ABSTRACT
HISTORY: A 35-year-old male was admitted with recurrent acute pancreatitis of unknown origin. He was found to have a cystic lesion in the upper abdomen believed to be a pancreatic pseudocyst (patient 1). A 59-year-old female with a choledochal cyst developed acute pancreatitis (patient 2). A 32-year-old male who had been operated upon for a choledochal cyst during childhood was admitted for upper abdominal pain, fever and vomitus (patient 3). INVESTIGATIONS AND DIAGNOSIS: Patient 1 was found to have a choledochal cyst type IV a according to TODANI. Patient 2 was diagnosed to have a choledochal cyst type Ib according to TODANI. The cyst was believed to contain a bile duct carcinoma. In patient 3, sonography showed an advanced Klatskin tumour with infiltration of the portal vein, the hepatic artery and the liver. Bile cytology confirmed the carcinoma. In all patients cholestasis was found. Pancreatic enzymes were elevated in patients 2 and 3. TREATMENT AND COURSE: Patient 1 underwent left hemihepatectomy and received a biliodigestive anastomosis. In patient 2 the choledochal cyst was resected while undergoing pylorus-preserving resection of the pancreatic head. The tumour suspected was confirmed and R0 resected. Patient 3 presented with an incurable bile duct carcinoma. He died 3 months later from multiple lung emboli. CONCLUSION: Choledochal cysts are associated with a 20 fold increase in the incidence of bile duct carcinoma.
Subject(s)
Bile Duct Neoplasms/etiology , Cholangiocarcinoma/etiology , Choledochal Cyst/complications , Pancreatitis/etiology , Acute Disease , Adult , Bile Duct Neoplasms/diagnosis , Bile Duct Neoplasms/surgery , Cholangiocarcinoma/diagnosis , Cholangiocarcinoma/surgery , Choledochal Cyst/diagnosis , Fatal Outcome , Female , Humans , Male , Middle Aged , Recurrence , Treatment OutcomeABSTRACT
In recent years the true incidence of impotence due to organic diseases in comparison with psychogenic disorders could be verified. New diagnostic tools as penile Doppler ultrasonography, PBI estimation, NPT measurement, invasive SKIT's, neurophysiological methods, selective phalloarteriography, artificial erection and dynamic cavernosography are introduced and are the guide to therapeutic approach.
Subject(s)
Erectile Dysfunction/etiology , Adult , Aged , Blood Pressure/physiology , Diagnosis, Differential , Humans , Male , Middle Aged , Papaverine , Penile Erection/physiology , Penis/blood supply , Phentolamine , Ultrasonography/instrumentation , Urodynamics/physiologySubject(s)
Pulmonary Fibrosis/diagnosis , Adult , Aged , Bird Fancier's Lung/diagnosis , Diagnosis, Differential , Female , Humans , Lung Neoplasms/diagnosis , Lymphangioma/diagnosis , Male , Middle Aged , Pulmonary Alveolar Proteinosis/diagnosis , Sarcoidosis/diagnosis , Silicosis/diagnosis , Tuberculosis, Miliary/diagnosis , Tuberculosis, Pulmonary/diagnosisABSTRACT
For the most frequent and important indications for radiologic examination of the small bowel (passage disorder, blood of unknown origin, inflammatory processes, malabsorption) a diagnostic strategy was established. From the contrast investigations the imaging of the small bowel with a tube, enteroclysma, is preferred. The significance of plain films and sonography is also pointed out. Computed tomography and angiography are rarely indicated. The recommendation of enteroclysma is substantiated by the evaluation of our own series of investigations.
Subject(s)
Intestine, Small , Contrast Media , Gastrointestinal Transit , Humans , Intestinal Diseases/diagnosis , Intestinal Diseases/diagnostic imaging , Intestine, Small/diagnostic imaging , Intestine, Small/physiopathology , Intubation, Gastrointestinal/instrumentation , Intubation, Gastrointestinal/methods , RadiographyABSTRACT
1. Issuing from the clinical method of proceeding in side-separated diagnosis of the renal function under theoretical aspect a survey orientation for the renal global function is tried. 2. The method orientation is done according to semiquantitative and quantitative valuation. The isotope and contrast remedy urography, the functional tests after Howard, Rapoport and Stamey, the conventional side-separated estimation of the clearance, the isotope sequence scintigraphy as well as the diagnostics of the renal and intrarenal haemodynamics (renin determination, measuring of the renal plasma flow by means of PAH and other indicators [133-xenon-wash-our-technique]). 3. Finally a valuation of the method concerning the side-separated diagnostics of the renal elimination function as well as of the stenosis of the renal arteries is done taking into consideration the performability of the investigation methods in the clinic.
Subject(s)
Kidney Function Tests/methods , Acid-Base Equilibrium , Erythropoietin/analysis , Humans , Kidney/diagnostic imaging , Radionuclide Imaging , Renal Artery Obstruction/diagnosis , Renin/analysis , UrographyABSTRACT
The standard examination method of the radiological diagnostics of pyelonephritis is the EU. In restricted function of the kidney the intensive urography is to be used. Above all decent changes of form and tonus in the hollow system show diagnostic problems. Concerning a pyelonephritis they can be classified only in connection with clinical data. In more than 90% of the examinations the chronic pyelonephritis is to be recognized in the EU. It is referred to aspects of the radiation load in the EU.
Subject(s)
Pyelonephritis/diagnostic imaging , Chronic Disease , Diagnosis, Differential , Humans , UrographyABSTRACT
With the help of special literature and the results of own investigations the usability and evidence of radiological examination methods in the diagnosis of pyelonephritis are described. The high value of urography in the ascertainment of predisposing factors for pyelonephritis is emphasized. Subject of nearer considerations is the characteristic radiological feature of chronic pyelonephritis in its different developmental stages. Especially in connection with the decent radiological changes in the early forms of chronical pyelonephritis is referred to the necessity of an optimal collaboration between clinician and radiologist.
