Biomedical subjects
Publications and source records attributed to Y Rechnic.
A 64-year-old patient who underwent splenectomy presented clinically with ectopic splenic tissue simulating a solid renal mass. The splenic origin of the mass was assessed by radionuclide spleen scan. Nephrectomy was avoided.
Suppurative thyroiditis due to branchial pouch sinus is a rare disease, affecting children and young adults. It presents as an abscess in the lower lateral neck, usually on the left side. Suppurative thyroiditis can be suggested by ultrasound, radionuclide scintigraphy or CT scan, but the diagnosis can only be established by barium swallow showing the sinus from the apex of the pyriform sinus to the perithyroid region. Complete surgical excision of the sinus is essential. Two patients are presented and the role of the various imaging modalities in the diagnosis is discussed.
Ninety patients, 85 of them jaundiced, were examined after the injection of Tc-99m pyridoxylidene glutamate, a substance rapidly concentrated by normal hepatocytes and excreted into the biliary tract. It appears in the gallbladder after 10-15 min, and in the gastrointestinal tract at 30 min. On the basis of the time of appearance in the intestine, four groups of patients were recognized: 1. Seventeen patients with a normal pattern, with visualization of the gut at 30 min. 2. Nineteen patients with a slight delay in passage, with appearance in the gut between 30-180 min. 3. Twenty-nine patients showing very slow excretion visualized only at 24 hr; 21 of these had parenchymatous disease of the liver, three choledocholithiasis and five had malignant disease causing partial obstruction. 4. Twenty-five patients with no visualization of the intestine; eight of them proved to be cases of medical jaundice, and 17 were surgical cases. Groups 3 and 4 comprise 54 patients where the question of medical or surgical jaundice was critical. If lack of intestinal activity is considered an indicating surgical jaundice, the accuracy of this study was only 72.4%.