Biomedical subjects
Publications and source records attributed to H C Meredith.
The segmental air esophagogram (SAE) is an incidental finding in normal and abnormal frontal chest radiographs. It recognition is important to the proper radiologic analysis of the mediastinum, and examples are presented to illustrate its variable appearance in healthy and diseased patients. The authors observe that the SAE may occur less frequently in patients with carcinoma of the thoracic esophagus.
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.
This article describes the angiographic findings in the case of a bleeding stump of the left gastric artery, following subtotal gastrectomy, into a pancreatic pseudocyst with instantaneous opacification of the pancreatic duct and duodenum. This is the first reported case to demonstrate a frank bleed with total opacification of the pancreatic duct. Based on our experience and previously reported cases, we conclude that subselective catheterization of the bleeding vessel is necessary to demonstrate total opacification of the pancreatic duct in such cases.
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.
Selective arterial embolization is an established technique to control gastrointestinal bleeding in patients who are poor surgical risks and in whom bleeding is uncontrolled by other methods. This article describes the control of upper gastrointestinal bleeding by subselective embolization of a bleeding branch of the dorsal pancreatic artery in a patient with severe pancreatitis. This is the first recorded successful embolization of the dorsal pancreatic artery to control hemorrhage.
The simultaneous occurrence of an intrahepatic hepatoportal fistula and portal hypertension generates questions about the priority and methods of treatment. Catheter embolization of the small-to-moderate fistula is not required, and surgical decompression of portal hypertension is recommended.
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An ectatic portal vein in a patient with portal hypertension and chronic active hepatitis simulated a vascular lesion in the head of the pancreas in a contrast-enhanced CT scan.
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Pulmonary lesions causing obliteration of the normal inferior vena cava (IVC) shadow on the lateral radiograph are described. Retrocardiac mediastinal mass lesions and subpulmonic pleural effusions may also obliterate the IVC contour. Loss of the IVC shadow is an additional radiographic sign of right lower lobe collapse and frequently of disease involving the medial basal segment of the right lower lobe. This finding should be an indication that further investigation is needed to explain the loss of normal aeration.
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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.
Gas in the joint and periarticular tissues appeared as an early radiographic manifestation of gram-negative septic arthritis of the hip in a diabetic patient. The features of gram-negative septic arthritis are discussed and the value of an early diagnosis is emphasized.
The patient was a 60-year-old white male who, for 18 months, had complained of a substernal wheeze on exertion, exertional dyspnoea and cough, and attacks of acute respiratory distress. There was no haemoptysis or dyshpagia and he was treated for bronchial asthma until bronchoscopy revealed the tumour which had not been recognized in plain chest films. He showed no evidence of a neurofibromatosis and apart from reduction in pulmonary function tests on a PO2 of 74, his laboratory tests were negative. There was no family history of neurofibromatosis. He underwent thoracotomy and a smooth rounded pedunculated tumour, 2.5 cm in diameter, arising from the posterior wall of the trachea, 3 cm above the carina was excised. He has had no tumour recurrence.
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