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Biomedical subjects

D J Nolan

Publications and source records attributed to D J Nolan.

12 recordsLinked to original sources
PubMed1992

Dose reduction of hyoscine-N-butylbromide for double-contrast barium meal examinations--a prospective randomized study.

A search of the literature suggests that the conventional 20 mg dose of intravenous hyoscine-N-butylbromide (HBB) for smooth muscle relaxation in double-contrast barium meal (DCBM) studies is largely empirical. This study analysed the merits of three different doses (5 mg, 10 mg, 20 mg) in the performance of routine DCBMs. One hundred and twenty DCBM examinations were prospectively and randomly allocated to receive one of three doses. Three parameters were measured for each examination: gastroduodenal distension, delay in gastric emptying and gastric antrum overlapping with barium-filled duodenal loops. Almost half the examinations using 5 mg produced undesirable duodenal-gastric overlay. Unacceptable early flooding of the duodenal bulb with barium was seen mostly with doses of 5 mg and 10 mg. Overall, the best results were obtained with 20 mg. The continued use of 20 mg HBB in routine DCBMs is recommended.

Butylscopolammonium Bromide↗
PubMed1991

Small bowel gas in severe ulcerative colitis.

The prognostic significance of excess small bowel gas on a plain abdominal radiograph has been assessed in 75 patients with severe attacks of ulcerative colitis requiring intravenous hydrocortisone. The radiographs were reviewed without knowledge of the subsequent outcome. Small bowel distension was defined as the presence of three or more loops of gas filled small bowel. Forty two patients responded to medical treatment and 33 underwent colectomy. The two groups were comparable for age, sex, and length of history. The surgical group had more extensive disease. Of those who did well on medical therapy, 18 (42.9%) had small bowel distension compared with 24 of 33 (72.7%) who failed medical therapy. The difference was significant (p less than 0.05, odds ratio = 3.55, 95% confidence interval of 2.27-5.87). Of the 24 patients with small bowel distension who came to surgery, five had more than four loops of gas filled small bowel. This degree of distension was not seen in any of the patients settling on medical therapy. Thus the presence of small bowel distension on a plain abdominal radiograph in a patient with severe ulcerative colitis may predict a poor response to medical therapy.

Adolescent↗
PubMed1979

Symptomless diverticular disease and intake of dietary fibre.

A study is reported in which the prevalence of symptomless diverticular disease of the colon is related to the consumption of dietary fibre in vegetarians and non-vegetarians. Vegetarians had a significantly higher mean fibre intake (41.5 g/day) than non-vegetarians (21.4 g/day). Diverticular disease was commoner in non-vegetarians (33%) than in vegetarians (12%). Comparison of subjects with and without diverticular disease in the vegetarian and non-vegetarian groups provided some further evidence that a low intake of cereal fibre is associated with the presence of diverticular disease.

Aged↗
PubMed1979

Small bowel strictures after blunt abdominal trauma.

Two patients with strictures of the small intestine after blunt abdominal trauma are reported. In the first there were multiple severe injuries and the ileal stricture due to a mesenteric tear was not diagnosed until 6 weeks later. In the second an apparently minor injury was responsible for direct damage to the wall of the jejunum and a subsequent stricture.

Adult↗
PubMed1979

Rapid duodenal and jejunal intubation.

A size 12 French radiopaque catheter, 135 cm long, suitable for rapid duodenal and jejunal intubation, is described. Its size and flexibility enable it to be passed with ease through the nose, stomach and duodenum. A guide wire is used to act as a stiffener as the catheter is passed through the stomach. The catheter is suitable for infusing barium directly into the small intestine and for performing hypotonic duodenography. The technique for duodenal and jejunal intubation is discussed.

Barium Sulfate↗
PubMed1979

Combined fine needle percutaneous transhepatic cholangiography and hypotonic duodenography in obstructive jaundice.

The information obtained at percutaneous transhepatic cholangiography in patients with obstructive jaundice is not always conclusive about the nature of the obstructing lesion. Hypotonic duodenography performed immediately after transhepatic cholangiography may assist in such cases by demonstrating the presence or absence of duodenal involvement. This ensures that the appropriate surgical procedure can be planned before operation. Our experience using the combined techniques in nine patients is reported.

Aged↗
PubMed1978

Small bowel melaena: 2 cases diagnosed by angiography.

Two cases of small bowel tumour presenting with melaena are reported. Selective visceral arteriography was found to be invaluable in the management of these cases. The first case presented with intermittent bleeding causing anaemia. Conventional barium studies of the small and large bowel revealed no abnormality. Superior mesenteric angiography revealed a mass lesion in the jejunum, with features characteristic of a leiomyoma. The second case presented with massive gastrointestinal bleeding. Selective visceral angiography was performed initially and revealed a large, mainly avascular, mass lesion in the ileum. Pathological examination showed a leiomyoma which had undergone cystic degeneration. The value of selective angiography in patients with suspected small bowel bleeding is discussed..

Adult↗
PubMed1975

Chondroblastoma of bone.

Chondroblastoma is a rare benign neoplasm of cartilaginous origin. It appears as a round or oval translucent area with a thin sclerotic rim situated most often in the epiphysis of a long bone, and occurs mainly in the 12-20 age group. It has an excellent prognosis and the radiological features should suggest the correct diagnosis. Ten cases have been reviewed in this paper. The clinical, pathological as well as the radiological features and the differential diagnosis of this entity are discussed. It is hoped that this will help in its earlier diagnosis.

Adolescent↗
PubMed1975

Gall-bladder emptying measured by a radioisotopic method.

A method of oral radioisotope cholecystography is described using 131I sodium ipodate. Gall-bladder emptying was measured by this method and radiographically: (a) in a model, (b) in 34 patients having oral cholecystography. There was a good correlation between the two methods of measuring volume changes, both in vitro and in vivo. The isotope cholecystogram has the advantage of a lower radiation hazard, and is the only satisfactory method of studying the onset, rate and duration of gall-bladder emptying. These may be easily measurable markers of disorders of the upper small bowel.

Cholecystography↗