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Biomedical subjects

R M Mendelson

Publications and source records attributed to R M Mendelson.

33 records · Page 2Linked to original sources
PubMed1994

Computed tomography in acute small bowel obstruction.

The abdominal computed tomograms of 28 patients with a clinical diagnosis of acute small bowel obstruction were reviewed. Computed tomography accurately identified the presence, severity and level of obstruction. Signs such as angulated bowel loops and adjacent streaks within the mesentery at points of luminal calibre change were recognized in 69% of cases with adhesive obstruction. Computed tomography may reveal non-adhesive causes and is the modality of choice for investigating patients with higher grades of bowel obstruction where early surgical intervention is contemplated.

Acute Disease↗
PubMed1991

A case of fibrolamellar hepatocellular carcinoma.

Fibrolamellar hepatocellular carcinoma is an uncommon histologic subtype of hepatocellular carcinoma, comprising 3.5% of all hepatocellular carcinomas in one large study (Brandt et al 1988). It usually occurs in young people, the average age being 18 years (Farhi et al 1983). It is not associated with cirrhosis and the serum alphafetoprotein is usually normal (Craig et al 1980). Fibrolamellar hepatocellular carcinoma has a more favourable prognosis than the usual hepatocellular carcinoma, with an average survival of 32 months from onset of symptoms, compared to 6 months for the usual type. The resectability rate and 5 year survival figures are also much better (Craig et al 1980). Hence distinguishing this histological subtype is important for surgical management and survival prognosis. This report describes a full radiological evaluation of such a case, covering the wide spectrum of relevant imaging modalities.

Adolescent↗
PubMed1988

Bile duct measurements after ceruletide as an aid to the ultrasound diagnosis of choledocholithiasis.

Despite good results in gallbladder imaging, ultrasound (US) diagnosis of choledocholithiasis remains a challenge. The value of US before and after a provocative injection of the decapeptide ceruletide was examined in 25 patients with suspected common duct stones immediately prior to diagnostic retrograde cholangiography. An abnormal response (increase in US duct diameter) was seen in 4 of 6 patients with an obstructed duct, giving a sensitivity of 67% and predictive value of 80% for the procedure. There was a normal response (decrease in US diameter of a dilated duct or decrease/no change in a normal duct) in 14 of 19 with an unobstructed duct (specificity 79%, predictive value 93%) and an equivocal response (no change in diameter of a dilated duct) in 5 patients. In 1 patient a calculus not seen on the initial US became visible as the duct distended by ceruletide administration. Symptoms after ceruletide were few and not discriminatory. Although it added to the time and difficulty of performing biliary US, ceruletide administration proved a useful adjunct to the diagnosis of choledocholithiasis.

Bile Ducts↗
PubMed1987

Atypical presentation of empyema of the gall bladder.

A case of empyema of the gall bladder complicated by liver abscesses is reported. The mode of presentation was atypical for both the empyema and the abscesses and computed tomography (CT) played a significant role in the diagnosis and management.

Cholecystitis↗
PubMed1985

The radiological features of chronic radiation enteritis.

The radiological findings, using a single-contrast barium infusion technique, are described in a series of 13 patients with chronic radiation enteritis. The signs include evidence of submucosal thickening, single or multiple stenoses, adhesions and sinus or fistula formation. A combination of these signs characterises the condition. This technique is particularly suited to the investigation of radiation enteritis because of its ability to distend maximally the small intestine. A cause, stenosis and/or adhesions, was demonstrated in the eight of the 13 patients presenting with intermittent small-intestinal obstruction. Three patients had diarrhoea as their predominant complaint and a fistula was demonstrated in two.

Adult↗
PubMed1980

The treatment of giardiasis.

Very effective treatment for giardiasis is available. There is little to choose in efficacy between the major drugs I have mentioned, used at optimum dosage, but mepacrine probably has a higher frequency of unwanted effects than many of the newer drugs, and the required duration of treatment is longer. Tinidazole is a very promising drug, being effective in single dosage with infrequent side effects.

Furazolidone↗
PubMedDate not supplied

A combined flexible sigmoidoscopy and double-contrast barium enema service: initial experience.

BACKGROUND: A service has been instituted offering a combined single-stage procedure of flexible sigmoidoscopy and double-contrast barium enema (FS/DCBE). The results have been reviewed in the first 80 patients to undergo this examination (45 male: 35 female; mean age 61.4 years). METHODS: Indications for investigation were abdominal pain or suspected diverticular disease (22 patients), altered bowel habit (19), rectal bleeding (17), iron deficiency anemia (6), and miscellaneous (16). FS was followed immediately by DCBE. Radiographs were reviewed by two radiologists unaware of the FS findings. RESULTS: The extent of FS was to the proximal sigmoid or sigmoid descending colon or splenic flexure in 12.5%, and mid or distal sigmoid in 37.5%. Biopsies were performed at FS in 26 patients (33%). In 67 (84%) of DCBEs the barium coating was assessed as satisfactory or better. FS yielded pathological findings not seen at DCBE in 21 patients (26%). DCBE demonstrated additional abnormalities within the range of the FS examination in 15 patients (19%), almost entirely due to its increased sensitivity for diverticular disease. CONCLUSION: FS/DCBE is feasible as a one-stage combined procedure. The quality of DCBE following FS is satisfactory, and the extra yield of FS and its potential for biopsy make the combined FS/DCBE a useful technique in the investigation of large bowel disease.

Adult↗
PubMedDate not supplied

Preoperative assessment of pancreatic malignancy using endoscopic ultrasound.

BACKGROUND: Endoscopic ultrasound (EUS) has been regarded as the most accurate modality for locoregional staging of pancreatic malignancy. However, several recent studies have questioned this. The current study assessed the accuracy of EUS in determining preoperative resectability of pancreatic neoplasia. METHODS: A retrospective review was performed of patients with pancreatic malignancy who had preoperative EUS and underwent surgery. EUS-predicted resectability was compared with surgical resectability. Where available, accuracies of vascular and nodal staging were also assessed. RESULTS: Forty-five patients were identified (mean age 60 years, age range = 36-79 years). All patients underwent surgical exploration; vascular staging was available in 32 cases and 17 cases underwent surgical resection. The sensitivity, specificity, and accuracy of EUS in determining unresectability were 66%, 100%, and 78% respectively. Overall EUS stage concurred with surgical stage in 56%, greater than surgical stage in 4%, and less than surgical stage in 40%. Vascular staging on EUS had a sensitivity of 69% and a specificity of 100%. Accuracy of nodal staging was 71%. CONCLUSION: EUS had a high specificity for assessing unresectable pancreatic malignancy. This technique should be used to avoid unnecessary surgical exploration of incurable lesions. However, EUS had only a moderate sensitivity, and a proportion of patients staged preoperatively as having resectable disease will not be surgically resectable.

Carcinoma, Pancreatic Ductal↗