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Biomedical subjects

K C Simpkins

Publications and source records attributed to K C Simpkins.

At least 19 recordsLinked to original sources
PubMed1994

Is it worth doing barium enemas on patients with unexplained iron deficiency anaemia?

The incidence on double contrast barium enema (DCBE) of carcinomas and polyps > 1 cm in size was compared in 92 patients with iron deficiency anaemia and a group of randomly obtained non-anaemic controls. In the anaemic group there were eight carcinomas and four polyps, and in the control group two carcinomas and no polyps. The incidence of neoplasms in the anaemic group (13.0%) was significantly greater than in the control group (1.6%). The incidence of neoplasms in iron-deficient males was 19% compared with 9% in females. The presence of bowel symptoms or weight loss were not found to be significant. This study confirms the value of DCBE in investigating patients with unexplained iron deficiency anaemia even in the absence of bowel symptoms.

Aged↗
PubMed1993

Case report: pericolic abscess secondary to torsion of an appendix epiploica.

Torsion of the appendices epiploicae is a rare condition which may present with acute abdominal pain and mimic appendicitis. Untreated, peritonitis or intestinal obstruction may result. We present a case in which torsion of an appendix epiploica led to the development of a pericolic abscess communicating between the colon and lesser sac. To our knowledge these radiological findings have not been described previously.

Abscess↗
PubMed1993

Is the appendix where you think it is--and if not does it matter?

For over 100 years the recognized surface marking for the appendix has been McBurney's point (the junction of the lateral and middle thirds of a line joining the umbilicus with the right anterior superior iliac spine (ASIS)). In order to test its validity, the relationship between McBurney's point and the appendix was determined on 275 double contrast barium enemas (DCBE). A wide spread of distribution of the site of the appendix base was seen. Only 35% of appendix bases were found to lie within 5 cm of McBurney's point, and 15% were more than 10 cm distant. Seventy-five per cent of appendix bases were below and medial to a line joining the umbilicus with the right ASIS. These findings are in agreement with world-wide studies conducted by the World Organisation of Gastroenterology which showed that less than half of all patients with appendicitis have tenderness maximal over McBurney's point. A record was also made in 93 cases of the position of the appendix in relation to the caecum. The importance of these results in the diagnosis and management of patients with suspected appendicitis is discussed.

Adolescent↗
PubMed1989

Aspiration of high-density barium contrast medium causing acute pulmonary inflammation--report of two fatal cases in elderly women with disordered swallowing.

Two cases are reported in which accidental inhalation of barium contrast medium occurred owing to disordered swallowing in elderly women. In each case there was a pulmonary inflammatory reaction followed within a few hours by death. Experimental and clinical reports of barium inhalation are reviewed and the hazard of aspiration of high density barium preparations in elderly and debilitated patients with dysphagia is emphasised. It is concluded that particular care should be taken in the radiological examination of such patients, and a suggested method for performing a contrast swallow in those who are liable to aspirate is described.

Acute Disease↗
PubMed1989

Annual oration 1989: bring out your barium.

A critical review of the use of barium examinations of the gastrointestinal tract compared with endoscopy provides evidence of a valid role for barium studies in contemporary radiology. It is concluded that there is no clinical, scientific, or economic justification for the wholesale replacement of barium radiology by endoscopy.

Administration, Oral↗
PubMed1985

New method for the dynamic assessment of anorectal function in constipation.

A new dynamic technique for the investigation of anorectal function has been developed. This involves radiological visualization of the rectum during voiding of a semisolid radio-opaque contrast medium, and simultaneous measurement of the intrarectal pressure and electrical activity of the external anal sphincter. The method has been used to study patients (n = 16) with profound difficulty passing formed stool. It has demonstrated an abnormal increase in the activity of the puborectalis and superficial and sphincter muscles during voiding in these patients, compared with normal subjects (n = 6). The inability to void was associated with failure to widen the anorectal angle on straining.

Adult↗
PubMed1985

The barium enema appearances in solitary rectal ulcer syndrome.

Solitary rectal ulcer syndrome is a benign condition of unknown aetiology, usually found in young adults. The main clinical complaint is of rectal bleeding, often with change in bowel habit. The radiological findings in 17 patients with histologically proven solitary rectal ulcer syndrome, seen at the General Infirmary at Leeds over an 8-year period, are presented. Ulceration, polypoid lesion, stricture, granularity or a normal rectal mucosa may all be found on barium enema. The histological findings and pathogenesis of the condition are discussed.

Adolescent↗
PubMed1983

Do plain films of the chest and abdomen have a role in the diagnosis of acute pancreatitis?

Radiographs taken on the day of admission on 52 patients with acute pancreatitis have been compared with similar radiographs of 30 patients with acute cholecystitis and 22 patients with perforated duodenal ulcer. Two radiologists, who were unaware of the clinical features, looked specifically for the presence of 30 radiological signs. The only abdominal signs seen more frequently in acute pancreatitis were fluid levels in the stomach and duodenum, usually associated with dilatation. Duodenal abnormalities were seen in 42% of patients with acute pancreatitis and 21% of the controls (P less than 0.05) while gastric dilatation with a fluid level was seen in 29% of cases of acute pancreatitis compared with 12% of controls (P less than 0.05). Seventy per cent of the patients with severe acute pancreatitis had an abnormal chest radiograph on admission compared with 18% of those with mild disease. Left pleural effusion was the most common abnormality in severe pancreatitis (43%) and was seen significantly more often than in mild pancreatitis (P less than 0.01) and the control group (P less than 0.05). Therefore, consideration of the admission chest radiograph may help at an early stage to distinguish patients with severe pancreatitis from those with mild disease.

Acute Disease↗
PubMed1983

Abdominal actinomycosis: a report of three cases.

Abdominal actinomycosis is a rare condition which is difficult to diagnose because of its close resemblance to other, more common conditions. The clinical and radiological features of three cases are described and illustrated. The diagnosis is suggested by the rapid development of a fixed mass with fistulae.

Actinomycosis↗
PubMed1982

A comparison of barium sulphate preparations used for the double contrast barium meal.

Radiologists' opinions of the properties of six barium suspensions with their recommended gas-producing agents designed for upper gastrointestinal use were assessed, using a linear analogue scale. Five radiologists independently assessed mucosal coating of stomach and duodenum, areae gastricae, gaseous distension and bubble formation in a total of 258 patient examinations. Preparation 1 (EZHD) was judged to give best overall results, coating stomach and duodenum particularly well. Preparation 2 (X-Opaque) gave good distension and also coated mucosa fairly well, as did preparations 3 and 4 (Medebar XAC and Field 2C). The latter two preparations produced good distension at the expense of bubble formation. Preparations 5 and 6 (Micropaque DC and Baritop G) were judged, by comparison, to have performed poorly as regards mucosal coating. None of the preparations delineated areae gastricae well, even in the presence of good, bubble-free gastric distension.

Barium Sulfate↗
PubMed1981

The barium enema diagnosis of paracolic abscess.

The barium enema diagnosis of 38 cases of paracolic abscess is discussed. The importance of an appreciation of the anatomy of the peritoneum and of the paracolic region is emphasized. Five features of paracolic abscess that can be recognised on double contrast barium enema examination are analysed. These are soft tissue mass; extraluminal gas collection; barium-filled cavitation; displacement, impression or narrowing of the lumen; and mucosal changes. The commonest feature, present in 95% of cases, is displacement or impression or narrowing of the bowel lumen. An analysis according to site and aetiology is presented and the commonest causes found to be diverticulitis and appendicitis. The differential diagnosis is discussed, and differentiation from primary colonic carcinoma, metastases, Crohn's disease, ischaemia and endometriosis is described.

Abdomen↗
PubMed1979

Experience with the Russian model 249 suture gun for anastomosis of the rectum.

The Russian Model 249 circular suturing device used for rectal anastomoses in 62 patients undergoing high or low anterior resection or colectomy and ileorectal anastomosis was technically easy to use. The 38 high anastomoses were all shown to be intact by a Gastrografin, meglucomine diatrigoate, enema study 14 days after the operation. Of the 24 low anastomoses, six demonstrated small, 5 to 10 millimeters, dehiscences, two of the latter being evident also upon clinical examination. At least six of the low anastomoses were made at levels too low for hand suture from the abdomen. In three patients, moderate hemorrhage from the anastomotic site during the first two or three days complicated the situation; in all, it ceased spontaneously. In two patients, strictures developed, one of which rectified itself once the fecal stream was restored to the rectum on closing the transverse colostomy, the other was submitted to instrumental dilation, perhaps unnecessarily. The Model 249 circular suturing device provides colorectal anastomoses that are at least as secure as those done by hand suture and, sometimes, enables an anastomosis to be made at a lower level than would be possible by the conventional suture technique through the abdomen. Bleeding from the anastomotic site and subsequent stricture formation are rare complications of this technique.

Colectomy↗
PubMed1978

Assessment of the double contrast barium meal: method and application.

A method of assessing and comparing double contrast barium meals has been devised. The use of the linear analogue scale has been found to be a consistent method of recording and measuring radiological impression of mucosal coating and gaseous distension. By this means the effectiveness of various currently available barium and gas preparations has been assessed in 125 patients. Appreciable differences in mucosal coating achieved by different barium preparations were detected. Satisfactory gaseous distension of the stomach and duodenum was produced in the majority of patients by all of the methods tested, and the following measurements are suggested as an index of good distension: gastric fundus 10 cm, gastric midbody 7 cm, duodenal loop 4 cm. The relationships between mucosal coating, gaseous distension and areae gastricae have been shown to be tenuous. It is suggested that the methods we have used are very suitable for repetition in other centres for the comparison of any of the many barium and gas-producing agents which continue to come on to the market.

Barium Sulfate↗