Urography with non-ionic contrast media: II. Diagnostic quality and tolerance of iopromide in comparison with ioxaglate.
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Biomedical subjects
Publications and source records attributed to P Meiisel.
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A case of acute thrombosis of the aorta is described; it extended from the superior mesenteric artery to the bifurkation and was probably due to oestrogen medication. The clinical features and diagnosis of this rare condition are described. The condition usually develops against a background of advanced arteriosclerosis and is initiated by certain haemodynamic factors such as intimal damage from blunt trauma, emboli or the thrombogenic effect of oestrogens. The symptoms, such as pain, absent pulses etcetera are the result of ischaemia and depend on the extent of the lesion. A definite radiological diagnosis can only be made by means of aortography, if necessary with oblique projections. The Seldinger technique with a femoral or axillary approach is the method of choice. Aortography shows a filling defect and occasionally a collateral circulation.
Hypernephromas were found in horseshoe kidneys in two patients; the diagnostic problems arising from this combination are discussed. Detailed demonstration of horseshoe kidneys by excretion urograms may be poor and tumours may therefore be overlooked and, on palpation, an abnormality within the gastrointestinal tract may be simulated. Angiography usually indicates the diagnosis and helps in planning surgery. Although there is no increase in the incidence of adeno-carcinomas in horseshoe kidneys, there is a significant increase in the incidence of Wilm's tumours and of carcinomas of the renal pelvis. Treatment consists of heminephrectomy or resection of the tumour; complications are relatively common.
The angiographic criteria of 19 renal pelvic carcinomas were analysed. Two groups of signs, direct and indirect, could be detected. Of 19 histologically proved cases of renal pelvic carcinomas, the diagnosis had not been made angiographically in the case of a small tumor, which was 11 mm in diameter. The usefulness of preoperative angiography for diagnosis and operative planning is emphasized.
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