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Biomedical subjects

F Kolmannskog

Publications and source records attributed to F Kolmannskog.

At least 55 records · Page 3Linked to original sources

Chronic pancreatitis in patients with sclerosing cholangitis and ulcerative colitis.

In the 4-year period 1980-83 sclerosing cholangitis was demonstrated in 7 out of 151 patients with ulcerative colitis hospitalized in our department. Total ulcerative colitis was demonstrated in all patients with sclerosing cholangitis, whereas abnormal pancreatograms compatible with chronic pancreatitis were seen in four of these patients. According to the criteria of Kasugai, one had minimal, two moderate, and one advanced changes of chronic pancreatitis. Although three of four patients had been treated with drugs known to induce pancreatitis (sulfasalazine and corticosteroids), it is tempting to assume that ulcerative colitis, sclerosing cholangitis, and pancreatitis, when seen in combination, are manifestations of autoimmune diseases with a genetic predisposition. A mechanical mechanism for the development of chronic pancreatitis in sclerosing cholangitis must also be considered.

Adolescent↗

The pancreatic ducts in primary biliary cirrhosis and sclerosing cholangitis.

Endoscopic retrograde pancreatograms were examined in a consecutive series of patients with cholestatic disease caused either by primary biliary cirrhosis (PBC) (35 patients) or by sclerosing cholangitis (SC) (38 patients). The pancreatic ducts were abnormal in three of the patients with PBC but in none with SC. Gallstone disease occurred concomitantly in the two patients with most advanced pancreatic involvement. The liver disease was classified as advanced PBC in 11 of the 35 patients. Symptoms of hepatobiliary disease were scarce in most SC patients. Eight of the 38 patients had histologically verified biliary cirrhosis. SC was associated with extensive, but most often inactive or mild, colitis in 97% (ulcerative colitis in 34 and Crohn's disease in 3 patients). Three of these patients had concomitant cholangiocarcinoma.

Adolescent↗

Reproducibility and observer variation at computed tomography and ultrasound of the normal pancreas.

In order to evaluate the reproducibility of computed tomography (CT) and ultrasound (US), 13 patients with a normal pancreas were examined twice with the two techniques by the same observers. The results of the measurements of the pancreas were reproducible using both CT and US. In estimating the intraobserver variation at CT in 20 patients, the location and spread of the measurements of the diameters of the pancreatic head were reproducible, but the diameters of the pancreatic body and tail were significantly larger at the second observation. Further, the differences in the measurements of the size and dispersion of the pancreatic diameters at CT between two observers were significant, apart from the diameter of the pancreatic tail, where no significant difference was noted. The differences between two observers were greater than for the same. Using US, the results may indicate that the measurements were even less reproducible than using CT, both for the same observer and between two observers. However, all the measured diameters within the 95 per cent confidence intervals, were within the normal range. Consequently, even if most measurements differed significantly, these differences may probably not lead to any false conclusions concerning the limits of the normal size of the pancreas.

Diagnostic Errors↗

Computed tomography and angiography in carcinoid liver metastases.

Fifteen patients with carcinoid metastases in the liver were examined with computed tomography (CT). In 13 patients, liver metastases were demonstrated, while 2 patients had a normal liver at CT. The attenuation of the metastases was lower than that of the liver parenchyma in 12 patients, higher in one. Angiography was performed on 10 patients, and liver metastases were diagnosed in 9. Eight patients had hypervascular metastases with dense accumulation of contrast medium. In one patient, displacement of the intrahepatic arteries was the only sign of an expansive process. In one patient, previously treated with ligation of the common hepatic artery, no signs of liver metastases could be revealed at angiography but were evident at CT.

Adult↗

Tolerability of iohexol after injection into healthy volunteers.

The effects of iohexol, a new non-ionic contrast medium, after intravenous injection into humans are reported. After injection of small doses into 2 subjects, iohexol was injected intravenously into 20 healthy male volunteers in doses of 125 to 500 mg I/kg body weight. A large number of physiologic, biochemical, hematologic and pharmacokinetic parameters were analysed. The results indicated that iohexol was well tolerated and that clinical trials in patients could be undertaken.

Adult↗

Computer tomography of the abdomen in patients with uncharacteristic abdominal disturbances.

Computer tomography (CT) was performed on 48 patients with uncharacteristic abdominal disturbances. Pathological CT findings were encountered in five patients, namely hepatic steatosis in three patients, liver metastases in one, and occlusion of the inferior vena cava in one. CT may be indicated in patients with uncharacteristic abdominal disorders when other investigations are negative. In some patients the negative result of the CT examination for organic disease was of great importance for the psychiatric approach to these patients' psychosomatic disease. In spite of this, the positive yield of abdominal CT seems to be highest when other less expensive examinations or tests have suggested abnormality of abdominal organs.

Gastrointestinal Diseases↗

Abdominal ultrasonography in patients with uncharacteristic abdominal symptoms.

Ultrasonography (US) was performed in a prospective study of 48 patients with uncharacteristic abdominal symptoms. All patients had been examined in other hospitals, but no diagnosis had been established. Pathologic US findings were encountered in five patients: fatty liver in two patients, gallstones in one patient, ovarian cyst in one, and liver metastases in another patient. US may be used as a diagnostic approach in patients with uncharacteristic abdominal complaints when conventional X-ray examinations are negative. In patients with psychosomatic disease a negative US result may be of importance in the psychiatric approach to these patients' disease.

Abdomen↗

Cholangiography in rabbits before and after papillotomy.

The gallbladder and the function of the sphincter of Oddi were studied after papillotomy (EPT) in New Zealand white rabbits. Intravenous cholangiography (IVC) was performed before and after papillotomy. After papillotomy, IVC showed gallbladder opacification in one of seven test animals, whereas gallbladder filling occurred in all six control animals. The bile ducts were not visualized in any of the test animals, whereas five of six controls showed contrast filling of the bile ducts. Reflux cholangiography was performed after EPT and showed free reflux of contrast from the duodenum to the bile ducts. These findings indicate that papillotomy results in the insufficiency of the sphincter mechanism of the ampulla of Vater, and hence intravenous cholangiography may not be valid for showing the gallbladder and the bile ducts after papillotomy.

Ampulla of Vater↗

Computed tomography in surgical complications following renal transplantation.

Satisfactory computed tomograms were obtained in 57 of 64 patients with impaired function of renal allograft transplants. Surgical complications such as urinary obstruction or obstruction of arterial inflow, hemorrhage, urinoma, lymphocele, or abscess were found in 21 of 57 patients. Lymphocele was the most frequent. Although best demonstrated following intravenous contrast medium injection, 17 of 21 lesions could be diagnosed on precontrast scans. Noninvasive methods such as precontrast computed tomography (CT) or ultrasound (US) have replaced urography as the primary procedure in the diagnostic workup of these patients. If CT or US are inconclusive with regard to the size of the renal pelvis or if urinoma is suspected, high dose urography should be performed.

Adolescent↗

Diagnostic value of computed tomography in pancreatic carcinoma: a comparison with other radiologic methods.

Computed tomography (CT) performed on 54 patients with pancreatic carcinoma showed evidence of pancreatic disease in 44, but a definite diagnosis of an inoperable pancreatic carcinoma could be made in only 16 by revealing liver metastases. Differentiation between neoplastic and inflammatory disease was impossible in most patients, particularly in patients with resectable tumors. CT was found to be inferior to angiography, PTC and ERCP in diagnosing pancreatic carcinoma. CT was also significantly less sensitive than angiography in assessing operability. However, in patients where CT demonstrated liver metastases, angiography and ERCP may be avoided.

Adult↗

Computed tomography and angiography in pancreatic apudomas and cystadenomas.

During a 4-year period 17 patients with pancreatic apudoma and 3 patients with cystadenoma of the pancreas were admitted to this hospital. Computed tomography correctly located 3 of 4 insulinomas examined, while angiography revealed 4 of 8, which indicates that CT may replace angiography as the primary examination of these tumors, and possibly also other types of apudomas. When CT fails angiography may demonstrate a pancreatic tumor, suggesting angiography as a supplementary examination. In cystadenoma sufficient information was obtained at CT.

Adolescent↗

Computed tomography and ultrasound of the normal pancreas.

Computed tomography (CT) and ultrasound (US) were performed on 47 patients with a normal pancreas. CT was a significantly better method than US to demonstrate the pancreatic body and tail. The pancreatic head was also shown more often using CT than US, but this difference was not statistically significant. The diameters of the different parts of the pancreas measured at CT were significantly larger than measured at US. The explanation is most probably that the widths of the splenic and superior mesenteric veins are added to the diameters of the pancreas measured at CT, while using US, these vessels are clearly differentiated from the pancreatic tissue. US was a significantly better technique than CT to register the vascular structures surrounding the pancreas, except from the left renal vein, which was more often demonstrated at CT.

Adolescent↗

Computed tomography and angiography in hepatocellular carcinoma.

Computed tomography and angiography were performed in 12 patients with hepatocellular carcinoma, all demonstrated with CT. In 11, the tumor had a lower attenuation than the liver parenchyma, in one a higher attenuation. Two patients had 2 lesions. The hepatic contour protruded in 10 patients. Angiography failed to demonstrate the tumor in 3 patients. The most common angiographic findings were arterial displacement in 8 patients and a hypervascular mass in 7.

Adolescent↗

Sclerosing cholangitis in ulcerative colitis. A follow-up study.

In the 5-year period 1974-78, 48 (14%) of 336 patients with ulcerative colitis were found to have hepatobiliary disease. Endoscopic retrograde cholangiography (ERC) was successfully performed in 39 of these 48 patients, and sclerosing cholangitis was demonstrated in 19. One is excluded from this series because Crohn's disease was diagnosed at reclassification of the bowel disease. Two of the 18 patients with ulcerative colitis and sclerosing cholangitis have died, one of cholangiocarcinoma and one of an unrelated cause. The remaining 16 patients have been observed for a median period of 6 years (3-13 years) since the diagnosis of hepatobiliary disease. Ten have remained symptom-free, four have had intermittent or non-progressive symptoms, and two have developed symptoms of advanced chronic liver disease. The bilirubin level, which was initially raised in one of the patients, was elevated in four at the follow-up examination. Otherwise the laboratory values have remained stationary. Evidence of a progression of the hepatobiliary disease was found in most patients by repeated liver biopsy and particularly ERC. It is concluded that sclerosing cholangitis may remain asymptomatic for several years. Since progressive cholangiographic changes were often seen without concomitant worsening of symptoms, laboratory data, and liver biopsy findings, it is concluded that these criteria are of limited use in evaluating the progression of this disease.

Adult↗