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Biomedical subjects

S K Teplick

Publications and source records attributed to S K Teplick.

At least 55 records · Page 3Linked to original sources
PubMed1986

Celiac plexus block for interventional radiology.

The effectiveness of regional anesthesia for pain control during biliary manipulations was evaluated. Celiac plexus and/or thoracic epidural blockade was used for 48 procedures in 31 patients. All blockades were administered and patients monitored by anesthesiologists in the radiology department. Thoracic epidural blockade did not alleviate the deep visceral pain associated with biliary manipulations. Celiac plexus blockade in conjunction with local skin anesthesia markedly reduced pain, minimizing the need for intravenously administered narcotics. Two patients experienced transient hypotension during induction of regional anesthesia. There were no other complications. Twelve patients who had previous biliary manipulations with only intravenously administered analgesia reported excellent pain relief with regional anesthesia and expressed a preference for regional anesthesia should another procedure be necessary. The authors conclude that celiac plexus block is a desirable technique of providing analgesia, especially when major biliary interventions are undertaken.

Adult↗
PubMed1985

Inflammatory changes proximal to obstructing lesions in the small intestine.

Ischemia proximal to colonic obstruction has been frequently described in the clinical and radiologic literature. These changes may obscure the obstructing lesion. A similar but much less frequently appreciated phenomenon may also occur in the small intestine. We present 2 such cases and discuss the possible pathogenesis and diagnostic pitfalls.

Aged↗
PubMed1985

Reduction of cecal volvulus by multiple barium enemas.

It has been frequently stated that barium enema has no value in the treatment of cecal volvulus. We present a patient with cecal volvulus who was effectively treated by barium enema; however, multiple studies were required to achieve optimal results. In a subset of patients with cecal volvulus, laparotomy may be avoided by the use of barium enema.

Barium Sulfate↗
PubMed1985

Squamous cell metastases to the gastric cardia.

Three patients with squamous cell carcinoma metastasized to the gastric cardia (1 from the esophagus, 1 from the hypopharynx, and 1 of unknown origin) are described. Two patients presented after apparent successful treatment of the primary malignancy. In all 3 cases the lesion appeared as a large solitary submucosal mass in the region of the gastric cardia. Squamous metastases should be considered in the radiographic differential diagnosis of a large submucosal gastric mass. Metastasis to the proximal stomach from carcinoma of the esophagus may be more common than suspected. Contrast evaluation of this area may be indicated in both the initial evaluation and the routine follow-up in these patients.

Aged↗
PubMed1985

Management of obstructed biliary endoprostheses.

In five patients with bile duct obstruction, a previously inserted endoprosthesis became occluded. After repeat percutaneous biliary drainage, the prostheses were mechanically unclogged, removed, or removed and replaced. No patient required surgery, and no prosthesis reoccluded. We discuss technique for deoccluding and, if necessary, removing and replacing obstructed stents.

Catheterization↗
PubMed1985

Crohn disease of the small intestine: diffuse mucosal granularity.

A diffuse granular mucosal pattern, produced by a reticular network of radiolucent foci 0.5 to 1 mm in diameter, was identified in 39 out of 46 consecutive patients with Crohn disease of the small intestine. Resected specimens demonstrated that this pattern represented wide, blunted villi with lymphocytic infiltration. Such a pattern was the only evidence of small bowel involvement in 17 cases. In 3 patients with the commonly recognized lesions, separate regions of diffuse granularity were seen. No such pattern was detected in normal patients. Demonstration of diffuse granularity may contribute to the diagnosis and management of Crohn disease.

Adult↗
PubMed1985

Biliary stent endoprosthesis: analysis of complications in 113 patients.

Stent endoprosthesis has been advocated as an alternative to internal-external catheter drainage for decompression of biliary obstruction, but drawbacks have never been specifically analyzed, to our knowledge. A retrospective review of 118 biliary stent endoprostheses placed in 113 patients assessed the frequency, nature, and treatability of significant complications. Complications were categorized as early (morbidity or mortality within the first 30 days) or late (after 30 days). The early complication rate was 17% (19/113); the late complication rate, 31% (32/102). Early complications were most often due to unstable stent positioning in technically difficult procedures involving periportal obstruction (4/8), while the most common late problems were lumen occlusion (23/102 [23%]), migrations (6/102 [6%]), and tumor overgrowth of the stent (3/102 [3%]). Neither the histologic features nor the location of the primary tumor correlated with the potential for long-term stent dysfunction. Specific treatment of complications was carried out in 17 of 102 patients (17%) and almost invariably required readmission and remanipulation or de novo biliary drainage.

Bile Duct Diseases↗
PubMed1985

Intestinal giardiasis: the importance of serial filming.

Intestinal giardiasis is a common enteric pathogen. Conventional diagnostic screening studies are only 50% accurate. Although radiologic abnormalities in the small intestine have been described, barium studies are often normal. Symptoms may be chronic and debilitating but are effectively treated with appropriate therapy. Three cases were encountered in which recognition of subtle radiographic abnormalities in the small intestine was responsible for proper diagnosis. These findings consisted of a progression from relatively normal jejunum on initial films to dilution, segmentation, and apparent increased fold thickness in the proximal small intestine on delayed films. When this pattern is identified, the radiologist may suggest the possibility of giardiasis and thus direct the referring physician to use definitive diagnostic procedures.

Barium Sulfate↗
PubMed1985

Percutaneous transcholecystic cholangiography: experimental study.

Percutaneous transcholecystic cholangiography was performed in three patients with normal-sized bile ducts and suspected obstructive jaundice, and it was performed 14 times in eight normal dogs. In every instance there was good demonstration of both the intra- and extrahepatic biliary tree. There were no significant clinical complications. Transcholecystic cholangiography is a technically easy, valuable alternative to transhepatic cholangiography for opacification of nondilated bile ducts.

Animals↗
PubMed1985

The hypertrophied antral-pyloric fold.

In 3.25% of 400 consecutive double-contrast upper gastrointestinal examinations, a prominent fold in the prepyloric gastric antrum that extends through the pylorus into the base of the duodenal bulb has been identified. Although the clinical significance of this fold is undetermined, endoscopic evaluation suggests it is a manifestation of chronic gastritis. This fold may simulate other entities, but can be distinguished by its characteristic features. Proper recognition may prevent unnecessary procedures such as endoscopy and biopsy.

Gastritis↗
PubMed1984

Interventional radiology of the biliary system and pancreas.

In recent years, newer techniques have become available to the clinician for the diagnosis and treatment of biliary and pancreatic disease. This article emphasizes interventional procedures through the liver, such as percutaneous transhepatic cholangiography, percutaneous transhepatic biliary drainage, and ancillary techniques. Also discussed are the nonsurgical management of bile duct calculi and the diagnosis and treatment of pancreatic tumors, abscesses, and pseudocysts.

Bile Duct Diseases↗
PubMed1984

The Diagnostic Imaging Information Center.

The authors have developed a Diagnostic Radiology Imaging Information Center, in which the physician can see at a glance, with minimum expenditure of time and maximum emphasis on relevance, a summary of the patient's studies and procedures done in the x-ray department.

Forms and Records Control↗
PubMed1984

Monooctanoin perfusion treatment of intrahepatic calculi.

Seventeen patients who had intrahepatic calculi underwent perfusion with monooctanoin. While five patients responded with a decrease in size or number of calculi, only one had a complete response; 12 showed no response; and one died during the perfusion (however, the perfusion was not believed to have contributed to the death). Fifteen of the 17 patients required further treatment by a combination of basket extraction, oral administration of chenodeoxycholic acid, or surgery. The lack of response to monooctanoin perfusion was in part due to calculus composition. Because of the poor response to this treatment and the prolonged hospitalization generally required, monooctanoin is not recommended for dissolution of intrahepatic calculi.

Adult↗
PubMed1984

Monooctanoin perfusion for in vivo dissolution of biliary stones. A series of 11 patients.

Monooctanoin, a cholesterol solvent, was infused into the biliary system of 11 patients. Twenty-eight (74%) of 38 total stones responded to monooctanoin: 16 (42%) decreased in size, and 12 (32%) dissolved completely. Ten stones (26%) did not change in size. We attribute this to inadequate drug-stone contact, which was corrected by placement of the infusion catheter contiguous to the stone(s). The use of a second catheter for biliary drainage avoided the side effect of biliary colic and increased patient compliance. An infusion rate greater than 5 ml per hour invariably produced pain and diarrhea. There were no significant side effects from monooctanoin in any of our patients when a two catheter system and an infusion rate of 5 ml per hour or less were used. A major drawback to use of this still experimental agent is the prolonged hospital stay. This may be ameliorated when at home use of monooctanoin is approved.

Adult↗