ABSTRACT
Spontaneous perforation of the esophagus still carries a high rate of morbidity and mortality because of frequent delay in diagnosis, extensive mediastinal contamination, and inadequate surgical repair. We used a nonoperative approach in two patients in whom the perforation was well contained, with evidence of drainage back into the esophagus and few symptoms or signs of sepsis. Nonoperative management included administration of intravenous antibiotics and hyperalimentation. Both patients had a satisfactory outcome.
Subject(s)
Esophageal Diseases/therapy , Adult , Esophageal Diseases/diagnostic imaging , Follow-Up Studies , Humans , Male , Middle Aged , Radiography , Rupture, SpontaneousSubject(s)
Osteomyelitis/diagnosis , Spinal Diseases/diagnosis , Adult , Aged , Anti-Bacterial Agents/therapeutic use , Back Pain/diagnosis , Bacterial Infections/drug therapy , Escherichia coli Infections/diagnosis , Female , Humans , Male , Osteomyelitis/diagnostic imaging , Osteomyelitis/drug therapy , Radiography , Spinal Diseases/diagnostic imaging , Spinal Diseases/drug therapy , Staphylococcal Infections/diagnosis , Streptococcal Infections/diagnosisSubject(s)
Hospital Departments/organization & administration , Medical Record Linkage , Medical Records , Radiology Department, Hospital/organization & administration , Forms and Records Control , Hospital Bed Capacity, 100 to 299 , Information Systems , Maine , Pathology Department, Hospital/organization & administrationABSTRACT
Desmoid tumor (aggressive fibromatosis) of the chest wall is rare and usually extrathoracic. A large extrapleural intrathoracic desmoid occurred at the site of previous thoracotomy, and recurred five years later.
Subject(s)
Fibroma/etiology , Postoperative Complications , Thoracic Neoplasms/etiology , Thoracic Surgery , Thorax/surgery , Adult , Fibroma/diagnostic imaging , Humans , Male , Neoplasm Recurrence, Local , Radiography , Thoracic Neoplasms/diagnostic imagingABSTRACT
Multiple contrast injections were necessary in 65% of the 140 epidural venograms performed at the Penobscot Bay Medical Center between January and December 1977. Several examples of the value of multiple injections are illustrated. Institutions interested in performing epidural venography or those performing the examination on a limited basis should be aware of the need for multiple injections, allowing time for reviewing the initial series of radiographs, for reloading the film changer and injector, and for repeating fluoroscopy and catheter manipulation.
Subject(s)
Contrast Media/administration & dosage , Phlebography , Spinal Canal/diagnostic imaging , Adult , Female , Humans , Injections , Intervertebral Disc Displacement/diagnostic imaging , Spinal Canal/blood supplySubject(s)
Bone Neoplasms/complications , Femoral Fractures/therapy , Fracture Fixation , Humeral Fractures/therapy , Adult , Aged , Female , Humans , Joint Prosthesis , Male , Middle Aged , Neoplasm MetastasisABSTRACT
Two patients with popliteal vein thrombosis secondary to popliteal artery aneurysm are described. The association of venous abnormalities in 623 reported cases of popliteal artery aneurysm is reviewed. The high morbidity from popliteal vein thrombosis would seem to justify preoperative leg venography in patients with popliteal artery aneurysm.
Subject(s)
Aneurysm/complications , Popliteal Artery , Popliteal Vein , Thrombosis/etiology , Aneurysm/diagnostic imaging , Angiography , Humans , Male , Middle Aged , Phlebography , Popliteal Artery/diagnostic imaging , Popliteal Vein/diagnostic imaging , Thrombosis/diagnostic imagingSubject(s)
Blood Vessel Prosthesis , Catheterization/instrumentation , Aged , Angiography/methods , Aorta , Female , Femoral Artery , HumansSubject(s)
Arteries/surgery , Femoral Artery/surgery , Foot/blood supply , Umbilical Veins/transplantation , Aged , Female , Humans , Methods , Transplantation, HomologousABSTRACT
We cite four examples of splaying of the proximal end of femoral bypass vein grafts accompanied by graft stenosis as a cause for late postoperative recurrent ischemic symptoms or graft failure. Though usually associated with dilation of the common femoral artery, one patient showed no arterial aneurysm. After appropriate angiographic views to demonstrate the "spoon bowl" deformity, corrective surgery to widen or bypass the stenotic segment and prevent further dilation of the artery, where indicated, resulted in patent grafts in all patients for at least one year. Diminishing pulses or the recurrence of ischemic symptoms after femoral bypass vein graft are indications for angiography of the graft. This should include appropriate views to demonstrate the proximal anastomosis that may show a "spoon bowl" deformity amenable to surgical correction.
Subject(s)
Femoral Artery/surgery , Femoral Vein/transplantation , Postoperative Complications , Aged , Aneurysm/surgery , Constriction, Pathologic , Humans , Male , Middle Aged , Transplantation, AutologousSubject(s)
Chondroma/diagnostic imaging , Elbow Joint , Synovial Membrane , Humans , Joint Diseases/diagnostic imaging , Male , Middle Aged , RadiographyABSTRACT
Most types of arteriographic procedures are performed on an outpatient basis at Knox County General Hospital. Four years of experience indicates no increased incidence of complications between the inpatient and outpatient groups. No patient had to be admitted to the hospital for delayed complications. Observation within the radiology department or short-stay recovery area for up to four hours seems adequate postarteriographic management and safely avoids routine overnight hospital admission.
