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Biomedical subjects

D J Ott

Publications and source records attributed to D J Ott.

At least 127 records · Page 7Linked to original sources

Multiphasic examinations of the stomach: efficacy of individual techniques and combinations of techniques in detecting 153 lesions.

Multiphasic examinations of 153 gastric abnormalities observed radiologically and endoscopically were reviewed to determine the efficacy of four radiologic techniques and of several common combinations of these techniques for examining the stomach. There were 68 gastric ulcers, 12 ulcer scars, 44 cases of gastritis including 27 with erosions, 24 benign neoplasms, and five malignancies. Double-contrast, compression, mucosal relief, and full-column techniques detected 82%, 65%, 62%, and 51%, respectively, of all lesions diagnosed with the complete multiphasic examinations. Results indicate that the greater the number of techniques employed, the more accurate the examination, with biphasic and multiphasic examinations detecting 9%-18% more lesions overall than simple single- or double-contrast studies.

Adolescent↗

Recurrent colorectal carcinoma: evaluation with barium enema examination and CT.

The efficacy of the barium enema examination and abdominal computed tomography (CT) was investigated in 81 patients who had undergone operation for colorectal carcinoma. Recurrent disease was found in 52 patients and was divided into local (anastomotic and perianastomotic) and remote (distant and hepatic metastases) types. In 32 patients with locally recurrent carcinoma, the sensitivity of the barium enema examination was 88%; for CT it was 69%. Conversely, the barium enema examination was not useful for detecting remote metastases shown on CT, which disclosed disease at one or more sites in 47 (90%) of the 52 patients. CT best evaluated recurrences remote from the anastomosis, pelvic recurrences in patients with colostomies, and hepatic metastases. Barium enema examination and CT were therefore found to be complementary modalities.

Adolescent↗

Detection of colonic polyps on single-contrast barium enema study: emphasis on the elderly.

A systems approach was employed to improve results of the single-contrast barium enema examination for detection of colonic polyps. Improvements were made in each of the following areas: radiographic-fluoroscopic equipment, fluoroscopic-television images, screen-film combinations, barium suspensions, examination techniques, imaging sequences, and quality controls. Radiologic-endoscopic correlation was undertaken for 137 colonic polyps seen endoscopically in 91 patients. The average age of the patients was 69 years. The sensitivity of the single-contrast examination for detection of all polyps was 80%. Polyps 5-9 mm in size were detected with 66% sensitivity, while 94% of polyps 10 mm or larger were detected. The results indicate that the sensitivity of a suitably performed single-contrast barium enema examination may approach that of the double-contrast study for the detection of colonic polyps, even in an elderly and infirm patient population.

Adult↗

Decreasing numbers of gastrointestinal studies: report of data from 69 radiologic practices.

A survey of the members of the Society of Gastrointestinal Radiologists was conducted to document changes in the numbers of gastrointestinal fluoroscopic procedures performed in the United States from 1975 through 1986. Data from 69 radiologic practices indicated that the numbers declined substantially. Decreases in the numbers of upper gastrointestinal examinations, small bowel studies, and barium enemas was 24%, 17%, and 29%, respectively. The number of oral cholecystograms declined 93%. Respondents listed the advent of new techniques (sonography, CT, and MR imaging) and competition from endoscopy as the two major factors that they thought contributed to these decreases. They thought that competition from endoscopy would be the factor most likely to affect the numbers of gastrointestinal fluoroscopic procedures in the near future.

Gastrointestinal Diseases↗

Esophageal radiography and manometry: correlation in 172 patients with dysphagia.

Radiographic and manometric examinations of the esophagus were correlated in 172 patients with dysphagia. Esophageal manometry was abnormal in 66 (38%), with diagnoses of nonspecific esophageal motor disorder (26), achalasia (19), nutcracker esophagus (12), diffuse esophageal spasm (seven), and scleroderma (two). Compared with manometry, radiographic sensitivities were 95% (18 of 19) for achalasia, 71% (five of seven) for diffuse esophageal spasm, and 46% (12 of 26) for nonspecific esophageal motor disorder. Nutcracker esophagus was not diagnosed specifically on the radiographic examination. Overall radiographic sensitivity was 56% (37 of 66) but increased to 89% by excluding nutcracker esophagus and nonspecific esophageal motor disorders. In 106 manometrically normal patients, radiographic specificity was 91% with 10 false-positive diagnoses of nonspecific motor disorder. We conclude that radiographic examination of the esophagus is useful in patients with dysphagia for evaluating functional esophageal abnormalities, although detection rates vary widely with the type of motor disorder.

Deglutition Disorders↗

Optimizing single- and double-contrast colon examinations.

Recent technical advances have greatly increased the effectiveness of barium enema examinations for detection of common diseases of the colon. As documented in the literature, the double-contrast enema may equal or exceed colonoscopy in detection of colonic neoplasms and, with proper technique, the single-contrast enema may also closely approach these results. This presentation reviews recent technical improvements in the areas of radiographic-fluoroscopic equipment, fluoroscopic images, film-screen combinations, barium suspensions, examination techniques, filming sequences, and quality controls. These are employed to optimize both the double- and single-contrast barium enemas to where their sensitivities are competitive with endoscopy.

Air↗

Pneumatic dilatation of the achalasic esophagus requiring the aid of an endoscope.

We describe a 65-yr-old man with achalasia, who had two previous Heller myotomies. He had a markedly dilated, tortuous esophagus, which defeated initial attempts at pneumatic dilatation. A method was improvised in which a Brown-McHardy dilator was attached by a string to a small caliber endoscope and both were successfully passed into the stomach. Pneumatic dilatation was then easily performed. Review of the literature and our experience with four patients suggests that pneumatic dilatation can be performed without substantial risk in patients after a failed Heller myotomy.

Aged↗

Radiological evaluation of dysphagia.

Radiological examination evaluates both structural and functional abnormalities of the esophagus in patients with dysphagia. Combined with the clinical history, the radiological results can guide the clinician to a specific diagnosis, such as carcinoma or stricture, or to additional studies, such as endoscopy or esophageal manometry. Based on cost and diagnostic efficacy, the radiological method, compared with endoscopy, is most useful as the initial screening examination in patients with dysphagia (Table 2). Its major limitations are poor detection of mild cases of esophagitis and occasional lack of specificity in diagnosing esophageal motor dysfunction. To achieve these results, however, effective radiological evaluation of the esophagus requires the meticulous use of a combination of examining techniques.

Contrast Media↗