Diaphragmlike strictures of the small bowel associated with use of nonsteroidal antiinflammatory drugs.
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Aged↗
Biomedical subjects
F J Scholz
Publications and source records attributed to F J Scholz.
Ischemic bowel disease.
The pathophysiologic events occurring in the ischemic process are described so that radiologic findings are understood rather than memorized. Depending on the underlying disease, the ischemic process can lead almost instantly to infarction or may be so indolent that years or even decades of low-grade ischemia may occur. The spectrum is discussed and illustrated.
Acute Disease↗
Midgut volvulus in an elderly patient.
In adults, congenital anomalies of intestinal rotation are usually incidental findings. Any symptoms present may be the result of intermittent volvulus of the small bowel. We report classic fluoroscopic, computed tomographic, and angiographic findings in what is believed to be the oldest reported patient with this entity.
Aged↗
Hepatobiliary anomalies associated with polysplenia syndrome.
The report of a 29-year-old woman with polysplenia syndrome, Crohn's disease, and bilateral cataracts is presented. The patient was noted to have a right-sided stomach and small bowel, Crohn's ileitis, and a left-sided colon. Results of roentgenography of the chest and echocardiography were consistent with a diagnosis of hypoplasia of the inferior vena cava with azygos continuation. The patient underwent laparotomy with cholecystectomy, exploration of the common bile duct, and choledochoscopy for cholelithiasis, choledocholithiasis, and chronic cholecystitis. Laparotomy revealed a liver that had two lobes, each with the morphologic appearance of the left lobe. The gallbladder was centrally located. T-tube cholangiography revealed a quadruplication of the intrahepatic biliary ducts. To our knowledge, this patient is the only known adult with this syndrome in whom cholangiography demonstrated isomerism of the biliary tree. A review of the literature on this subject is given with emphasis on biliary anomalies.
Abnormalities, Multiple↗
Surgical aspects of sclerosing cholangitis. Results in 178 patients.
Of 178 patients with sclerosing cholangitis treated since 1950, 88 patients had associated inflammatory bowel disease, 72 had no such history, and 18 had iatrogenic injury or stone disease. A total of 233 biliary operations were performed, with a 75% rate of temporary improvement after initial operation. Subsequent operations resulted in a lower success rate and a higher mortality rate. Radiologic findings included predominant extrahepatic, intrahepatic, and diffuse disease in 29%, 28%, and 43% of patients, respectively; no survival differences were noted. Seventy-five of one hundred three deaths (73%) were related to liver failure, bleeding, or sepsis. Of 14 patients undergoing portosystemic shunt, 13 died of surgical complications or related disease. Orthotopic liver transplantation was performed in 16 patients and resulted in eight deaths, mainly in patients who had previously undergone extensive surgical treatment. No survival differences were seen between the patients with inflammatory bowel disease, those without the condition, or those who had colectomy. Surgical treatment in patients with sclerosing cholangitis should be minimized. Orthotopic liver transplantation should be offered as the treatment of choice for patients with portal hypertension, refractory cholangitis, advanced cirrhosis, or progressive liver failure.
Adolescent↗
Manual compression device for fluoroscopy.
A device for manual compression and palpation during supine fluoroscopy has been designed. It enables effective use of the physiologic grasping and lever force potentials of the hand and wrist. The device permits optimal fluoroscopic palpation and compression techniques and prevents direct exposure to the lead-gloved hand.
Fluoroscopy↗
Computed tomographic findings of giant intestinal pseudopolyposis.
The cases of 3 patients with giant intestinal pseudopolyposis are presented. Giant pseudopolyposis complicated chronic ulcerative colitis in 2 patients and granulomatous colitis in 1 patient. Each patient was evaluated with either barium or Gastrografin enema as well as with computed tomography (CT) after administration of oral contrast material. The unique manifestations of this unusual lesion as demonstrated by computed tomography are described.
Adult↗
Breast calcifications: analysis of imaging properties.
The imaging characteristics of microcalcifications in both benign and malignant breast conditions were analyzed in 48 digitized film mammograms. Each case included in this analysis had findings considered suggestive of malignancy by the radiologist, with the underlying histologic structure determined by excisional biopsy. Imaging properties of each microcalcification--such as pixel intensity, relative location, distribution, size, and local neighborhood intensities--were recorded. This information was statistically analyzed at the population level according to such selection criteria as histologic type, size of calcification, and cluster size. Distribution ranges were determined for these criteria. Statistical differences between data from benign and malignant cases show the average distance between calcifications in malignant conditions was greater than in benign conditions, and tissue region averages surrounding calcifications associated with malignant conditions were consistently higher than those for benign conditions.
Adult↗
Algorithm for the detection of fine clustered calcifications on film mammograms.
An algorithmic process for the detection and marking of clustered calcifications in digitized film-screen mammograms has been applied to mammograms from 50 clinical cases sampled at two digitization levels, in both the craniocaudal and mediolateral views. In all but one case the detector accurately located suggestive clusters found by radiologists in normal screening. In five cases additional clusters were also found by the detector. The detector has a negligible false-positive rate for the detection of clustered calcifications, although it is sensitive to clusters of emulsion defects displayed as artifactual calcification densities in the original film. The detector is flexible in structure and is easily adapted to various calcification/cluster criteria. The detector shows considerable promise when applied to clinical examples but will require refinement before formal testing.
Algorithms↗
Computed tomography of xanthogranulomatous cholecystitis.
A case is presented of xanthogranulomatous cholecystitis that resembled carcinoma of the gallbladder on computed tomography. The large, infiltrating mass satisfied the criteria for massive carcinoma of the gallbladder.
Calcinosis↗
Digital subtraction angiography.
Digital subtraction angiography is a new imaging technique that uses a computer to subtract background distractions and to enhance contrast and density. The intravenous administration of contrast material permits safe outpatient screening for arterial disease. The exact role of intravenous digital subtraction angiography in cerebrovascular disease is still in evolution and remains the subject of debate. The value of intravenous digital subtraction angiography in screening for renovascular hypertension is less controversial, but selection of patients remains a subject for further study. Intra-arterial digital subtraction angiography has become a standard imaging technique that offers both the inherent safety produced by reduction of the volume of contrast material and the added safety afforded by reduction of both the size of the catheter and the time required to perform complex arterial interventional procedures. With the evolution of more sophisticated computed technology and radiographic equipment, the impact of both intravenous and arterial digital subtraction angiography will become even more dramatic.
Angiography↗
Outpatient metrizamide myelography: prospective evaluation of safety and cost effectiveness.
A group of 228 consecutive patients undergoing metrizamide myelography was prospectively evaluated for postprocedure symptoms. The observed prevalence of these symptoms concurs with previously reported inpatient studies, with the most common sequelae being exacerbation or onset of spine or extremity pain, headache, nausea, and paresthesia. Limitation of administered dose of metrizamide in lumbar myelography may slightly reduce the occurrence of common symptoms, but withdrawal of contrast medium at the completion of examination had no impact on their occurrence. There was a higher occurrence of paresthesia in cervical myelography, but otherwise there was no significant difference in symptoms between cervical and lumbar studies. Outpatient metrizamide myelography can be performed with relative safety with the potential for significant cost savings.
Adolescent↗
Esophagogastric polyps: radiographic and endoscopic findings.
Radiographic, endoscopic, and pathological findings were correlated in 20 patients with polypoid esophagogastric lesions. In 16 patients, pathological examination showed chronic inflammatory change and epithelial hyperplasia; the polyp was located on the gastric side of the squamocolumnar junction, usually in association with a prominent gastric fold, and probably represented a localized form of gastritis. In the other 4 patients, the lesion was adenocarcinoma. An inflammatory esophagogastric polyp may be differentiated from polypoid carcinoma when adequate radiographs are available and specific diagnostic criteria are followed. Endoscopic biopsy is recommended if the lesion does not fulfill the criteria of an inflammatory esophagogastric polyp.
Adenocarcinoma↗
Digital subtraction angiography system evaluation with phantoms.
Advances in digital subtraction angiography imaging demonstrate the need for critical evaluation of the performance of digital subtraction equipment. The design of a phantom set for noninvasive assessment of the imaging quality of digital subtraction equipment is described; components include a remotely controlled transport system and individual patterns to evaluate the contrast and detail properties of the image intensifier, low-contrast sensitivity and resolution of the system, geometric distortion of image, linearity, mechanical and electronic stability of equipment, and effects of bone and bowel gas on iodine perception. The performance of an add-on digital radiographic system is presented, along with radiation exposure levels at the image intensifier for a range of radiographic techniques.
Angiography↗
Radiology of the ileoanal reservoir.
The radiology of the ileoanal reservoir based on a study of 50 consecutive patients is presented. Small-bowel obstruction (12%) and leakage at the ileoanal anastomosis (8%) were detected most commonly. Partial outlet obstruction from reservoirs fashioned from three segments of terminal ileum was noted radiographically as a common problem unique to this form of ileoanal reservoir. Superior mesenteric artery syndrome (6%), pelvic abscess (4%), pouch-vesicular fistula (2%), and several other problems were less frequent.
Adolescent↗
Common bile duct calculi. 1. Surgical therapy.
Multiple techniques are now available for management of the patient with retained or recurrent common bile duct calculi. The goal of treatment is extraction of calculi with the lowest possible incidence of morbidity and mortality, the lowest cost and least discomfort to the patient, and the best long-term results. The choice of therapy--surgical or nonsurgical--depends on several factors, including presence or absence of the gallbladder and a T tube, type of calculi, operative risk, accompanying conditions, and expertise available at a particular institution. The decision to explore the common bile duct at the time of elective cholecystectomy is based on clinical, operative, and cholangiographic information. A rigorous technique of surgical exploration that includes duodenal mobilization, choledochoscopy, and cholangiography is necessary. In selected patients, biliary enteric anastomosis decreases the incidence of retained or recurrent calculi.
Alkaline Phosphatase↗
Common bile duct calculi. 2. Nonsurgical therapy.
Several nonsurgical methods of therapy are available for treatment of retained common bile duct calculi. These include percutaneous extraction, endoscopic extraction, dissolution, and endoscopic sphincterotomy. The method chosen depends on location and size of calculi, size of sinus tract, patient age, surgical risks, and other factors. In most cases, procedures can be carried out safely and successfully with few or no complications.
Aged↗
Anorectal herpes: radiographic findings.
Radiography revealed aphthous ulcers, plaquelike erosions, and deep collar button ulcerations in a patient with herpes involving the rectum and the sigmoid colon. It is concluded that herpes simplex virus should be added to the list of disease entities that produce aphthous and collar button ulcerations.
Adult↗