Wedged catheter management of a bleeding renal pseudoaneurysm.
A patient with significant gross hematuria following renal biopsy is managed successfully with subselective wedged arterial occlusion.
Biomedical subjects
Publications and source records attributed to R S Frankel.
A patient with significant gross hematuria following renal biopsy is managed successfully with subselective wedged arterial occlusion.
Sixty-five children were evaluated for presence of skeletal inflammatory and ischemic disease with bone scans and roentgenograms. Several characteristic scintigraphic patterns were observed. Bone scans were significantly more sensitive than roentgenograms in early diagnosis of osteomyelitis and its differentiation from cellulitis, septic arthritis, and bone infarction. The child presenting with possible inflammatory bone disease now is benefited by this important refinement in diagnosis. Faced with the difficult dilemma of choosing appropriate therapy in these frustratingly similar problems, the physician can integrate the clinical findings with nuclear imaging to arrive at early appropriate diagnosis and management.
Renal localization of 67Ga citrate has been observed in 1.7% of 2,000 whole-body gallium scans in three major diseases: lymphoreticular neoplasms, leukemia, and malignant melanoma. Correlation of this finding with autopsy data in 13 cases revealed 9 with tumor and 2 with an inflammatory process. Findings in two cases were normal. In the remaining patients, correlation with abnormal urograms and laboratory data was poor. Nevertheless, gallium localization in the kidneys may be the first indicator of renal involvement with either tumor or inflammation.
Radionuclide breast scintigraphy was evaluated as a noninvasive tumor-localizing modality. Technetium-99m-pertechnetate (99mTcO4) demonstrated good correlation between malignancy and postive scintigraphy (88% accuracy in 16 cases of breast carcinoma). The high false-positive rate (29% of proven benign breast disease) limits the use of 99mTcO4 as an aid to differential diagnosis. Gallium-67-citrate (67Ga) is limited as a diagnostic adjunct (localizing in only five of ten breast malignancies). Refined techniques of positioning, shielding, gamma camera imaging, and computer assistance have helped in visualizing abnormal radionuclide accumulation.
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