Gastric emphysema resembling pneumoperitoneum: presentation of a case with a review of the literature.
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Biomedical subjects
Publications and source records attributed to S K Teplick.
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A huge pancreatic pseudocyst which nearly filled the entire abdomen ruptured into the sigmoid colon, and caused perplexing clinical and radiographic findings. Because of the thickness of its wall, the pseudocyst did not collapse but became filled with intestinal gas. The more common features of pseudocysts that rupture are discussed.
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Three cases of esophagitis caused by oral medication are reported: 2 were the result of prolonged use of quinidine tablets (producing focal subacute inflammation mimicking carcinoma in one and stricture in the other) and one occurred soon after ingestion of liquid KCl. Previous reports have implicated KCl tablets ("slow KCl"), tetracycline and doxycycline capsules, and ferrous sulfate tablets. The factors predisposing to this uncommon complication of oral medication are discussed. In all reported cases caused by KCl tablets, left atrial enlargement was present as the result of mitral stenosis.
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The pyelographic and angiographic changes in acute unilateral bacterial pyelonephritis are illustrated in our series of 12 patients. The radiographic abnormalities were completely reversible within a few weeks after clinical recovery. Complications (abscess) occurred in only one patient. Unilateral renal enlargement, diffuse or focal, impaired or absent excretory function, and attenuated calyces were the predominant findings; non-obstructive pelvicalyceal and/or ureteral dilatation were infrequent. Angiographic studies (fivepatients), performed to rule out vascular occlusion, tumour or carbuncle, showed attenuated and somewhat stretched intrarenal vessels associated with the diffuse or focal cortical swelling. Occasionally, a characteristic striated nephrogram is seen.
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Ninety-nine adults with an enlarged retrorectal space on barium enema examination have been evaluated. Measurements were based on previously described methods using the lateral view of the barium filled rectum. In 38.4% of the cases there was no lesion (normal variations). The rest were classified as inflammatory conditions, tumours, and miscellaneous lesions. It is concluded that an increased width of the presacral space per se does not necessarily connote a lesion. Pathological widening of the space is usually associated with changes of the contour of the rectum, abnormalities of the sacrum, or other alterations of the presacral soft tissues.
Although rena vein thrombosis usually presents with a large or normal-sized kidney radiographically, a small atrophic kidney may be the end stage result of complete renal vein thrombosis with subsequent hemorrhagic infarction. A small atrophic kidney secondary to renal vein thrombosis (probably of neonatal origin) was diagnosed by selective renal arteriography in a 31-year-old woman being studied for hypertension of unknown etiology.
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Three cases illustrate the principal clinical and roentgenographic varieties of granular cell myoblastoma (GCM) of the lung. The vast majority are small benign intrabronchial tumors without roentgenographic findings. These remain asymptomatic and are detected accidentally at autopsy, surgery, or bronchoscopy (Case III). Larger obstructing lesions (Case I) cause focal atelectasis or pneumonitis, leading to cough, expectoration, and hemoptysis. Hilar enlargement from reactive lymph node hyperplasia is common. Clinically and roentgenographically these are indistinguishable from bronchial adenomas. Least often the tumor extends entirely extrabronchially (Case II) presenting as a parahilar parenchymal asymptomatic nodule, simulating a granuloma, hamartoma, arteriovenous malformation or a neoplastic nodule.
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This report documents the 4th case in the world literature of a malignant melanoma metastatic to the esophagus. The value of gallium scanning in the evaluation of known cancer patients is exemplified by this patient.