RESUMO
AIM: To evaluate prospectively the usefulness of ultrasound in determining the site and cause of distal small bowel and colonic obstruction. MATERIALS AND METHODS: Ultrasound findings in 60 consecutive patients with suspected distal ileal or colonic obstruction were correlated with final surgical and radiological diagnoses. The diagnostic value of ultrasound was compared with plain abdominal radiography (AXR) for the presence and level of obstruction. RESULTS: Forty-five patients were confirmed to be obstructed. Ultrasound correctly identified obstruction in 44/45 and the cause in 36/45 (80%). Overall sensitivity of US for obstruction was 98% and specificity 80%, compared with 79% and 53% respectively for the AXR. CONCLUSION: Ultrasound is useful in determining the presence and cause of distal ileal and colonic obstruction.
Assuntos
Doenças do Colo/diagnóstico por imagem , Doenças do Íleo/diagnóstico por imagem , Obstrução Intestinal/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Neoplasias do Colo/complicações , Neoplasias do Colo/diagnóstico por imagem , Diagnóstico Diferencial , Reações Falso-Negativas , Feminino , Humanos , Obstrução Intestinal/etiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Sensibilidade e Especificidade , UltrassonografiaRESUMO
OBJECTIVE: To assess the ability of radiographers to identify abnormal radiographs of patients attending accident and emergency departments. DESIGN: Prospective study over six weeks. SETTING: Teaching hospital casualty x ray department. PATIENTS: 3394 consecutive patients referred for radiography. INTERVENTIONS: Radiographs were assessed by radiographers who were offered a four point triage scheme: normal, abnormal, insignificantly abnormal, or further advice required. MAIN OUTCOME MEASURES: Comparison of radiographers' assessments with an assessment made independently by the reporting radiologists. RESULTS: Overall disagreement between the radiographers and radiologists was 9.4%. There were 7% false positives and 14% false negatives. Most errors occurred in assessing radiographs of the skull, facial bones, chest, abdomen, and soft tissues. CONCLUSION: Unselected radiographers can offer useful advice on radiographs to casualty officers, but their high rate of false positive diagnoses indicates that they cannot triage casualty radiographs sufficiently accurately to allow them to extend their current reporting role.
Assuntos
Competência Clínica , Serviço Hospitalar de Emergência/normas , Radiografia/normas , Triagem/normas , Erros de Diagnóstico , Emergências , Inglaterra , Humanos , Variações Dependentes do Observador , Estudos Prospectivos , Radiologia , Serviço Hospitalar de Radiologia/normas , Ferimentos e Lesões/diagnóstico por imagemRESUMO
A randomised double-blind comparative study was performed to assess the imaging properties and side-effects of two non-ionic contrast media, iopromide and iopamidol, in intravenous urography in high risk patients. The results showed the two contrast media to be similar in their imaging efficacy and incidence of side-effects. Using 50 or 100 ml of iopromide or iopamidol (370 mgI/ml), the quality of nephrograms was found to be dose dependent but the quality of pyelograms was not dose dependent.
