RESUMO
Two patients with Acquired Immunodeficiency Syndrome (AIDS) and infectious esophagitis developed squamous cell carcinoma of the esophagus. The clinical, radiographic, and endoscopic presentations in both cases were atypical. One patient developed a focal flat lesion that imitated segmental esophagitis, and the other patient developed a superficially spreading carcinoma that mimicked diffuse esophagitis. In the setting of AIDS, a changing radiographic or endoscopic mucosal pattern requires biopsy to exclude the possibility of a superimposed squamous cell carcinoma.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Carcinoma de Células Escamosas/complicações , Neoplasias Esofágicas/complicações , Carcinoma de Células Escamosas/diagnóstico por imagem , Neoplasias Esofágicas/diagnóstico por imagem , Esofagite/complicações , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , RadiografiaRESUMO
Six patients in whom errors of diagnosis and therapy occurred because of reliance on colonoscopic tumor localization are presented. Three of the patients required a second laparotomy for surgical resection of a tumor that was missed at the first exploration. While endoscopy is regarded as the diagnostic gold standard, there are problems in its use for colonoscopic localization. Reliance on distance measurements may be misleading. Anatomical variants can be confusing. For this reason, a preoperative barium enema for precise delineation and localization of tumors is recommended. When a barium enema is not feasible, such as when a malignant polyp has been removed endoscopically, preoperative endoscopic localization with injection of India ink or intraoperative colonoscopy must be performed.
Assuntos
Neoplasias do Colo/diagnóstico por imagem , Pólipos do Colo/diagnóstico por imagem , Colonoscopia , Adulto , Idoso , Idoso de 80 Anos ou mais , Sulfato de Bário , Colo/patologia , Neoplasias do Colo/patologia , Pólipos do Colo/patologia , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , RadiografiaAssuntos
Doença Diverticular do Colo/complicações , Intestino Delgado , Doenças do Colo Sigmoide/complicações , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença Diverticular do Colo/diagnóstico por imagem , Feminino , Humanos , Enteropatias/diagnóstico por imagem , Enteropatias/etiologia , Intestino Delgado/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Radiografia , Estudos Retrospectivos , Doenças do Colo Sigmoide/diagnóstico por imagemRESUMO
Nd:YAG laser therapy is an attractive palliative treatment for carcinoma of the esophagus and gastric cardia. Twenty-five patients with these tumors underwent laser therapy over a 2-year period, receiving a total of 52 courses of therapy with 189 treatments. Treatments per course averaged 3.6, with a mean of two courses per patient. Luminal diameter is increased with this method; symptomatic improvement in dysphagia occurred in all patients after one course of therapy. Radiographic improvement also is seen. The complication rate in this series was four (2.1%) of 189 procedures, consisting of one perforation, one tracheoesophageal fistula, one pneumopericardium, and one pneumoperitoneum without leak.
Assuntos
Carcinoma/diagnóstico por imagem , Neoplasias Esofágicas/diagnóstico por imagem , Terapia a Laser , Neoplasias Gástricas/diagnóstico por imagem , Idoso , Carcinoma/cirurgia , Neoplasias Esofágicas/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radiografia , Neoplasias Gástricas/cirurgiaRESUMO
The radiologic features were examined in a retrospective review of 25 patients with gastrointestinal complications of acquired immunodeficiency syndrome (AIDS). Factors of risk for AIDS present in these patients included homosexuality (n = 10), intravenous drug abuse (n = 7), multiple blood transfusions (n = 1), and unconfirmed or unknown factors (n = 7). Gastrointestinal abnormalities identified on radiologic studies (including upper gastrointestinal, small bowel, and barium enema studies) were correlated with histopathologic specimens and the results of bacteriologic, viral, fungal, and parasitologic studies. The most common disorders (88%) were candidal esophagitis and cytomegaloviral colitis; neoplastic involvement of the gastrointestinal tract was far less common (12%), with only two patients (8%) having Kaposi sarcoma. Gastrointestinal studies, which can provide useful if not always definitive diagnostic information, are recommended to precede more invasive diagnostic studies in evaluating patients with suspected AIDS.
Assuntos
Síndrome da Imunodeficiência Adquirida/diagnóstico por imagem , Gastroenteropatias/diagnóstico por imagem , Síndrome da Imunodeficiência Adquirida/complicações , Candidíase/diagnóstico por imagem , Colite/diagnóstico por imagem , Criptosporidiose/diagnóstico por imagem , Infecções por Citomegalovirus/diagnóstico por imagem , Esofagite/diagnóstico por imagem , Gastroenteropatias/complicações , Humanos , Ileíte/diagnóstico por imagem , Infecções/complicações , Infecções/diagnóstico por imagem , Infecções por Mycobacterium/diagnóstico por imagem , Radiografia , Sarcoma de Kaposi/diagnóstico por imagem , Neoplasias Gástricas/diagnóstico por imagemRESUMO
Six cases of cytomegalovirus (CMV) colitis are described. The radiographic manifestations of this colitis are nonspecific and usually mimic the findings of ulcerative colitis with diffuse mucosal ulceration or granulomatous colitis with aphthous ulceration and skip areas. Terminal ileal involvement was noted in 1 patient. Nonspecific edema was present in 2 other cases. One patient demonstrated unusual cecal and ascending colonic nodularity due to pseudomembranes and, in another, large, flat discrete ulcerations were identified. Angiography, in 1 case, demonstrated marked hypervascularity and identified a site of hemorrhage in the ascending colon. With the radiographic identification of colitis in an immunocompromised patient, particularly a patient with acquired immunodeficiency syndrome (AIDS), CMV colitis must be strongly considered in the differential diagnosis. Endoscopic biopsy is the most effective method of establishing the diagnosis.
Assuntos
Síndrome da Imunodeficiência Adquirida/complicações , Colite/diagnóstico por imagem , Infecções por Citomegalovirus/diagnóstico por imagem , Adulto , Idoso , Biópsia , Colite/patologia , Colo/patologia , Infecções por Citomegalovirus/patologia , Feminino , Humanos , Masculino , RadiografiaRESUMO
Complications of gastrostomy tubes have been reported principally in the surgical literature and primarily affecting infants and children. Recent reports in the radiologic literature draw attention to the role of the radiologist in the evaluation of these complications.
Assuntos
Sistema Digestório/diagnóstico por imagem , Gastrostomia/efeitos adversos , Fatores Etários , Constrição , Falha de Equipamento , Gastrostomia/instrumentação , Humanos , Obstrução Intestinal/diagnóstico por imagem , Prolapso , Radiografia , Gastropatias/diagnóstico por imagemRESUMO
In order to evaluate the feasibility of performing double-contrast barium enemas in the elderly, a consecutive series of 310 patients above 60 years of age referred for barium enema examinations was analyzed relative to the rate of successful studies. There was an overall success rate of 94.8%. There was a 99% success rate in patients in the seventh decade, 94.9% in the eighth decade, and a 90% success rate in patients 80 years and over. A conclusion is reached that the double-contrast barium enema examination is feasible in the elderly.
Assuntos
Sulfato de Bário , Colo/diagnóstico por imagem , Enema , Fatores Etários , Idoso , Neoplasias do Colo/diagnóstico por imagem , Pólipos do Colo/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , RadiografiaRESUMO
A volvulus of the transverse colon in a 78-year-old woman is reported. The diagnosis is established by abdominal film and barium enema with surgical confirmation. Women are more commonly affected than men. There is a higher mortality rate for volvulus of the transverse colon than for either sigmoid or cecal volvulus.
Assuntos
Doenças do Colo/diagnóstico por imagem , Obstrução Intestinal/diagnóstico por imagem , Doença Aguda , Idoso , Sulfato de Bário , Enema , Feminino , Humanos , RadiografiaRESUMO
Twelve patients with Crohn disease were studied by computed tomography. Characteristic findings of small intestinal involvement include symmetrical bowel wall thickening, a "double halo" appearance on cross section of the diseased bowel segment, and an associated mesenteric fat mass. Computed tomography provided crucial diagnostic information in the management of some of the intestinal and extraintestinal complications of the disease.
Assuntos
Doença de Crohn/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Sulfato de Bário , Ceco/diagnóstico por imagem , Colo/diagnóstico por imagem , Diagnóstico Diferencial , Duodeno/diagnóstico por imagem , Enema , Humanos , Íleo/diagnóstico por imagemAssuntos
Sistema Digestório/diagnóstico por imagem , Gastroenteropatias/diagnóstico por imagem , Meios de Contraste , Duodeno/diagnóstico por imagem , Esôfago/diagnóstico por imagem , Reações Falso-Negativas , Reações Falso-Positivas , Humanos , Métodos , Cuidados Pós-Operatórios , Radiografia , Estômago/diagnóstico por imagemRESUMO
Previous reports have well documented the radiographic appearance of typhoid fever as seen on barium meal antegrade studies. A case is presented whereby barium enema, with small bowel reflux, presents similar radiographic findings. Because the enema is more likely to be employed in emergency situations to exclude appendicitis prior to definitive diagnosis, knowledge of such an appearance of typhoid fever is important.