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Biomedical subjects

R D Redvanly

Publications and source records attributed to R D Redvanly.

9 recordsLinked to original sources
PubMed1998

Primary hepatic malignant neoplasms.

Although metastatic disease is by far the most common form of neoplastic involvement of the liver, a variety of primary hepatic malignant neoplasms may develop from any of the cell types within the liver. Primary hepatic neoplasms include hepatocellular carcinoma, intrahepatic cholangiocarcinoma, biliary cystadenocarcinoma, and a variety of mesenchymal tumors. This article reviews the clinical presentation and pathology of these tumors and discusses their sonographic, CT scan, and MR imaging appearance.

Humans↗
PubMed1998

Management of pancreatic pseudocysts.

BACKGROUND: Operative internal drainage has been standard treatment for chronic unresolved pancreatic pseudocysts (PPs). Recently, percutaneous external drainage (PED) has become the primary mode of treatment at many medical centers. STUDY DESIGN: A retrospective chart review was performed of 96 patients with PPs who were managed between 1987 and 1996. Longterm followup information was obtained by telephone and mail questionnaire. RESULTS: Twenty-seven patients underwent computed tomographic (CT)-guided PED. PP resolution occurred in 17 patients. Clinical deterioration or secondary infection mandated urgent pancreatic debridement in 7 (26%) patients and cystgastrostomy in 2 (7%) patients. There was one hospital death in this group. Thirty-two patients underwent cystgastrostomy or cystjejunostomy (n = 21), distal pancreatectomy (n = 8), pancreatic debridement and external drainage (n = 2), or cystectomy (n = 1). Two (6%) patients required postoperative pancreatic debridement for failure of resolution and peritonitis and two patients underwent PED of abscess. There was one hospital death in the expectantly managed group of 37 patients. Median followup of 3 years (range, 0.5-9.3 years) in 66 patients revealed that 6, 3, and 4 patients of PED, surgery, and expectantly managed groups, respectively, had radiologic evidence of recurrent PPs. CONCLUSIONS: Operative management for PPs appears to be superior to CT-guided PED. Although the later was often successful, it required major salvage procedures in one third of the patients. An expectant management protocol may be suitable for selected patients.

Abscess↗
PubMed1997

Intra-abdominal manifestations of AIDS.

Infection with HIV results in profound immunocompromise that places patients with AIDS at risk for the development of numerous opportunistic infections and neoplasms. Many patients have symptoms referable to the GI tract and abdomen, and undergo imaging studies. The radiologist thus plays a pivotal role in establishing a presumptive diagnosis, which may lead to empiric treatment until a definitive diagnosis is established.

AIDS-Associated Nephropathy↗
PubMed1995

Imaging in the preoperative evaluation of adult liver-transplant candidates: goals, merits of various procedures, and recommendations.

Advances in organ procurement and surgical techniques have made orthotopic liver transplantation (OLT) an accepted treatment for many adult patients with end-stage hepatic disease. At present, OLT is being performed in patients with a variety of diseases, and 5-year survival is estimated at 65-78% [1]. Over 80% of hepatic transplants are performed in patients with cirrhosis or primary cholestatic liver disease, and only 5% of transplants are performed for malignant hepatic neoplasms (Table 1) [2]. Because the supply of donor organs is limited, preoperative clinical and radiologic evaluation of the transplant candidate is critical for appropriate patient selection. The main objective of preoperative imaging is to provide the surgeon with the pertinent information needed to plan and perform OLT and to exclude patients for whom surgery either is not feasible or will be of no benefit.

Algorithms↗
PubMed1993

Malignant hepatic tumors: safety of high-dose percutaneous ethanol ablation therapy.

The authors retrospectively analyzed clinical records to determine the safety and complication rate of percutaneous ethanol ablation therapy with more than 10 mL of ethanol administered per session for treatment of malignant hepatic tumors. Ten patients underwent a total of 35 sessions with 10 mL or more of ethanol, and four underwent 18 sessions with 10 mL or less. No serious complications occurred with any dose. Pain and fever were the most common complications at all doses, and the higher frequency of these at larger ethanol volumes may be related to the greater degree of tumor necrosis induced by the larger volume.

Adult↗
PubMed1992

Persistence of portosystemic collaterals and splenomegaly on CT after orthotopic liver transplantation.

OBJECTIVE: The appearances of portosystemic collaterals and splenomegaly on CT before and after liver transplantation were evaluated. MATERIALS AND METHODS: The records of 54 patients undergoing liver transplantation during a 2.5-year period were reviewed retrospectively. Twenty-five of these patients, in whom both a preoperative abdominal CT scan and a follow-up CT scan at least 1 year after transplantation had been obtained, were clinically well and had had no significant episodes of rejection, severe recurrent hepatitis, or other complication at the time of study. A total of 94 abdominal CT scans in these patients were reviewed to assess changes in portosystemic collaterals and splenic volume. RESULTS: At 6 months after transplantation, portosystemic collaterals at one or more sites were seen in 14 (74%) of the 19 patients scanned at this time in whom collaterals had been seen on CT preoperatively. At 1 year after transplantation, splenic hilar collaterals persisted in 64% of patients, splenocolic ligament collaterals in 50%, retroperitoneal collaterals in 38%, and peripancreatic collaterals in 38% of patients with preoperative varices at these sites who were examined with CT at this interval. Splenic hilar, coronary, and retroperitoneal collaterals were found to persist for up to 4 years after transplantation in the single patient examined at that time. Splenic volume decreased in 94% of patients examined after transplantation, with a mean reduction of 60 +/- 19%. However, the spleen remained significantly enlarged in 56% of patients. CONCLUSION: We conclude that portosystemic collaterals and splenomegaly frequently persist after liver transplantation, but that this finding need not indicate recurrence of hepatic disease or other posttransplantation complications.

Adult↗