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Results for “Constriction, Pathologic”

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At least 307 records · Page 17Linked to original sources

PubMed2000

Miniprobe ultrasonography and gastrointestinal tract stenosis.

OBJECTIVE: Malignant and nonmalignant stenosis of the gastrointestinal tract are a significant diagnostic and therapeutic challenge. Malignant stenosis is difficult to stage because the endosonographic catheter cannot be passed through the stricture. The objective of this study was to stage tumoral stenosis using a miniprobe. METHODS: We evaluated 30 patients (20 men, 10 women, average age 65 years). There were 9 nonmalignant cases and 21 malignant cases of stenosis of the gastrointestinal tract. Of the malignant cases, two were caused by extradigestive neoformations that infiltrated the wall of the digestive tract. Twelve of the remaining 19 cases were treated by surgery (63%). Echoendoscopy was done with a miniprobe through the working channel of the videoendoscope. The TNM classification was used to diagnose extension. The pathology study was used to confirm the final diagnosis after surgery for malignant lesions. Nonmalignant stenosis was confirmed in clinical follow-up. RESULTS: Sensitivity of the miniprobe in determining stage T and stage N were 83% and 64% respectively. CONCLUSIONS: Miniprobes provide valuable additional information in the study of stenosis of the digestive tract. Sensitivity is good in classifying tumoral T stage, and acceptable for classifying N stage, and may be improved by using low-frequency miniprobes.

Aged↗

PubMed1995

Endoscopic, radiographic, and manometric findings in dysphagia associated with sarcoid due to extrinsic esophageal compression from subcarinal lymphadenopathy.

Esophageal dysphagia associated with sarcoid has been attributed to dysmotility from neuropathy, dysmotility from myopathy, mechanical obstruction from esophageal mural involvement, and mechanical obstruction from extrinsic compression by subcarinal lymphadenopathy. The relative importance of these etiologies has not been evaluated because of variable and nonstandardized analysis. In particular, manometry has not been performed to exclude esophageal dysmotility in dysphagia attributed solely to extrinsic compression. A 42-yr-old male with chronic sarcoid for 20 yr presented with mild dysphagia to solids. An upper gastrointestinal series revealed smooth narrowing of the esophageal lumen and transient hang-up of the barium column and a 1.3-cm diameter radiopaque pill at the level of the carina. Chest computerized tomography revealed esophageal narrowing at the level of the carina and splaying of the two mainstem bronchi from compression by subcarinal lymphadenopathy. Esophagogastroduodenoscopy revealed elliptical esophageal narrowing due to multiple, smooth, and nodular deformities at 29-32 cm from the incisors. Pathological examination of deep biopsies of the nodules revealed normal mucosa and submucosa without granulomas. Esophageal manometry revealed a highly localized high pressure zone of 39.8 +/- 6.1 mm Hg at 29-31 cm from the incisors (lab normal about -5 mm Hg). Esophageal muscle contractions were peristaltic and of normal amplitude above, within, and below this high pressure zone. This case report demonstrates that extrinsic compression from subcarinal lymphadenopathy is a sufficient mechanism for dysphagia with sarcoid, but it does not exclude a role for other mechanisms, such as nerve injury, in some cases.

Adult↗

PubMed1977

[5 adult cases of cerebral aqueduct stenosis caused by ependymitis granularis].

In the present report five autopsy cases of adult aqueductal stenosis arising from granular ependymitis have been reported. In all cases the aqueduct was obstructed or markedly stenosed by subependymal gliosis mainly consisting of fibrillary astroglia. Islands and tubules of ependymal cells were embedded in a dense bed of subependymal glia with the loss of ependyma. The walls of all ventricles showed the same pathologic findings with the aqueduct, although the degree was not so marked. Such findings support the view that some type of chronic infection produces the aqueductal stenosis, because it is impossible to produce such diffuse ependymal changes by congenital anomaly. It is of particular importance in this report that all cases were adults. In comparison with the microscopical findings in cases of aqueductal stenosis of infants and children arising from granular ependymitis, which have been reported in the literature, there were no principle differences between infants, children and adults.

Adult↗

PubMed1986

Radiology of colonic interposition and its associated complications.

A retrospective review of the medical records, pathology reports, and radiographic studies of 81 patients who had undergone colonic interposition was undertaken, with special attention to postoperative complications. Both early (within 30 days postoperatively, 81 patients) and late (later than 30 days postoperatively, 57 patients) complications were reviewed. Early findings included anastomotic narrowing (18 patients), anastomotic leak (13), aspiration (11), and ischemic necrosis of the colon (3). Late findings included aspiration (9 patients), anastomotic strictures (8), gastric stasis (6), redundancy and tortuosity of the colon (5), anastomotic ulcers (4), gastrocolic reflux (3), and gastroesophageal reflux into the residual esophagus (2).

Colon↗

PubMed1988

Angioplasty techniques for stenoses involving coronary artery bifurcations.

Branch occlusion during coronary angioplasty is an infrequent but potentially serious complication. The overall incidence of branch occlusion during dilatation of a primary vessel is 5%. Branch vessels most jeopardized by dilatation generally have a complex plaque that not only involves the target vessel but also extends into the origin of the branch vessel. Branches free of pathology at their origin generally have an exceedingly low incidence of occlusion during adjacent balloon dilatation. Side branches at risk for occlusion should be "protected" if the branch vessel is of an important size that could be dilated with a conventional dilatation catheter. The advent of lower profile dilatation catheters and guidewires has provided an opportunity to introduce several pieces of dilatation hardware into the coronary system through a single guiding catheter. Several techniques are described for both "protecting" and dilating side branches, either simultaneously or secondarily, after balloon dilatation of a primary vessel.

Angioplasty, Balloon↗

PubMed1992

[Incidence of local complications after heart catheter studies and their imaging with intravenous digital subtraction angiography: a retro- and prospective study].

Frequency of local complications following punction of the femoral artery aimed to cardiac catheterisation has been checked with 1051 patients retrospectively as well as 300 patients prospectively. Intravenous DSA was carried out when symptoms like stenotic murmurs, pulsations, hematoma, swelling or resistance within the concerned inguinal region appeared with suspicion diagnose of pseudoaneurysm, arteriovenous fistula or any other complications of vessels. The retrospective study reviewed a rate of complications of 1.62% and the prospective study a rate of 2.7%. The study reviewed that by using of DSA-checkings during a time period of 4 up to 10 month later no rest aneurysm or AV-fistula could be proved. That means a spontaneous thrombose took place with patients without operation indication. Significant connections were found between clinical pathological findings next to the position of punction and the occurrence of local complications. The single symptoms like stenotic murmurs or large hematoma are statistically proved indications to a complication of vessel. There is no connection between findings like pseudoaneurysm or AV-fistula and small hematomas next to the punction position. The intravenous DSA has been proved as easy and proof method with a small quantity of complications for the inclusion and differentiation of local complications following punction of the artery femoral.

Adult↗

PubMedDate not supplied

A pelvic scoring system for infertility surgery.

A pelvic scoring system for infertility surgery was devised in which pelvic pathology is assessed for comparative and prognostic purposes. Pelvic pathology was divided into three areas: adhesions (ADH), salpingitis (SPG), and tubal occlusion (TOC). The extent of pathology was scored as mild (1), moderate (2), severe (3), or extensive (4). The maximum scores for adhesions, salpingitis, and tubal occlusion were 48, 24, and 28, respectively--various weightings were applied and subareas accounted for. The pelvic score (PLV#) was simply the sum of the adhesions (ADH#), salpingitis (SPG#), and tubal occlusion (TOC#) scores. The stage of pelvic pathology was arbitrarily assigned as stage 0, I, II, III, and IV with PVL#'s of 0, 1-25, 26-50, 51-75, and 76-100, respectively. A close correlation (r = .960-.990) of PLV# was noted between different observers using this system. Poorer reproductive potential was observed in the patients with higher scores and stages. This scoring system properly reflects clinical experience and can be relied on for patient counseling via prediction of prognosis. This system can be utilized to compare objectively the results of infertility surgery between surgeons as well as among institutions.

Constriction, Pathologic↗

PubMed1998

MR imaging of symptomatic osteochondromas with pathological correlation.

OBJECTIVE: To demonstrate the value of MR imaging in the diagnosis and differentiation of the various symptomatic complications of osteochondromas, providing pathological correlation with emphasis on the usefulness of MR imaging as a single imaging modality in these patients. DESIGN: We retrospectively reviewed all MR examinations of clinically symptomatic osteochondromas (30 patients) performed at our institution between March 1990 and October 1997. PATIENTS: Thirty patients had clinically symptomatic osteochondromas during the study period. Twenty patients were male and 10 were female. There were five cases of multiple osteochondromatosis. Pathological correlation was available in 24 patients. RESULTS AND CONCLUSION: Symptomatic complications included fracture (7%), osseous deformity limiting range of motion (23%), vascular injury (7%), neurological compromise (10%), bursa formation (27%) and malignant transformation (27%). MR imaging was able to diagnose or suggest the etiology for the clinical symptomatology in all cases, demonstrating that it is an ideal imaging modality in the diagnostic evaluation of symptomatic complications of osteochondromas and often avoids the need for further imaging.

Adolescent↗

PubMed1989

[Diagnosis and therapy of benign stenoses of Vater's papilla].

Experience obtained from operations on 2,458 patients for benign stenosis of Vater's papilla provided a background against which a classification was made of this pathological pattern. Preoperative and intraoperative diagnostic methods and surgical techniques are discussed and are critically appraised. Endoscopic papillospincterotomy had been introduced to clinical practice in 1979 and has ever since been the optional surgical approach to Vater's papilla. Differentiated attitudes to various possible corrections of benign stenosis together with high technical standards in surgery proper have so far yielded good long-term results for 89 per cent of patients.

Adolescent↗

PubMed1978

[Sclerodystrophy of the sphincter of Oddi (author's transl)].

Among 1,645 biliary operation carried out between 1952 and 1974, the authors count 177 organic stenoses of the Oddi region. They recall the authenticity of chronic odditis, the pathological substratum of which is Oddi sclerodystrophy, a primary and progressive lesion. They emphasise the radiomanodebimetric criteria. The risk of an error of interpretation was 2% in this series. After discussing the etiopathogenesis and the physiopathological consequences of Oddi sclerodystrophy, they discuss the therapeutic choice between sphincterotomy and choledoco-duodenostomy. Temporary gall bladder drainage is only of interest in inflammatory labile manifestations without sclerodystrophy. The interest of diagnosis and initial surgical treatment of the lesion is that the classical post-cholecystectomy syndrome almost disappears.

Ampulla of Vater↗

PubMedDate not supplied

Lymphoma invading the anterior eustachian tube. Temporal bone histopathology of functional tubal obstruction.

The temporal bones of a man with poorly differentiated lymphocytic lymphoma, who had had a bilateral conductive hearing loss and incomplete left-sided facial palsy, were obtained. Sections were prepared for histologic study by staining with hematoxylin and eosin and were examined under the light microscope. The left temporal bone showed marked tumor cell involvement, not only of the lateral part of the cartilaginous portion of the eustachian tube (ET) where the tensor veli palatini muscle had been partially destroyed, but also in the anterior part of the temporal bone. A serous middle ear effusion was present, but the lumen of the ET was unaffected by tumor or inflammation. The pathological findings in the right temporal bone were similar to those in the left, although the cartilaginous part of the ET and its surrounding structures were not available for study. The pathogenesis of otitis media with effusion appeared to be secondary to functional ET obstruction, due to the dysfunction of the tensor veli palatini muscle as a result of the tumor destruction. This case is the first to be reported in which functional ET obstruction, secondary to tumor invasion of the active muscle dilator of the ET, has been histologically confirmed.

Adult↗

PubMed1993

Proximal tubal occlusion by hysterosalpingogram: a role for falloposcopy.

Eight infertility patients with proximal tubal occlusion by HSG and at least one other independent method underwent falloposcopy to evaluate the etiology of uterotubal occlusion. Patency was established in 9 of 12 tubes evaluated. Falloposcopy revealed 5 tubes with multiple or extensive intratubal lesions that would be unsuitable for unilocular tubal resection with subsequent reanastomosis. In addition, 5 tubes were visually normal or had only minor pathological changes (2 of these patients became pregnant). Only 2 of the tubes examined in a single patient would be considered candidates for microsurgical correction at laparotomy. Falloposcopy will become a useful adjunct in the evaluation of the patient with suspected tubal infertility. It provides information regarding the condition of the tubal mucosa that is unavailable by any other technique, adding precision to surgical techniques when they are deemed necessary while directing other patients to assisted reproductive technologies. However, falloposcopy is still in its infancy and data from larger studies are needed.

Adult↗

PubMed1995

State-of-the-art flexible hysteroscopy for office gynecologic evaluation.

STUDY OBJECTIVE: To evaluate office flexible hysteroscopy without anesthesia with regard to pain, inconvenience and cost. DESIGN: A survey of patients to evaluate the level of pain they experienced during office hysteroscopy, and a comparison of costs for these procedures with those of hospital dilatation and curettage. SETTING: Office-based hysteroscopy suite in the outpatient building of a tertiary institution. PATIENTS: Women referred to this institution for gynecologic evaluation between February 1992 and December 1993. INTERVENTION: Diagnostic flexible hysteroscopy without anesthesia, cervical dilatation, or paracervical block. MEASUREMENTS AND MAIN RESULTS: A total of 417 women (mean age 42 yrs, range 16-84 yrs; 78 postmenopausal) were referred for evaluation during the study period. The most common indication for referral was abnormal uterine bleeding (86%). Hysteroscopy could not be completed in 29 women (7%), primarily because of cervical stenosis. Pain ratings obtained from 387 patients were as follows: easily acceptable discomfort, minimal discomfort during procedure, 133 (34.5%); acceptable discomfort, uncomfortable but easily bearable, 86 (22.2%); tolerable discomfort, equivalent to menstrual cramps and spasms, 106 (27.4%); barely tolerable pain, tolerable for short time only, 48 (12.4%); and intolerable pain, severe enough to stop the procedure before completion, 14 (3.6%). A single adverse event, a postprocedure temperature elevation, was easily treated with oral antibiotics. No pathology was identified in 183 (43%) of the women; 95 (22%) had polyps and 90 (21.5%) had fibroid tumors. The average duration of a procedure was 5 minutes. The charge for office hysteroscopy was $475. CONCLUSION: Flexible office hysteroscopy without anesthesia was well tolerated by the majority of the women. In addition, the procedure is far less expensive and time consuming than when it is performed in an operating room. We believe that it is a safe, well-tolerated, and cost-effective procedure of great diagnostic value.

Adolescent↗

PubMed1982

[Radiological biliary tract diagnosis after cholecystectomy (author's transl)].

Fifty-three patients with biliary symptoms were studied at least four years after cholecystectomy by isotope techniques. There was a highly significant correlation between symptoms and disturbances of bile flow, such as dyskinesia or obstruction. There was no correlation with serum enzyme levels such as gamma-GT, alkaline phosphatase, bilirubin or transaminases. Measurements of the diameter of the bile duct on cholangiograms provided no evidence of obstruction up to 15 mm., although a diameter in excess of 10 mm, made obstruction likely. The upper value for "normal" bile flow derived from hilar flow curves of patients without dyskinesia showed a half value period of 27.5 minutes. The disturbances of flow demonstrated by isotope methods in the presence of typical symptoms, and without other pathological findings, indicate a pre-clinical stage of a partly compensated bilio dynamic insufficiency. Where there is no morphological evidence of biliary obstruction, one must assume inflammatory changes round the papilla of Vater; these are frequent even in normal biliary tracts and almost always present after cholecystectomy. Quantitative hepato-biliary scintigraphy is the most reliable method for objective measurement of disturbances of bile flow and make it possible to avoid the vague diagnosis of "post-cholecystectomy syndrome".

Alanine Transaminase↗

PubMedDate not supplied

[Iatrogenic venous pathology and post-radiosurgery swollen arm. Apropos of 100 cases].

Lymphostasis of the upper limb, succeeding the radiosurgical treatment of breast cancer, has been known for some time, along with the clinical entity generally called "swollen arm". Post radiosurgical venous disorders have, however, been much less studied, and so the author's survey is based on a systematic, clinical, and phlebo-lympho-scintigraphical study of 100 case histories. Out of the 100 cases studied, almost 80% presented mixed lympho-venous anomalies, whilst 25% of the cases proved to be "swollen arm" of purely venous origin. Finally the author analyses the different vascular lesions encountered in the follow-up of radio-surgical treatment and the therapeutic conclusions to be drawn from these.

Adult↗

PubMed1996

Extraocular muscle changes in experimental orbital venous stasis: some similarities to Graves' orbitopathy.

BACKGROUND: Graves' orbitopathy (GO) is generally considered to have an autoimmune etiology. Recently, however, it has been hypothesized that orbital venous obstruction may contribute significantly to the clinical manifestations. To determine whether such obstruction could induce histologic and clinical findings consistent with GO, we developed an animal model of orbital venous obstruction by ligating the draining ophthalmic veins of the right eyes of four cats. METHODS: The branches of the ophthalmic veins were isolated and ligated following a lateral orbitotomy. Weekly photographs and echographs were taken of the cats; one cat was killed at each of four time points, namely 1, 2, 3, and 4 weeks after surgery. Histologic stains were applied to isolated orbital tissues to characterize pathologic changes. RESULTS: Clinically, there was onset of marked proptosis, chemosis, and exotropia. Histological findings within the extraocular muscles included activation and the presence of acid mucopolysaccharides 1 week after ligation, increased collagen and the presence of lymphoid cells at 2 weeks after ligation, and persistent interstitial lymphocytic infiltrates the 3rd and 4th weeks after ligation. CONCLUSION: Without evoking a primary orbital inflammation or inducing a systemic autoimmune disease, an animal model has been developed that closely mimics many of the advanced clinical and histologic changes that occur in GO.

Animals↗

PubMed2000

The use of chorionic villus biopsy catheters for saline infusion sonohysterography.

BACKGROUND: Saline infusion sonohysterography is one of the recent refinements of ultrasonography that has the ability to enhance imaging of the uterine cavity in a safe, inexpensive and expedient manner. The technique can be difficult in women with a stenotic cervical os. This report describes a single-pass technique using chorionic villus sampling (CVS) catheters for saline infusion sonohysterography. METHOD: Saline infusion sonohysterography requires the transcervical passage of a catheter, through which saline is infused. The subsequent distension of the uterine cavity enhances the ability to detect intrauterine pathology with ultrasonography. In women with cervical stenosis, a catheter can be used in place of the more conventional two-pass technique, which requires the use of a uterine sound or probe followed by a conventional catheter. EXPERIENCE: We have used CVS catheters in women with cervical stenosis on 12 occasions. All have been successful and without significant discomfort to the patient. CONCLUSION: The use of CVS catheters for saline infusion sonohysterography in women with cervical stenosis can alleviate the need to remove the cervical probe prior to introduction of the catheter.

Catheterization↗

PubMed1981

[Postcholecystectomy syndrome: endoscopic and radiological aspects (author's transl)].

542 patients were subjected to ERCP at various periods after cholecystectomy. In this selected patient material there was a 56% incidence of morphological abnormalities in the biliary system, stenosis of the papilla and choledocholithiasis being the most frequent pathological findings. Laboratory examinations proved to be irrelevant with respect to the morphology of the bile ducts. A direct relationship between the clinical symptoms and the surgical procedure was established only in cases presenting with biliary duct stenosis (11% of all cases examined). In the majority of patients the postcholecystectomy complaints were due to incorrect surgical indication or inadequate surgical technique. Postcholecystectomy syndrome can be prevented by more accurate evaluation of the patient prior to and during surgery.

Adult↗