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Biomedical subjects

A Bowen

Publications and source records attributed to A Bowen.

At least 55 records · Page 3Linked to original sources
PubMed1989

Spontaneous perforation of the common bile duct in children.

The authors describe radiologic findings in five patients with spontaneous perforation of the common bile duct (a rare disorder). The patients were 5 weeks, 9 weeks, 3 months, 11 months, and 2 1/2 years old at presentation. The most common presenting complaints were jaundice and abdominal distention (due to ascites). Sonographic findings included ascites in three patients, a loculated fluid collection around the gallbladder in two patients, and both in one patient. The biliary tree was undilated in all patients. Results of hepatobiliary scintigraphy definitely demonstrated that intraperitoneal fluid originated from the biliary tract. Intraoperative cholangiography was used to confirm the diagnosis at surgery. All children were successfully treated with surgery. Recognition of these findings on sonograms and subsequent confirmation with scintigraphy are important to prevent delays in diagnosis of a potentially fatal condition.

Child, Preschool↗
PubMed1988

Pseudoaneurysms complicating organ transplantation: roles of CT, duplex sonography, and angiography.

In a retrospective study of proved pseudoaneurysms (PAs) in 15 patients with transplanted organs (11 liver, three kidney, one pancreas), the results of computed tomography (CT), duplex sonography, and angiography were reviewed. Of the 15 cases of PA, eight occurred at the arterial anastomosis and seven were nonanastomotic. Three of the eight anastomotic PAs were caused by infection. Of the seven nonanastomotic PAs, four were caused by percutaneous biopsy, two were caused by infection, and one was of undetermined cause. In nine (60%) of the 15 patients the PAs were incidentally detected at imaging studies performed for other reasons. Diagnosis requires a high degree of suspicion. CT was performed in nine cases and duplex sonography in ten. The diagnosis of PA was made with CT in six (67%) patients and with duplex sonography in five (50%). CT and duplex sonography could not enable diagnosis when the PA was small, when the arterial anastomosis was not included in the field of study, or when enhancement with intravenously administered contract material was suboptimal. Angiography depicted the PAs in all 15 patients. In three liver transplant recipients with gastrointestinal tract bleeding, the causative PAs were detected only with angiography.

Adult↗
PubMed1988

Duplex sonography of hepatic artery thrombosis after liver transplantation.

When hepatic artery thrombosis occurs after liver transplantation, another transplantation is required to ensure the patient's survival. Because of the importance of establishing this diagnosis, we reviewed the results of duplex sonography in 37 angiographically or surgically proved cases of hepatic artery thrombosis after liver transplantation. There were 20 children and 17 adults. Ten of the 20 children had angiographically documented hepatopetal arterial collaterals. Such collaterals were not seen in the adult patients. This subset of patients was evaluated separately to determine if intrahepatic arterial blood flow reestablished by collaterals after hepatic artery thrombosis was a cause of false-negative Doppler studies. Thirty-four (92%) of the 37 cases of hepatic artery thrombosis were correctly identified by Doppler. A Doppler pulse was not identified in any of the children with arterial collaterals. We conclude that duplex sonography is sensitive in detecting hepatic artery thrombosis after liver transplantation. Furthermore, the presence of blood flow in hepatopetal arterial collaterals does not cause false-negative examinations.

Adolescent↗
PubMed1988

Radiologic evaluation of the diaphragm.

Recent technical advancements allow us to better evaluate the diaphragm and juxtadiaphragmatic lesions. Plain radiographs demonstrate morphology of the diaphragm in most cases. Function of the diaphragm can easily be evaluated by ultrasonography and fluoroscopy. Ultrasonography can be performed at bedside and should be used before fluoroscopy in infants and children. Ultrasonography can also demonstrate congenital anomalies of the diaphragm in utero. CT clearly discloses the underlying pathology and the extent of most juxtadiaphragmatic lesions. The newest modality, MRI, is quite promising and may become the procedure of choice for evaluation of diaphragmatic as well as juxtadiaphragmatic lesions in the very near future.

Diaphragm↗
PubMed1988

Pulmonary pseudofibrosis and pseudomass lesions.

Abnormal size and/or number of the pulmonary and bronchial vessels and lymphatics may mimic pulmonary parenchymal lesions (pseudofibrosis). Abnormalities of the central pulmonary artery, pulmonary vein, thoracic aorta, and brachiocephalic branches may mimic intrathoracic mass lesions (pseudomass lesions). Radiologists should interpret these radiographic findings in the light of other accompanying radiographic findings and the clinical presentation.

Bronchial Arteries↗
PubMed1988

The vomiting infant: recent advances and unsettled issues in imaging.

The evaluation of infantile vomiting is bound up with many unresolved questions and continually evolving imaging technologies. This article addresses three specific areas of interest: the use of newer low-osmolality, water-soluble contrast media in the infant's gastrointestinal tract; the ever-controversial subject of gastroesophageal reflux; and the burgeoning role of gastrointestinal ultrasonography.

Gastroesophageal Reflux↗
PubMed1986

Hepatic artery thrombosis after liver transplantation: radiologic evaluation.

Hepatic artery thrombosis after liver transplantation is a devastating event requiring emergency retransplantation in most patients. Early clinical signs are often nonspecific. Before duplex sonography (combined real-time and pulsed Doppler) capability was acquired in October 1984, 76% of all transplants in this institution referred for angiography with a clinical suspicion of hepatic artery thrombosis had patent arteries. In an effort to reduce the number of negative angiograms, CT, real-time sonography, and pulsed Doppler have been evaluated as screening examinations to determine which patients need angiography. Of 14 patients with focal inhomogeneity of the liver architecture detected by CT and/or real-time sonography, 12 (86%) had hepatic artery thrombosis, one had slow arterial flow with hepatic necrosis, and one had a biloma with a patent hepatic artery. In 29 patients undergoing duplex sonography of the hepatic artery, six (21%) had absence of a Doppler arterial pulse. All six had abnormal angiograms: Four had thrombosis, one had a significant stenosis, and one had slow flow with biopsy-proven ischemia. Of 23 patients with a Doppler pulse, two had hepatic artery thrombosis at surgery. However, real-time sonography demonstrated focal inhomogeneity in the liver in both cases. Our data demonstrate that pulsed Doppler of the hepatic artery combined with real-time sonography of the liver parenchyma currently is the optimal screening test for selecting patients who require hepatic angiography after liver transplantation. A diagnostic algorithm is provided.

Adolescent↗
PubMed1985

Transient myocardial ischemia of the newborn infant.

Ten full-term newborn infants with transient myocardial ischemia developed radiographic evidence of cardiomegaly and pulmonary venous congestion within the first few hours of life. In five patients, radiographic findings returned to normal during the first week of life. In the remaining five patients, radiographic findings improved within the second week and eventually became normal. Echocardiography done on six patients demonstrated left ventricular dysfunction in all six patients. Those infants with documented perinatal insults tend to have a protracted clinical course with eventual recovery. Pathophysiology and clinical course are discussed.

Cardiac Catheterization↗
PubMed1985

Juvenile laryngeal papillomatosis with pulmonary parenchymal spread. Case report and review of the literature.

A 6.5-year-old boy developed laryngeal papillomas at 20 months of age and pulmonary parenchymal spread at age 3.5 years, the lung lesions beginning as solid nodules which rapidly cavitated. The cavitary lesions have stabilized in size but no appreciable improvement has resulted from trials of bleomycin, methotrexate, or interferon. A review of 14 other cases indicates that the lung lesions may develop many years after the onset of laryngeal papillomatosis, and the lung lesions do not tend to regress spontaneously as uncomplicated juvenile laryngeal papillomas often do. Three of 15 patients developed carcinomas in their lung lesions without prior therapeutic irradiation.

Antibiotics, Antineoplastic↗
PubMed1985

Ovarian torsion diagnosed by ultrasonography.

We have reported the ultrasonographic findings in a 9-year-old girl with torsion of a normal ovary. In this and six previously reported cases ultrasonography has shown hypoechoic, solid, intrapelvic masses sometimes containing small cysts. Liquid may be present in the pelvic cul-de-sac, and in one instance an anechoic halo surrounded an infarcted ovary. A second case, a seemingly false-positive ultrasonic diagnosis of ovarian enlargement, illustrated a possible pitfall. Ultrasonography can aid in earlier diagnosis of ovarian torsion, which may permit more ovaries to be salvaged.

Adolescent↗
PubMed1985

Pediatric liver transplantation. Part I. Standardization of preoperative diagnostic imaging.

The preoperative radiologic imaging workups of 44 pediatric liver transplantation patients were reviewed. Biliary atresia (43%) and metabolic disorders (33%) with end-stage liver disease were the leading indications for pediatric liver transplantation at our institution. The radiologic imaging examinations included chest and skeletal radiography, upper gastrointestinal tract series, abdominal ultrasonography (US), computed tomography, angiography, and contrast echocardiography. Abdominal US (performed in 38 of 44 patients) was the pivotal screening imaging examination; it was invaluable in determining the patency and size of the extrahepatic portal vein and inferior vena cava. Angiography is mandatory if this vascular anatomy is not established with certainty on sonograms or if malrotation is seen on the upper gastrointestinal tract series. Congenital malrotation should be differentiated from small bowel malposition caused by portoenterostomy in patients with biliary atresia. Vascular anomalies, especially absent portal vein and/or inferior vena cava, in patients with biliary atresia and polysplenia syndrome may preclude liver transplantation.

Adolescent↗