RESUMO
Two tests of cystic duct patency were compared in 37 patients with suspected acute cholecystitis. Ultrasound (US) measurement of gallbladder contraction induced by 40 Ivy dog units of cholecystokinin (CCK) was followed by the radionuclide (RN) test for cystic duct patency. In all 13 patients in whom US showed significant gallbladder contraction after CCK, the cystic duct was proved to be patent by the RN test. The gallbladder did not contract significantly in 24 patients. Eleven of these patients had acute cholecystitis, with evidence of cystic duct obstruction, and 12 had patent cystic ducts and final diagnoses other than acute cholecystitis. The measurement of contraction of the gallbladder in response to CCK is a valuable improvement over simple US when cystic duct obstruction is excluded; failure of contraction is not specific, and independent evaluation of cystic duct patency is required.
Assuntos
Colecistocinina , Ducto Cístico/diagnóstico por imagem , Vesícula Biliar/efeitos dos fármacos , Ultrassonografia , Adulto , Idoso , Doenças dos Ductos Biliares/complicações , Doenças dos Ductos Biliares/diagnóstico por imagem , Colecistite/diagnóstico , Colecistite/etiologia , Colelitíase/diagnóstico , Vesícula Biliar/diagnóstico por imagem , Vesícula Biliar/fisiopatologia , Humanos , Pessoa de Meia-Idade , CintilografiaRESUMO
This is a case report of the ultrasonic detection of an enlarged urinary bladder in a 20 1/2 week fetus which subsequently was proven to have the prune belly or Eagle-Barrett syndrome. Serial sonograms were used to follow the progress of this abnormal pregnancy and were instrumental in the subsequent clinical management of the patient.
Assuntos
Anormalidades Múltiplas/diagnóstico , Diagnóstico Pré-Natal/métodos , Ultrassonografia , Anormalidades Urogenitais , Músculos Abdominais/anormalidades , Adulto , Feminino , Humanos , Recém-Nascido , Masculino , Gravidez , Testículo/anormalidadesRESUMO
Sternal dehiscence is a recognized complication of median sternotomy in 2.5-4.8% of patients. The authors describe the prognostic significance of a lucent midsternal stripe which was seen in 12 patients over a two-year period. Sternal dehiscence requiring surgical revision developed in 4, and radiological suspicion preceded clinical evidence of dehiscence in 3 of them. A review of 100 consecutive median sternotomies revealed that sternal dehiscence did not develop in any patient who did not have a midsternal stripe. It is suggested that this may be a useful tool in identifying those patients who are at high risk of the development of sternal dehiscence.
