ABSTRACT
Ten patients with normal serum creatinine and no evidence of acute cholecystitis were found to have vicarious excretion of water-soluble contrast media into the gallbladder 20 minutes to 72 hours after injection. Eight of the ten had unilateral renal pathology. Two patients, however, had bilaterally normal kidneys. The patients had been injected with either diatrizoate, iothalamate, or iodamide. The mechanisms and pathophysiology of vicarious contrast excretion are discussed. The vicarious excretion of intravascular contrast in the gallbladder does not in itself indicate renal or hepatobiliary disease. Although commonly associated with unilateral renal pathology, vicarious gallbladder excretion of urographic contrast may be a normal variant in some patients.
Subject(s)
Contrast Media/metabolism , Creatinine/blood , Gallbladder/metabolism , Adolescent , Adult , Child , Diatrizoate/metabolism , Female , Humans , Iodamide/metabolism , Iothalamic Acid/metabolism , Kidney/metabolism , Male , Middle AgedABSTRACT
Diffuse neonatal hemangiomatosis is an often fatal disorder characterized by widespread capillary hemangiomas of the skin and visceral organs. Ultrasound and computed tomographic scans may be useful in determining the extent of visceral disease. The organs most commonly affected are the gastrointestinal tract, brain, liver, and lung. Complications include high-output cardiac failure, gastrointestinal bleeding, hydrocephalus, and consumption coagulopathy. Despite therapy with corticosteroids, the mortality rate is high.
Subject(s)
Hemangioma/congenital , Neoplasms, Multiple Primary/congenital , Skin Neoplasms/congenital , Brain Neoplasms/pathology , Facial Neoplasms/pathology , Female , Hemangioma/blood , Hemangioma/drug therapy , Humans , Infant, Newborn , Liver Neoplasms/pathology , Methylprednisolone/therapeutic use , Mouth Neoplasms/pathologyABSTRACT
The safety and efficacy of enteral feeding by needle catheter jejunostomy has prompted its use after many major gastrointestinal operations. Indeed, the technical complications of this procedure are infrequent. This report details the development of massive pneumatosis intestinalis associated with elemental feeding via jejunostomy. The proposed etiology includes excessive gas accumulation within the small intestine secondary to 1) inadequate nasogastric suction, 2) post-traumatic intestinal ileus, and 3) disaccharide fermentation; combined with a mucosal defect created by the catheter jejunostomy. Successful management consists of nasogastric suction and immediate termination of the enteral feeding.
Subject(s)
Emphysema/etiology , Enteral Nutrition/adverse effects , Jejunum , Pneumatosis Cystoides Intestinalis/etiology , Subcutaneous Emphysema/etiology , Adult , Catheterization/adverse effects , Enteral Nutrition/methods , Humans , MaleABSTRACT
A significant correlation between brain atrophy and impairment on neuropsychological testing in young alcoholics was found. Chronological age also correlated with brain atrophy, supporting the hypothesis that excessive drinking causes premature aging of the brain.
Subject(s)
Alcoholism/pathology , Brain/pathology , Psychomotor Performance , Adult , Age Factors , Alcoholism/diagnostic imaging , Alcoholism/physiopathology , Atrophy/chemically induced , Brain/diagnostic imaging , Brain/physiopathology , Humans , Intelligence , Middle Aged , Psychological Tests , Tomography, X-Ray ComputedABSTRACT
Displacement of a sharp "costophrenic angle," rather than blunting of the "costophrenic angle," is emphasized as one of the earliest signs of pleural fluid. Examples of this sign are illustrated, and its pathophysiology is discussed.
Subject(s)
Pleura/diagnostic imaging , Pleural Effusion/diagnostic imaging , Humans , Pleura/anatomy & histology , Pleura/physiopathology , Pleural Effusion/physiopathology , RadiographyABSTRACT
Twenty neonates with a suspected intracranial hemorrhage were studied by computed tomography (CT). The exact site and extent of the hemorrhage in all infants were clearly demonstrated on serial CT scans. In intraventricular hemorrhage, a dense subependymal halo lined the ventricular system and could be recognized for up to 2 weeks. Discrete hemorrhage adjacent to the ventricular system also appeared as discrete nodules rather than as a diffuse hemorrhage. Blood in the ventricular system could be recognized up to 2 weeks when there were blood-cerebrospinal fluid levels. Hydrocephalus was a common sequela and was readily detectable before a measurable change in head size.
Subject(s)
Cerebral Hemorrhage/diagnostic imaging , Infant, Premature, Diseases/diagnostic imaging , Tomography, X-Ray Computed , Cerebral Hemorrhage/cerebrospinal fluid , Cerebral Hemorrhage/diagnosis , Humans , Hydrocephalus/diagnostic imaging , Infant, Low Birth Weight , Infant, Newborn , Infant, Premature, Diseases/cerebrospinal fluid , Infant, Premature, Diseases/diagnosis , MaleABSTRACT
A case of radiologically demonstrable gas gangrene of the colon was proved pathologically to be caused by C. perfringens. The case was radiologically indistinguishable from that of bowel infarction. When intramural gas is seen in patients with the symptoms of toxemia but without the bloody diarrhea associated with bowel infarction, infectious gas gangrene should be considered.
Subject(s)
Colonic Diseases/diagnostic imaging , Gas Gangrene/diagnostic imaging , Aged , Colonic Diseases/etiology , Diagnosis, Differential , Humans , Infarction/diagnosis , Intestines/blood supply , Male , RadiographyABSTRACT
Rational management of patients with pulmonary thromboembolic disease should include assessment of the risk of additional emboli. Other authors have shown that the possibility of fatal pulmonary embolism is higher when the iliofemoral system contains thrombus, and it is recommended that vena caval interruption rather than simple anticoagulation is indicated. Additional factors governing the therapeutic choice should include the magnitude of the original embolic occlusion as well as the presence of antecedent cardiopulmonary disease. In these instances large thrombi in the iliocaval system should be regarded as potentially life threatening. A sequence of angiography beginning with right iliac and vena caval opacification, proceeding to pulmonary arteriography, and terminating with retrograde left iliac vein study provided information needed to individualize the therapeutic approach. Several case reports illustrate the spectrum of abnormalities and their therapeutic implications.
