The value of isotope scanning in patients with clinical signs of fracture of the carpal scaphoid bone and negative or non-diagnostic initial radiographs was examined. 30 patients were examined using both radiography and isotope scanning. A normal scan excludes a fracture. Increased activity localized to the scaphoid bone indicates a fracture. 9 patients had fracture of the scaphoid evident on bone scans within 2 weeks of the injury. It took 2-6 weeks before these fractures showed up on radiographs.

Adolescent↗

PubMed1980

[C-reactive protein (CRP) in clinical practice].

Explore the source record for details and available documents.

Appendicitis↗

PubMedDate not supplied

Water-soluble contrast media in obstructed in ischemic small intestine. A clinical and experimental study.

In this study the attention was focused on the possible application of the new low-osmolar water-soluble contrast media in already existing routines for radiologic diagnostic work-up and management of the abdominal emergencies of simple intestinal obstruction and ischemia: Iohexol was a good, or better, alternative to sodium diatrizoate regarding taste acceptance and patient reactions: Seventy-five per cent of patients characterized the taste of iohexol as good or neutral, while 52% gave sodium diatrizoate similar scores. The scores were also consistently in favor of iohexol as compared with sodium diatrizoate for the other chosen criteria; nausea, vomiting and diarrhea, but a larger number of patients may be needed for conclusive evaluation. Water-soluble media may have therapeutic effects on intestinal obstruction when preceded by conventional gastric suction using a short gastric tube: Twenty-three of 25 patients with subtotal small bowel obstruction due to peritoneal adhesions improved following the ingestion of either iohexol or sodium diatrizoate. Hyperosmolar contrast media might stimulate peristalsis and dilute the bowel contents, hence, easing the passage through a subtotally obstructed bowel. In rats, a direct relationship was found between contrast medium osmolality and the degree of intestinal distension, fluid influx to the bowel lumen and the speed of contrast medium progression. The water-soluble, low-osmolar contrast media seem promising as diagnostic aids in examination of the gastrointestinal tract: The low-osmolar contrast media gave better intestinal details on films than both barium sulphate and sodium diatrizoate in rats with intestinal obstruction or ischemia when high volumes of radiopaques were employed. Also in patients iohexol retained its radiographic density in the small bowel better than sodium diatrizoate. The diagnostic efficacy of the water-soluble radiographic media varied directly with their osmolality and the resulting fluid influx to bowel lumen. Hyperosmolality stimulated contrast medium progression and bowel distension, and reduced the radiographic density of the contrast media and the alignment to the bowel wall. Water-soluble contrast media may aid the diagnosis of bowel ischemia and the evaluation of the degree of ischemic injury: No bladder opacification, following absorption of water-soluble contrast media from the simply obstructed bowel, was observed in the majority of the animals and was only faintly present in 8%. Distinct radiographic opacification of the urinary bladder in rats with intestinal ischemia was demonstrated as early as 1-2 hours after the administration of contrast medium.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

PubMedDate not supplied

Urinary excretion of iohexol after intestinal administration in rats with bowel ischaemia. The effects of mesenteric arterial and/or venous occlusion.

Serum and urinary levels of iohexol (Omnipaque) were evaluated in 28 rats after instillation of 1.5 ml of contrast medium directly into closed small bowel segments of equal length. Ten rats had a ligature applied to the anterior mesenteric artery and vein via laparotomy, 10 animals had a ligature of the vein only and 8 had no vascular occlusion (operated controls). In addition, 3 rats (non-operated controls, normals) were gavaged with a similar volume of the same contrast medium. Radiographs were obtained every hour. Biopsy samples and blood and urine tests were taken at the end of the 4-hour observation period. On radiographs, a marked increase of urinary bladder opacity was observed after 2 to 4 hours in the rats with both vessels tied. Correspondingly high iodine levels were measured in the urine and serum at 4 hours by x-ray fluorescence analysis. Urinary levels were 27 times and serum levels 8 times that of operated controls, respectively, and 81 and 25 times that of normals. Venous occlusion affected the bladder opacity to a lesser extent, giving urinary iodine levels 12 times and serum levels twice that of normal controls. Neither urinary nor serum iodine levels were significantly different from the operated controls. The operated controls had urinary concentrations of contrast medium 3 times that of the gavaged normal controls, but a barely visible urinary bladder on radiographs. Measuring iodine levels in serum or urine may be helpful in the evaluation of the degree of mucosal injury induced by intestinal ischaemia.

Animals↗

PubMedDate not supplied

Acute lethality after enteral administration of contrast media in anaesthetized rats with intestinal ischaemia.

The acute lethality was evaluated during enteric follow-through in anaesthetized rats with a ligature applied to the anterior mesenteric artery and vein. In 121 animals 3 ml of either sodium diatrizoate, iohexol or barium sulphate was administered via orogastric tube. Alternatively, they had the oro-gastric tube inserted but no test substance instilled (controls). A total of 103 rats was observed until spontaneous death while 18 were sacrificed after 8 hours of observation. The survival time in the sodium diatrizoate group was significantly shorter than for the other three groups (p less than 0.006). The 50% survival time was 5 h 42 min (range 2 h 48 min to 12 h 45 min) for sodium diatrizoate as compared with 8 h 4 min to 8 h 26 min for the other three groups; iohexol 8 h 4 min (range 2 h 4 min to 14 h 43 min), barium 8 h 13 min (range 4 h 55 min to 16 h 26 min) and no instilled substance 8 h 26 min (range 3 h 38 min to 16 h 10 min) with no significant differences between these 3 groups. The use of hyperosmolar contrast media in enteric follow-through significantly shortens the survival of rats with acute intestinal ischaemia. A more rapid spread of intestinal bacteria through the distended bowel wall and the ensuing septicaemia, accompanied by enhanced dehydration, are probably the mechanisms responsible for the earlier deaths.

Anesthesia↗

PubMedDate not supplied

Water-soluble contrast media in radiography of small bowel obstruction. Comparison of ionic and non-ionic contrast media.

Fifty patients with possible gastrointestinal obstruction, referred for enteric follow-through examination, were randomized for a double-blind, parallel comparison of the hyperosmolar contrast medium Gastrografin and the low-osmolar Omnipaque. The result was that Omnipaque retained its radiographic density in the small bowel better than Gastrografin. Omnipaque was thus a better alternative than Gastrografin in follow-through examinations of intestinal obstruction. Also, 23 patients out of 28 with small bowel obstruction due to peritoneal adhesions, had spontaneous relief of symptoms during the observation period following contrast medium ingestion with no significant difference between the two media. This indicated that enteric follow-through procedures may have a therapeutic efficacy similar to the treatment of small bowel obstruction using nasogastric suction and gastrointestinal rest. Possible mechanisms for this action of the contrast media are discussed.

Aged↗

PubMedDate not supplied

Water-soluble contrast media compared with barium in enteric follow-through. Local effects and radiographic efficacy in rats with simple obstruction of the small bowel.

The local effects and radiographic efficacy of 4 water-soluble contrast media, barium and saline were evaluated in 86 anaesthetized rats with the distal ileum ligated. The rats were observed for 8 hours after instillation of 3 ml of the test substance via orogastric tube. Radiographs were taken after 1, 4 and 8 hours of observation. After 8 hours the intestines were weighed and biopsied for light microscopy, and blood and urine were sampled for testing. Sodium diatrizoate caused increased fluid influx to the bowel lumen and, like barium, provided poorer radiographic images as compared with iohexol, ioxaglate or iodixanol. Barium showed slower progression through the small bowel than the other agents, while sodium diatrizoate was the most rapidly progressing contrast medium and caused the greatest distension. Correlation to osmolality was obvious. No significant morphologic effects on the small bowel mucosa were seen in any of the groups. Low-osmolar, water-soluble contrast media may have prospects for clinical use in patients with suspected small bowel obstruction.

Animals↗