Thrombotic side-effects of lower limb venography. The use of heparin-saline flush.

In a prospective study of 256 postoperative patients, bilateral lower limb venography was performed using meglumine iothalamate followed by heparin-saline flushing of the deep veins, and the complications of the procedure were assessed. No patient developed clinical evidence of deep-vein thrombosis after the venogram. In 117 patients fibrinogen uptake was performed 24 hours after the venogram. A new positive area on the uptake scan developed in 3 patients (2.6%). Local swelling or haematoma at the injection site occurred in 15 patients (5.9%), cellulitis in 2 (0.8%) and minor contrast reactions in 6 (2.3%). There were no major reactions and no procedure-related mortality. The reasons for the wide variation in the reported incidence of post-venogram thrombosis are considered and the importance of heparin-saline flushing of the deep veins to prevent this complication is discussed.

Anteromedial (perineal) dislocation of the hip: a case report.

Anteromedial (perineal) dislocation of the hip is rare. The authors describe the case of a 13-year-old girl whose femoral head was dislocated into the vagina as a result of a motor vehicle accident. The hip could not be reduced by traction but was pushed through the vagina with moderate ease. When the patient was placed in the lithotomy position, the hip redislocated and further reduction was required. The vagina and soft tissues were repaired and the hip joint was irrigated and closed over a drain. Antibiotics were given for 10 days. The girl recovered completely.

Ultrasound and computed tomography of the infant brain: a clinical comparison.

The ultrasound and computed tomography examinations of the brain in 89 infants were correlated and compared. In 85% of cases both provided information of equal diagnostic accuracy. In the remaining 16% it was the combination of both examinations that provided the maximal information about anatomical localisation, extent of disease and tissue characterisation.

Ultrasound diagnosis of a benign calcified testicular mass: report of a case.

Calcification within a testicular mass is rare. We report here a patient with a large focal benign calcification detected by ultrasonography.

Falciform ligament abscess in the infant.

Two cases of abdominal abscesses related to the falciform ligament are described. The importance of ultrasonic localization is stressed, as these extrahepatic abscesses require surgical drainage, whereas an intrahepatic abscess, particularly amoebic, may be treated with antimicrobials.

Two unusual causes of jaundice with similar ultrasound and CT findings.

The ultrasound and CT patterns of multilocular cystic areas in the liver in two jaundiced patients are presented. In one case the pattern represented a choledochal cyst and in the other an hydatid cyst of the liver. This unusual pattern, although nonspecific, should suggest one of these two diseases.

Ultrasonic assessment of infectious meningitis.

Real-time ultrasonography was performed, utilising the patent anterior fontanelle, on 82 infants with viral or bacterial meningitis. One third of the cases had normal ultrasonic appearances. The other two thirds demonstrated abnormalities of the subdural space, parenchyma and ventricles. Ventricular dilatation was the commonest abnormality and was present in 57% of the infants; ultrasonic evaluation was used to monitor the progress of treatment of these patients.

Ultrasound evaluation of complications in shunted hydrocephalus.

In the infant the cranial and abdominal complications of ventriculoperitoneal shunting can be assessed by real-time ultrasound via the anterior cranial fontanelle or the abdominal wall. The possible complications are listed and eight cases document the spectrum.

The radiology of oesophageal tubes for malignant strictures.

The insertion of oesphagogastric tubes in the palliative treatment of carcinomatous obstruction of the oesophagus is well established. Complications of this procedure are not uncommon whether the tubes are inserted via a gastrotomy or endoscopically. As the aim of insertion is to palliate the patient's condition the prompt recognition of complications is essential. The two most commonly used tubes are described and the complications associated with their use illustrated and discussed. The important role of the radiologist in the initial assessment of the oesophagus (prior to tube insertion) and in the prompt diagnosis of post-insertion complication is stressed.

Ultrasonic prediction of complications following normal vaginal delivery.

One hundred uncomplicated pregnancies of primigravida and secundigravida gestation were scanned within 24 h of delivery. The ultrasonic appearances of the uterus were categorized into three groups: 1) empty uterus; 2) cavity separation indicating blood or clot; and 3) dense cavity echoes representing retained tissue. The presence of blood and clot in the puerperium is a common occurrence that resolves spontaneously. Retained tissues of conception were present in 10 cases and were passed spontaneously in four women within the first 3 days postpartum. The presence of retained tissue after the fourth day is support for surgical evacuation of the uterus. Gray-scale ultrasonic examination was accurate in diagnosing all of these cases.

Computed tomography of fetal specimens.

Computed tomography has been used to provide cross-sectional images of fetal specimens. This technique allows us to gain information on anatomic malformations and in general is a useful tool for research and teaching.

Ultrasound and the postpartum uterus.

Five case reports illustrate the spectrum of ultrasound findings in the postpartum period. When examining patients with symptoms of secondary haemorrhage, the ultrasonographer may find: (i) an empty uterus (no retained tissues): (ii) blood clots which will pass spontaneously; or (iii) retained tissues, which are an indication for evacuation of the uterus. The importance of grey-scale assessment of symptomatic patients is stressed.

Pneumothorax complicating bronchiolitis in an infant.

Pneumothorax is an uncommon complication of bronchiolitis. The case illustrates an unusual pattern of atelectasis of the right lung with pleural air surrounding the right upper lobe and the remainder of the lung expanded. It is thought that the hyperinflated lung is unable to collapse as a result of the 'ball valve' effect of air trapping.

Exogenous lipoid pneumonitis.

The clinical and radiologic diagnosis of exogenous lipoid pneumonitis often goes unrecognized. A specific history of lipoid aspiration is rarely obtained unless specifically sought. We analysed the clinical, radiologic and pathologic findings in 11 patients with pathologically-proven exogenous lipoid pneumonitis. Lipid aspiration results in a predictable pathologic and consequently radiologic pattern of disease, often simulating bronchogenic carcinoma. Transthoracic percutaneous fine-needle aspiration biopsy is useful as a complementary procedure to bronchoscopy in making the diagnosis.