Tc-99m methylene diphosphonate accumulation by a pulmonary hamartoma.
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Biomedical subjects
Publications and source records attributed to L S Schechter.
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We report a case involving the localization and surgical removal of a traumatically introduced foreign body deep within the infratemporal fossa. Needle-hookwire placement with computed tomographic guidance allowed the precise localization and marking of the foreign body. Surgical removal under local anesthesia and without extensive exploration was, therefore, possible. The details of the localization and marking techniques are described. Needle-hookwire localization under computed tomographic guidance should be considered for deeply located foreign bodies in the head and neck area.
The hepatic angiographic features of a 45-year old black woman who was found to have abdominal tuberculosis are described. The clinical and arteriographic findings were similar to those found in malignant disease. A histological diagnosis is essential in such cases.
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A retrospective assessment of the presence of air in the biliary tract is presented, based on plain film findings in 16 proven cases of gallstone ileus. In addition to five cases that demonstrated air in the biliary radicles, four cases exhibited air exclusively in the gallbladder and duodenal bulb. A clearly identifiable radiographic appearance composed of two adjacent small air-fluid levels in the right upper quadrant is described. This radiographic feature represents the air- and fluid-filled duodenal cap adjacent to the visualized shrunken gallbladder. Recognition of this combination of findings helps in establishing a prompt preoperative diagnosis in cases of gallstone ileus.
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The outstanding angiographic features of small intestinal intussusception are: (a) abrupt disappearance of mesenteric vessels at the neck of the intussusception with crowding of the vasa recta; (b) appearance of long collateral channels at the neck of intussusception; (c) angulation and retraction of major intestinal branches; (d) reversal of the course and angulation of the invaginated mesenteric vessels; (e) overlapping of the mesentery vessels by branches of the intussuscipiens; (f) abrupt change in the appearance of the vasa rectae of the distended intussuscipiens and the distal nondistended small intestines.
In Osler-Weber-Rendu syndrome, visceral organs are frequently involved in addition to cutaneous and mucous membranous lesions. Detailed arteriographic investigation of 5 patients with this abnormality disclosed characteristic angiodysplastic lesions involving the lungs, liver, spleen, pancreas, gastrointestinal tract and mesentery. Arterial and aortic aneurysms appear to be an integral part of this abnormality. Common to angiodysplastic lesions is a variable degree of arteriovenous shunting. The arteriographic characteristics and the hemodynamic significance of major visceral arteriovenous shunts in hereditary hemorrhagic telangiectasia are discussed.
Gastric leiomyoblastoma is a rare intramural tumor which originates in the smooth muscle. Nine cases were studied with respect to their clinical, radiological, and pathological features. Six distinct radiological patterns may be seen, of which 5 are represented in this series. Most such lesions occur in the gastric antrum. Leiomyoblastomas are generally benign and do not recur following removal.
Our experience based on the analysis of 12 proved cases of gallstone ileus is presented emphasizing the fact that the plain abdominal roentgenogram may be inconclusive or deceiving. It allowed us to suggest the correct diagnosis in only 4 cases. A high index of suspicion, particularly in elderly female patients, followed by barium examination of the upper gastrointestinal tract leads to a correct and rapid diagnosis. The demonstration of a diverticulum-like structure or a fistulous tract adjacent to the first portion of the duodenum associated with jejunal dilatation and barium dilution is highly reliable.
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