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Biomedical subjects

R Udén

Publications and source records attributed to R Udén.

At least 19 recordsLinked to original sources

Peritoneocele and enterocele. Formation and transformation during rectal evacuation as studied by means of defaeco-peritoneography.

PURPOSE: To study, by means of defaeco-peritoneography, the formation and transformation of the peritoneocele, with and without an enterocele, during rectal evacuation. MATERIAL AND METHODS: Forty-six patients with a peritoneocele at defaeco-peritoneography were selected for the study, and examined at three different stages: 1) at the start with a contrast-filled rectum; 2) at maximum straining; and 3) at rest after rectal evacuation. RESULTS: Fourteen patients had a peritoneocele at the start. These peritoneoceles were largest at maximum straining and were all still present at rest after rectal evacuation. In 32 patients defaeco-peritoneography was regarded as normal at the start. At maximum straining these patients developed a peritoneocele and 20 of these were still present after rectal evacuation. No enterocele was seen at the start. At maximum straining 21 patients developed an enterocele and 15 of these were still present after rectal evacuation. Liquid in varying amounts was found in the peritoneoceles. CONCLUSION: The present study demonstrated that peritoneoceles were present at different stages of the defaeco-peritoneographic investigations. Peritoneoceles were most frequent and largest at maximum straining. An enterocele was present in half of the peritoneoceles at maximum straining, but never at the start. Liquid was often present in the peritoneoceles.

Adult

Pelvic anatomy and pathology is influenced by distention of the rectum: defecoperitoneography before and after rectal filling with contrast medium.

PURPOSE: The aim of the present study was to evaluate how distention of the rectum with contrast medium at defecoperitoneography affected pelvic anatomy, i.e., position, form, and size, of organs and pouch of Douglas. PATIENTS AND METHODS: Twenty-six female patients with a peritoneocele at defecoperitoneography were selected for the present study. Radiographs taken at the start, before, and after filling the rectum with contrast medium were compared. RESULTS: There was an obvious change in the position of the organs in the pelvis when the rectum was distended with contrast medium. The peritoneocele disappeared completely in 19 of the patients and was reduced in size in the remaining 7 patients, and the enterocele disappeared completely in 13 patients. The small bowel and vaginal portion of the uterus moved cranially. CONCLUSIONS: A distended rectum may conceal existing pathology, such as peritoneocele and enterocele, at defecoperitoneography. Defecoperitoneography should, therefore, include a radiograph before the rectum is filled. This radiograph shows the habitual anatomy of the patient in the sitting position and may demonstrate pathologic findings.

Adult

Defaeco-peritoneography in the diagnosis of rectal intussusception and rectal prolapse.

PURPOSE: The aim of the present study was to evaluate the use of defaeco-peritoneography in diagnosing rectal intussusception as distinct from mucosal folds in the rectum, and rectal prolapse as distinct from mucosal prolapse. MATERIAL AND METHODS: Fifty-seven patients with defaecation disorders were examined by means of defaeco-peritoneography. RESULTS: Twenty-three patients had rectal intussusception and 7 patients had rectal prolapse at defaeco-peritoneography. All these patients had a rectal peritoneocele in the serosal ring-pocket of the rectal intussusception or in the rectal prolapse. Twenty-seven patients had neither rectal intussusception nor rectal prolapse and none of these patients had a rectal peritoneocele. CONCLUSION: The present study demonstrated that only patients with a rectal intussusception or rectal prolapse have a rectal peritoneocele. Defaeco-peritoneography therefore offers correct diagnosis of rectal intussusception as distinct from mucosal folds in the rectum, and of rectal prolapse as distinct from mucosal prolapse.

Barium Sulfate

Peritoneocele: visualization with defecography and peritoneography performed simultaneously.

PURPOSE: To evaluate the use of simultaneous defecography and peritoneography (defecoperitoneography) in patients with an unexplained widening of the rectovaginal space noted at defecography. MATERIALS AND METHODS: Twenty-two patients with unexplained widening of the rectovaginal space noted at defecography were studied with defecoperitoneography. Defecoperitoneography was a combination of defecography and peritoneography with water-soluble contrast medium administered intraperitoneally. RESULTS: The outline and movements of the peritoneum and alterations in the pelvic peritoneal cavity could be visualized with defecoperitoneography during the dynamic act of defecation. Unexplained widening of the rectovaginal space was completely due to a peritoneocele in 14 patients and partially due to a peritoneocele in six patients. In two patients, there was no peritoneocele. Only nine of 22 patients had bowel in the unexplained widening (enterocele). Three patients had a rectal peritoneocele; six, a septal peritoneocele; one, a vaginal peritoneocele; and 10, a combination of these findings. CONCLUSION: Visualization of the pelvic floor with defecoperitoneography is improved compared with visualization with defecography alone.

Adult

Simultaneous defecography and peritoneography in defecation disorders.

UNLABELLED: A number of physiologic and radiologic investigations are used in investigating defecation disorders. Defecography is one important part of these investigations. However, a correct diagnosis of an enterocele is sometimes difficult despite use of contrast media in the rectum, vagina, and small bowel. PURPOSE: This study was undertaken to ascertain if it was technically possible to perform simultaneous defecography and peritoneography in an effort to improve the diagnostic possibilities in patients with defecation disorders. METHODS: Twelve patients with defecation disorders and an unexplained widening of the rectovaginal space at defecography were investigated. Contrast medium was introduced intraperitoneally, after which conventional defecography was performed. RESULTS: All investigations were carried out without complications and demonstrated the peritoneal outline in all patients. Simultaneous defecography and peritoneography differentiated between an enterocele and a pathologically deep pouch of Douglas--a peritoneocele. Three types of peritoneocele were visualized: vaginal peritoneocele, septal peritoneocele, and rectal peritoneocele with or without enterocele. Combinations of the three types were also found. Eight of the 12 patients had rectal intussusception or rectal prolapse. All of these eight patients had a rectal peritoneocele. CONCLUSIONS: Simultaneous defecography and peritoneography can be performed without technical difficulties or complications. Peritoneal outlines and pouches can, therefore, be studied directly during the act of defecation. An unexplained widening of the rectovaginal space at defecography can be clarified as a peritoneocele, with or without an enterocele. Peritoneocele can be of three different types: rectal, septal, or vaginal.

Aged

Defecography. Results of investigations in 2,816 patients.

PURPOSE: This study was designed to analyze the frequency of different findings at defecography in patients with defecation disorders and see in what way the evaluation could be improved. METHODS: The reports of investigations in 2,816 patients were analyzed. RESULTS: Twenty-three percent of the investigations were considered normal. Thirty-one percent of the patients had rectal intussusception, 13 percent had rectal prolapse, 27 percent had rectocele, and 19 percent had enterocele. Twenty-one percent of the patients had a combination of two or three of these diagnoses. The combination of rectocele and enterocele was rare. The majority of patients with enterocele had other concomitant findings. Patients with or without abnormal perineal descent had similar frequencies of rectal prolapse, rectal intussusception, and enterocele. Rectocele was more common in patients with abnormal perineal descent. CONCLUSIONS: Defecography is valuable when investigating patients with defecation disorders. Pathologic findings were found in 77 percent of the patients. A standardized protocol should ensure a complete evaluation of defecography.

Adolescent

Colloid scintigraphy showing red bone marrow extension in patients with prostatic carcinoma.

In 25 of 30 patients with bone metastases from prostatic carcinoma, red bone marrow extension was observed by scintigraphy of the reticuloendothelial system (RES). The degree of bone marrow extension in the lower extremities increased with increasing number of bone metastases. In 8 patients, 15 peripheral metastases were detected, all located in areas with extended red bone marrow. The distal level of bone marrow extension coincided with that of the most distal metastases. This is of importance for the detection of peripheral metastases at risk for fracture. Bone marrow extension was also seen in 5 of 8 patients with prostatic carcinoma without bone metastases and was interpreted as a paramalignant activation of RES.

Aged

Bone marrow scintigraphy in Paget's disease of bone.

Sixteen patients with 20 lesions of Paget's disease of bone were studied with bone marrow scintigraphy (colloid), bone tissue scintigraphy and radiography. Bone marrow scintigraphy showed normal or increased colloid uptake in 15 of 20 pagetic lesions, and decreased uptake in 4. Bone tissue scintigraphy showed increased metabolic activity in all lesions and was useful in detecting polyostotic disease as well as the extent of the lesions. Conventional radiography most often showed the typical appearance of Paget's disease, but the changes observed were sometimes difficult to differentiate from malignant disease. However, a preserved or increased reticuloendothelial function in the pagetic lesion contradicts metastatic disease as a differential diagnosis. Bone marrow scintigraphy with radiocolloid is a valuable method in the analysis of Paget's disease of bone.

Aged

Recording of bone marrow activity in liver-spleen (RES) scintigraphy.

The bone marrow activity in the liver-spleen (RES) scintigraphy has been difficult to estimate correctly. If the activity of the bone marrow is to be decided as counts/time unit it is of importance that structures with a high activity as the liver and spleen are excluded from the registration. A dorsal registration of the pelvis during 180 s will give a rather correct information of bone marrow activity and besides an image of the pelvic bone marrow is obtained. Using 270 to 280 MBq 99Tcm-Albures all 45 normal cases had values below 150 KCNT (1 KCNT = 1 000 counts). All cases with cirrhosis (n = 15) or metastases in the liver (n = 14) had values over 150 KCNT. Values over 150 KCNT were also found in 29 of 34 patients with an increase in ASAT and ALAT (GOT, GPT) as the only pathologic finding and in 12 of 21 patients with a carcinoma but without metastases in the liver.

Aged

Effect of somatostatin on regional splanchnic blood flows in man. Angiographic studies.

The effect of somatostatin (1 microgram/kg b.w. i.v. over one minute) on regional splanchnic blood flows was studied in nine patients subjected to diagnostic angiography of the coeliac artery, the superior mesenteric artery or the aorta. Following somatostatin there was a prolongation of the circulation times and a marked constriction of the hepatic and splenic vascular beds corresponding to a 50% decrease in blood flow. Blood flow in the gastroduodenal, pancreatic, superior mesenteric and renal arteries was also decreased, but to a lesser extent. There was no effect on the lumbar arterial flow. The time for maximum filling of the portal vein was delayed and the contrasting effect in this vessel was decreased, indicating a decrease in portal flow. It is concluded that somatostatin reduces splanchnic blood flow in unanaesthetized man, while there is no decrease in skeletal muscle blood flow. It is suggested that this effect of somatostatin is due to a direct action on vascular receptor sites.

Angiography

Influence on symptoms and transit-time of Vi-SiblinR in diverticular disease.

Nine patients complaining of constipation and with diverticuli of the colon on barium-enema were examined with regard to transit-time, bowel movements and subjective symptoms. They were treated with placebo and Vi-SiblinR, using a doubleblind cross-over technique. The transit-time remained normal during the Vi-SiblinR treatment. The feces became softer and increased in weight and the subjective symptoms were significantly reduced (p less than 0,05).

Aged