The value of ultrasonic B-mode scanning in the diagnosis of persistent jaundice.

The use of ultrasonic B-mode scanning of the liver and biliary tract in patients with persistent jaundice is described. Sixty-seven consecutive jaundiced patients have been scanned. A correct diagnosis was obtained in 66 per cent, useful information in 26 per cent and in only 8 per cent was the information misleading or of no diagnostic value. In our opinion this simple and non-invasive technique is of great value in the definite diagnosis of persistent jaundice and should allow earlier surgery in the obstructive cases.

Partial nephrectomy for stone disease.

The results of 227 partial nephrectomies for stone were reviewed. Radiologically visible calcification remaining in the kidney at the end of the operation increased the risk of further stone formation. Ipsilateral and contralateral true recurrence rates after partial nephrectomy were the same, and increased with time up to 34% at 20 years. Ipsilateral recurrence rates after partial nephrectomy were half those found in a similar study of nephrolithotomy, pyelolithotomy and ureterolithotomy. Anatomical factors are important in stone formation, and partial nephrectomy is of value in the management of renal stones.

Evaluation of biliary tract disease by ultrasonic B-mode scanning.

To establish the value of diagnostic ultrasound (sonar) in the diagnosis of bilitary tract disease, 140 patients were scanned and also had a plain film of the biliary tract. Of these, 105 had contrast radiography and 123 were subjected to laparotomy. The results obtained suggest that in the absence of jaundice, sonar compares well with oral cholecystography in demonstrating the gallbladder, but is not as good as intravenous cholangiography in showing the duct system. In the presence of jaundice, however, sonar is considered the imaging investigation of choice.