ABSTRACT
OBJECTIVE: We wanted to report on our experience with modified radiology-guided percutaneous gastrostomy (MRPG) without endoscopic or nasogastric access for treating patients with complete obstruction of the upper digestive tract. MATERIALS AND METHODS: Fourteen oncology patients (13 had hypopharyngeal cancer and 1 had upper esophageal cancer) with complete obstruction of the upper digestive tract were recruited. Conventional percutaneous endoscopic gastrostomy (PEG) and radiologic (fluoroscopy-guided) percutaneous gastrostomy (RPG) were not feasible in all the patients. An MRPG technique (with a combination of ultrasound, an air enema and fluoroscopic guidance) was performed in these patients. RESULTS: We achieved successfully percutaneous gastrostomy using the modified technique in all patients without any major or minor complications after the procedure. CONCLUSION: A modified radiology-guided percutaneous gastrostomy technique can be safely performed in patients who failed to receive conventional PEG or RPG due to the absence of nasogastric access in the completely obstructed upper digestive tract.
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Conscious Sedation , Contrast Media , Esophageal Neoplasms/diagnostic imaging , Gastrostomy/methods , Intestinal Obstruction/diagnostic imaging , Iothalamate Meglumine , Laryngeal Neoplasms/diagnostic imaging , Radiography, Interventional , Retrospective Studies , Upper Gastrointestinal Tract/diagnostic imagingABSTRACT
The purpose of this study was to show that the nonionic contrast media of low osmolarity are better tolerated than ionic media of high osmolarity, which to date are most frequently used in the authors hospital. We found that adverse reaction occurred in 80% of the group in which nonionic contrast medium was used. The authors conclude that nonionic, low osmolarity contrast media significantly reduce the frequency of adverse reactions and increase their safe use
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Contrast Media/adverse effects , Triiodobenzoic Acids , Osmolar Concentration , Prospective Studies , Injections, Intravenous , Iothalamate Meglumine/administration & dosage , Iothalamate Meglumine/adverse effects , Contrast Media/administration & dosageABSTRACT
The purpose of this study was to verify and compare the different types of reactions to iodinated contrast media available at the Social Security Metropolitan Hospital Complex: Conray 60%, Vascoray and Uromiron. These are ionic, high osmolality compounds. The authors found that, in 400 patients not only the osmolality had an important role in the reactions observed, but that the intrinsic nature of the molecule of the contrast medium used was the determining factor
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Iodamide/analogs & derivatives , Iothalamate Meglumine/adverse effects , Contrast Media/adverse effects , Iothalamic Acid/adverse effects , Drug Combinations , Osmolar Concentration , Prospective Studies , Iodamide/adverse effectsABSTRACT
The authors reviewed findings of enhanced abdominal computed tomographic (CT) scans to the difference between a higher dose of conventional ionic contrast media(iothalamate meglumine) and a lower dose of a new, nonionic contrast material (ioversol). One hundred adult patients were divided into two groups. Each group consisted of 50 patients. Iothalamate meglumine and ioversol were intravenously administered in each group. The ratio of the male to female in the former was 28.22, and the latter 29:21. We examine the degree of renal streak artifact and measure the Hounsfield number of urine in renal collecting system. There were significant differences of the degree of the streak artifact depending upon the osmolality of contrast media used and that was related with urine CT number (P value<0.005). We authors conclude that nonionic low osmolar contrast media is prone to cause streak artifacts and distortions of renal image than conventional ionic high osmolar contrast media.
Subject(s)
Adult , Female , Humans , Male , Artifacts , Contrast Media , Iothalamate Meglumine , Kidney , Osmolar ConcentrationSubject(s)
Child , Child, Preschool , Diatrizoate Meglumine/diagnosis , Female , Humans , Infant , Infant, Newborn , Iothalamate Meglumine/diagnosis , Male , Methods , Urethra/diagnostic imaging , Urinary Bladder/diagnostic imaging , Urinary Catheterization , Urinary Incontinence/diagnostic imaging , UrinationABSTRACT
Foram analisadas as alteraçöes hemodinâmicas, eletrocardiográficas e reaçöes sistêmicas, em 30 pacientes estudados pela cinecoronariografia e ventriculografia esquerda, com o objetivo de comparar os efeitos de dois meios de contraste. Aleatoriamente, foram empregados os meios de contraste AG 64-03 e o iotalamato de meglumina e sódio, em 18 e 12 pacientes (grupo A e B), respectivamente. A freqüência cardíaca (FC) e as pressöes sistólica, diastólica final e média do ventrículo (VE) (PSVE, PD2 VE e PMVE) foram registradas antes e após a ventriculografia esquerda e ao final da cinecoronariografia. Observou-se, após a ventriculografia, maior aumento da FC no grupo B (p < 0,01) e maior aumento da PSVE, após a coronariografia (p < 0,001). As outras variáveis näo apresentaram diferenças significativas. O tempo de recuperaçäo do eletrocardiograma (ECG), no grupo A foi de 14 + ou - 3s, contra 28 + ou - 10s no grupo B (p <0,001). Durante a injeçäo de contraste na coronária esquerda (CE), o grupo B apresentou uma incidência de 40% de arritmias no ECG, enquanto o grupo A nada registrou. Os efeitos colaterais sistêmicos foram discretos em ambos os grupos. Visto que as maiores diferenças dos efeitos colaterais destes dois meios de contraste säo verificadas no ECG, conclui-se que a menor viscosidade (7,5/9,0 cP) e a menor concentraçäo de sal de sódio (9,66/26,00%) do contraste AG 64-03 devem ser os fatores responsáveis pela diminuiçäo de tais efeitos indesejáveis e que o contraste AG 64-03 oferece mais segu
Subject(s)
Humans , Iothalamate Meglumine/pharmacology , Electrocardiography , Hemodynamics/drug effects , CineangiographyABSTRACT
Conray ventriculography is a method for the roentgenographic visualization of the cerebral ventricular system with meglumine iothalamate 60%(Conray). Although it has been known that ventriculography using Conray 60% offers definite advantages compared to that with other contrast media and untoward reactions have been reported as mild and transitory ones, a significant disadvantage is the possible development of seizures. Recently we had performed Conray ventriculogrqaphy and analized their untoward reactions in 25 cases which were previously proved hydrocephalic by cerebral angiographies, from march, 1973 to August, 1974. They included twenty cases of brain tumor and five cases of hydrocephalus. Untoward reactions were analized with respect to the different concentration of the contrast media used, communicating or noncommunicating pathway of the cerebrospinal fluid and the different sites of obstruction in the cerebrospinal fluid pathway. The results were as follows: 1. Headache and convulsion were more frequently observed in cases of ventriculography using undiluted Conray. 2. High frequency of vomiting was observed in cases with communicating pathway of the cerebrospinal fluid. 3. There seemed to be no difference in untoward reactions between the levels of obstruction in the cerebrospinal fluid pathway.