ABSTRACT
The advantages of tomodensitometry and ultrasonography were compared with those of small bowel series in Crohn's disease of the small bowel in 18 patients. These two examinations give results which are inferior to those of small bowel series, for the positive diagnosis and the evaluation of the intraluminal extension of the disease, since their sensitivity was only 60 p. cent in identifying the pathological loop. On the contrary, their advantage lies in the evaluation of the intraluminal extension of the disease, which was correctly demonstrated with ultrasonography in 22 p. cent of cases, and tomodensitometry in 45 p. cent. This confirms the supplementary value of these two examinations in the study of the mesenteric involvement of the disease, screening of abscesses, and makes desirable a prospective evaluation of the influence of mesenteric abnormalities on the prognosis and surgical indications.
Subject(s)
Crohn Disease/diagnosis , Intestine, Small/diagnostic imaging , Tomography, X-Ray Computed , Ultrasonography , Adolescent , Adult , Aged , Crohn Disease/diagnostic imaging , Female , Humans , Male , Middle AgedABSTRACT
Diagnosis of perforation of a solitary diverticulum of transverse colon followed the discovery at operation of an abdominal mass, ultrasound and CT scan imaging demonstrating a heterogeneous mass of enhanced density provoking apparent extrinsic compression of colon. A literature review showed the rarity of this complication, only 22 cases being reported but associated almost constantly with a pseudo-tumoral abscess centered on the diverticulum. This was the case in the patient reported but current imaging methods (ultrasound and particularly CT scanning) allowed correct evaluation of the nature and relations of the mass preoperatively, eliminating, its neoplastic nature by precise morphologic criteria. Despite its rarity, the diagnosis of perforation of an isolated transverse colon diverticulum should be evoked systematically by an extrinsic mass developed in contact with its wall, the nature of which is now simple to define preoperatively by CT scan imaging.
Subject(s)
Diverticulitis, Colonic/complications , Intestinal Perforation/etiology , Diverticulitis, Colonic/diagnosis , Humans , Intestinal Perforation/diagnosis , Intestinal Perforation/surgery , Male , Middle Aged , Preoperative Care , Tomography, X-Ray Computed , UltrasonographyABSTRACT
In 32 patients, 58 angiographically proven pulmonary infarcts were followed for 3 months or longer by serial chest radiography. Complete clearing was seen in 29 (50%) of the infarcts on chest radiography. In the other 29 infarcts that left residual findings, linear scars were identified in 14, pleural diaphragmatic adhesions in nine, and localized pleural thickening in six; in all cases the features were diminutive when compared with the original abnormality. Follow-up perfusion lung images at similar time intervals to the chest films were available for 44 infarcts. Seven of these showed complete resolution and the other 37 showed a residual but much smaller perfusion defect. None of the patients had known preexisting pulmonary disease. The frequency of permanent radiographic scarring seemed to be the same at all ages.
