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J E Jacobs

Publications and source records attributed to J E Jacobs.

58 records · Page 4Linked to original sources
PubMedDate not supplied

Omental infarction as a delayed complication of abdominal surgery.

Omental infarction, an uncommon cause of acute abdominal pain, is the result of compromised perfusion to the greater omentum. Although its etiology remains uncertain, predisposing factors include obesity [Surg. Today 30 (2000) 451], strenuous activity [N. Z. Med. J. 111 (1998) 211], trauma, and idiopathic omental torsion. Often confused with acute appendicitis or cholecystitis on clinical grounds [Surg. Today 30 (2000) 451], its diagnosis has traditionally been one of exclusion, based on intraoperative and pathologic findings. This diagnosis can be made radiologically based on the characteristic findings of an inflammatory mass containing fat and fluid. We describe a case of right lower quadrant omental infarction temporally related to bowel surgery.

Abdomen, Acute↗
PubMedDate not supplied

Comparison of resistive index versus pulsatility index in assessing the benign etiology of adnexal masses.

Retrospective analysis of pelvic sonograms with colorguided spectral Doppler evaluation of 189 adnexal masses yielded four malignancies, 20 benign neoplasms, 32 cysts, and 14 endometriomas. Fifty-eight masses were presumed benign on additional imaging. Pulsatility index (PI) < 1.0 was seen in 70% neoplasms, 63% benign cysts and 50% endometriomas. Thirteen percent of benign cysts and no neoplasms had resistive index (RI) < 0.4. Fifty percent malignancies had PI < 1.0. None had RI < 0.4. Both thresholds lack sufficient sensitivity and specificity for distinguishing benign and malignant lesions.

Adolescent↗
PubMedDate not supplied

Sonography of transjugular intrahepatic portosystemic shunts: detection of elevated portosystemic gradients and loss of shunt function.

PURPOSE: To evaluate the role of ultrasound (US) in the detection of elevated portosystemic gradients and loss of shunt function in patients with a transjugular intrahepatic portosystemic shunt (TIPS). MATERIALS AND METHODS: The authors' prospectively compared 151 Doppler hepatic sonograms with follow-up portal venograms in 64 patients with TIPS. Sonographic data from within the portal system, hepatic arteries, and three areas within the TIPS were collected. Statistical analysis of these parameters was used to establish the US criteria for shunt dysfunction. RESULTS: Midshunt velocity thresholds of less than 50 and less than 60 cm/sec yielded sensitivities and specificities of 46% and 93%, and 57% and 89%, respectively, for the detection of portosystemic gradients exceeding 15 mm Hg. Use of a threshold midshunt velocity of less than 60 cm/sec or main portal vein velocity of less than 40 cm/sec raised the shunt dysfunction detection sensitivity to 86%, with a specificity of 54%. CONCLUSION: Doppler US is an effective noninvasive screening tool for detecting elevated portosystemic gradients and evaluating the functional status of a TIPS. Midshunt velocities of less than 60 cm/sec or main portal vein velocities less than 40 cm/sec are a useful threshold for detecting shunt dysfunction.

Adult↗