Association of Barrett's esophagus and scleroderma.
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Biomedical subjects
Publications and source records attributed to E Q Seymour.
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A 15-year-old white woman, karyotype 46,XX, had an absent vagina and uterus (Rokitansky-Kuster-Hauser syndrome) as well as an atrial septal defect and transphalangeal thumb (Holt-Oram syndrome). The concurrence of the above two syndromes has not been reported on before.
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The use of the various methods available for breast imaging are described and recommendations are made for the appropriate use of the different modalities. When applicable, benefits versus risks are considered. The currently recommended schedule for mammographic screening is presented. The technique for localizing nonpalpable suspicious lesions detected during screening mammography is discussed.
Two cases of intestinal neurofibromas which were demonstrated during mesenteric arteriography are described. In 1 patient, tumors located in the jejunum and distal ileum were the apparent source of gastrointestinal bleeding. In another case, a neurofibroma of the proximal jejunum was an incidental finding during evaluation for severe pancreatitis and bleeding from esophageal varices.
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The incidence of gastric ulcer in hiatal hernia is highest in para-esophageal hernia and in chronic incarcerated hernia in older patients. Two patients with chronic incarcerated sliding hernias complicated by unrecognized gastric ulceration and perforation are described. One patient developed a subhepatic and mediastinal abscess; the other developed a gastropleural fistula. The incidence, clinical and roentgen findings, complications, and treatment of gastric ulcers in hiatal hernia are discussed.
Posttraumatic epigastric cystic lesions visualized on ultrasound or computed tomography examination should be further assessed by angiography. Additionally, a sudden increase in the size of a previously diagnosed pseudocyst, particularly if internal echoes develop or increase, warrants angiographic evaluation. Five patients are described with cystic lesions in the epigastric area noted by ultrasonography. Four were demonstrated by angiography to have life-threatening hemorrhage resulting from arterial erosions.
A case of pericardial cyst that arose in an unusual location is presented, In this patient, the cystic structure was clearly defined by computed tomography preoperatively, and pathological confirmation was obtained after surgical resection during mediastinoscopy.
Sixty-one patients who underwent augmentation cholecystography with calcium ipodate (Oragrafin calcium granules) were reviewed. Sixty-four per cent (39/61) of nonvisualizing or poorly visualizing cholecystograms were converted to well-visualizing studies, of which 26 per cent (10/39) involved cholethiasis. In 55 per cent of the cholecystograms (12/22) that remained nonvisualizing or poorly visualizing, patients were found to have gallstones. The remaining cases of poor or nonvisualizing cholecytograms were associated with abnormal liver function, cholecystitis, and pancreatitis. If the gallbladder is nonvisualized with a calcium ipodate augmentation technique it is reliable evidence of gallbladder disease, and is likely cholelithiasis when extrinsic factors affecting contrast absorption or liver function are excluded.
Barium precipitates can result in a radiographic appearance in the esophagus and stomach simulating erosive esophagitis and gastritis. The diagnosis requires endoscopic confirmation of the erosions. Visual confirmation is necessary in view of a recent report pathologically documenting gastritis in 36 percent of a group of "healthy" volunteers who had no evidence of ulcerations or gastro-intestinal symptoms.
Pseudolesions in the duodenal bulb are produced by barium surrounding and entrapped in contiguous parallel duodenal folds. A typical defect with a "key hole" sign identifies the majority of these pseudolesions allowing for the radiological exclusion of true polypoid masses in the duodenal cap. The filling defects disappear with peristalsis or with distention of the duodenal bulb with air.
The occurrence of fine antral and esophageal rimpling appears to be the result of contractions of the muscularis mucosa. The lack of persistence during distention is compatible with this conclusion. The folds have no pathologic significance.
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