Mammography versus physical exam at a community hospital.
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Biomedical subjects
Publications and source records attributed to M E Zelenik.
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This case report describes the value of CT diagnosis and subsequent pathologic verification of torsion and associated hemorrhage in a benign ovarian cyst manifested by symptoms of an acute abdomen.
Seventeen examples of different pathologic conditions, including malignant and benign tumors, and inflammatory, traumatic, and congenital lesions involving the sacrum, are presented. The value of computed tomography is compared with that of conventional methods with respect to diagnostic evaluation and clinical management of these patients. Computed tomography proved to be more accurate in delineating the extent of bony lesions, diagnosing adjacent soft tissue involvement, evaluating the progress of a lesion, and defining the approach for biopsy of a sacral lesion or determining the feasibility of surgery.
A system to simplify infusion and maintain a high level of intravascular contrast material during CT scanning is described. A standard 150 ml container of 60% iothalamate meglumine (Conray), standard intravenous tubing, and a charge of air, which is introduced into the contrast material, are used. The system provides more uniform intravenous levels of contrast material over the interval of the scanning procedure, which results in consistently improved vascular opacification.
When urinary drainage is necessary but urethral catheterization is not satisfactory or not feasible, percutaneous nephrostomy can be considered. The nonsurgical technique, which was high success and low complication rates, often allows postponement of surgical intervention or may make such treatment unnecessary.
Stenosis in the right common iliac artery of a 61-year-old man was manifested as pain in the right leg and foot and cyanosis of the second and third toes. Dilatation of the lesion was performed using a Grüntzig catheter; arteriography and measurement of femoral artery pressure confirmed a successful result. The patient was pain free at six-month follow-up. Dilatation of stenoses by percutaneous transluminal angioplasty provides an alternative to conventional operative procedures, with lower cost and morbidity plus an acceptable success rate.
The computed tomographic (CT) findings in three patients with posterior fossa epidural hematoma are reviewed. Both acute and subacute forms of presentation are depicted. Discussion is centered on the efficacy of both noncontrast (NCCT) and contrast-enhanced (CECT) computed tomography in the diagnosis and management of this type of injury. The extension of hematoma across a dural sinus, a pathognomonic CT finding of posterior fossa epidural hematomas, is demonstrated.
Bowel infarction is a cause of acute abdominal emergency with high associated morbidity and mortality. Prior to the advent of CT, specific diagnosis was made either by mesenteric angiography or by direct visualization at surgery. This article describes the CT detection of intravascular mesenteric gas as a reliable indication of bowel infarction. Other nonspecific findings associated with bowel infarction and ischemia are also discussed.
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