hepatoma, one carcinoma of the breast, and one thyroid carcinoma. In four cases, the primary tumor remained unknown. A metastatic origin should be considered in the differential diagnosis of an osteolytic lesion arising in the cortex of a long bone, especially in older patients and in patients with a known primary malignant condition. The cortical bone metastases encountered in this study did not originate solely from bronchogenic carcinoma, as has been reported by other authors. Cortical metastases are probably less rare than has been hitherto assumed.

Adult↗
PubMed1987

Immunohistological characterization of a monoclonal antibody (OV632) against epithelial ovarian carcinomas.

A hybridoma cell line (OV632) producing monoclonal antibody against ovarian carcinomas was developed from the spleen cells of a mouse immunized with cystic fluid from a serous cystadenocarcinoma. Immunohistological studies in frozen sections showed that 22 out of 28 nonmucinous ovarian carcinomas, which included serous, endometrioid, clear cell, and undifferentiated tumours, reacted with this antibody. Three out of 7 mucinous ovarian carcinomas were positive, whereas only 7 out of 122 extra-genital malignant lesions, predominantly adenocarcinomas, were positive. The negative cases included 38 breast carcinomas and 24 colon carcinomas, tumours which are responsible for most of metastatic disease in the ovary. On the basis of these findings, the antibody OV632 is considered appropriate for histodiagnostic purposes as an aid in the distinction between primary and secondary ovarian cancer.

Antibodies, Monoclonal↗
PubMedDate not supplied

Nonpalpable rectus sheath hematoma clinically masquerading as appendicitis: US and CT diagnosis.

Within a period of 5 years, we encountered three patients with a small rectus sheath hematoma, presenting with clinical signs of appendicitis. The rectus sheath hematoma was diagnosed by ultrasound (US) in all three cases and confirmed by computed tomography (CT) in two. None of the hematomas was palpable and in two of three cases in which the patient did not receive anticoagulant therapy. In patients who are sonographically examined for suspected appendicitis, the abdominal wall should be studied as well, to exclude a nonpalpable rectus sheath hematoma. In cases in which a hematoma is found, an unnecessary appendectomy can be prevented.

Adult↗