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H G Zegel

Publications and source records attributed to H G Zegel.

9 recordsLinked to original sources

Retained anchoring suture after removal of a Cope-loop drainage catheter: use of the retract-and-cut method.

A method is described for managing retention of the anchoring suture within the tract after a Cope-loop drainage catheter has been removed. In the authors' experience, the overwhelming majority of such strings can be extracted by sliding a dilator over the suture and using gentle manipulation at the site of adherence. However, in 12 patients, this technique was not successful. In these patients, the retract-and-cut method was used: The suture is pulled taut and cut at the surface, allowing it to retract into the tract. This provided a safe and simple solution for this complication.

Bile

Repair of Achilles tendon ruptures with a polylactic acid implant: assessment with MR imaging.

An investigational tendon repair device composed of a polymer of lactic acid (PLA) is currently undergoing multicenter clinical trials for use in repairing rupture of the Achilles tendon. The advantages of the PLA device include high tensile strength and the induction of a rapid proliferative tissue response resulting in a shorter rehabilitation period than with conventional surgical repair. We reviewed 16 MR examinations performed in 10 patients 3-35 months after repair to characterize the MR appearance. All 16 T1-weighted sagittal images revealed a thickened fusiform tendon with streaks of moderate signal within the tendon corresponding to the PLA device and its surrounding collagenogenic response. The double-echo T2-weighted axial images at the mid tendon level demonstrated progressive changes in the signal pattern of the central portion of the tendon that reflected the maturation of the healing tendon. All tendons repaired with PLA implants were uniformly hypertrophied relative to the contralateral normal side because of the induced proliferative collagenogenic ingrowth. Two follow-up MR examinations were performed in six patients and showed mean reductions in tendon caliber of 24% and 30% at the mid and inferior levels. MR imaging of the Achilles tendon repaired with PLA implants shows a diffusely thickened tendon with streaks of signal within the tendon that distinguish it from tendons repaired by conventional techniques.

Achilles Tendon

Evaluation of the lacrimal apparatus with digital subtraction macrodacryocystography.

Patients who suffer from epiphora can benefit from reconstructive surgery in many cases of obstructive and nonobstructive lesions of the lacrimal apparatus. We describe our technique of digital subtraction macrodacryocystography (DSM) and discuss its efficacy in the evaluation of various abnormalities involving the lacrimal drainage pathway. A variety of pathologic conditions of the lacrimal apparatus are portrayed. DSM is an accurate, easy to perform, but relatively unrecognized method of anatomic localization of obstructive lesions within the lacrimal drainage system.

Dacryocystitis

Delayed esophageal perforation after pneumatic dilatation for the treatment of achalasia.

Two cases of delayed esophageal perforation following a pneumatic dilatation for the treatment of achalasia are presented. Esophagrams obtained immediately after pneumatic dilatation failed to reveal a perforation. Increasing symptoms prompted repeat contrast studies, at which time an esophageal perforation was demonstrated. The occurrence of delayed esophageal perforation after pneumatic intrumentation is emphasized. An ischemic etiology for this delayed perforation is postulated.

Dilatation

Filiform polyposis.

Filiform polyposis presents a characteristic radiographic appearance consisting of long, filamentous filling defects in an otherwise normal colon. It has previously been reported in patients with a prior history of ulcerative colitis and in one patient with granulomatous colitis. The authors document its development in patients with ulcerative and granulomatous colitis. The authors have also seen a solitary filiform polyp in a patient with previously undiagnosed inflammatory bowel disease, and filiform polyps in the stomach in a patient with documented Crohn disease involving the small bowel. It is believed that this represents a nonspecific sequela of diffuse mucosal inflammation; it should not be mistaken for a neoplastic form of polyposis.

Adult