Search PubMed⌕ Search

Biomedical subjects

E T Stewart

Publications and source records attributed to E T Stewart.

At least 73 records · Page 4Linked to original sources
PubMed1981

Computed tomography of the normal and abnormal pancreatic duct: correlation with pancreatic ductography.

Eighty-seven patients underwent both pancreatic computed tomography (CT) and pancreatic ductography. Measurements of pancreatic ducts identified by CT correlated well with measurements from pancreatic ductograms. The anatomic relationships of the pancreatic duct to the margins of the pancreas, and the pancreatic and common bile ducts at their junction were clarified. In 86% of both normal and abnormal ducts at least a part of the duct was identified when optimal CT technique was used. Pancreatic CT is particularly helpful in identifying abnormalities proximal to duct obstruction. CT identification of an abnormal pancreatic duct is a sensitive indicator of pancreatic disease.

Humans↗
PubMed1980

Rectal balloon catheters and the barium enema examination.

Inflation of a rectal balloon during the barium enema examination has the potential for obscuring rectal lesions or causing rectal injury. The purpose of this communication is to emphasize a rationale for the radiologist that minimizes the use of rectal balloons and reduces the risk of rectal injury when inflation of a rectal balloon is necessary.

Barium Sulfate↗
PubMed1980

Computed tomography, ultrasonography, and endoscopic retrograde cholangiopancreatography in the diagnosis of pancreatic disease: a comparative study.

A prospective study was performed comparing the sensitivity of computed tomography, ultrasonography, and endoscopic retrograde cholangiopancreatography (ERCP) in the diagnosis of pancreatic disease. Forty patients with suspected pancreatic carcinoma, acute recurrent or chronic pancreatitis, and/or jaundice were studied. CT was the most sensitive study in evaluation of pancreatitis. ERCP was most accurate in evaluation of pancreatic malignancy. Ultrasonography was the least sensitive method in detecting pancreatic disease and dilatation of the extrahepatic biliary ducts.

Endoscopy↗
PubMed1980

The value of digital rectal examination before barium enema.

The authors recommend that the radiologist perform a digital examination of the rectum before barium enema. Rectal examination may disclose unsuspected lesions, facilitate tube insertion, indicate inadequate preparation of the colon, and aid in the decision of whether a rectal balloon is to be used.

Barium Sulfate↗
PubMed1980

Intraluminal pressure recording from the human sphincter of Oddi.

In this study we recorded intraluminal pressure from the human sphincter of Oddi during ERCP examination and determined the effect of enteric hormones on sphincter of Oddi motor function. Studies were obtained in 26 patients who had no demonstrable evidence of pancreaticobiliary disease. After cannulation of the common bile duct (CBD) or pancreatic duct (PD), pressure measurements were made across the sphincter of Oddi (SO) during 1-2 mm incremental withdrawals of the catheter pausing 1 min or longer at each station. The findings showed an SO segment, 4-6 mm in length, that had basal, steady-state pressure about 4 mm Hg higher than CBD or PD pressure. Pronounced phasic contractions were superimposed on the basal SO pressure. These phasic contractions measured 101 +/- 50 SE mm Hg in amplitude and 4.3 +/- 1.5 sec in duration. They had a frequency of 4.1 +/- 0.9/min. Corresponding phasic contractions were not observed in the CBD, PD, or duodenum. Intravenous pulse doses of cholecystokinin octapeptide and glucagon depressed SO motor activity, whereas pentagastrin increased SO pressure. Secretin caused a mixed response of excitation followed by inhibition. We conclude that the human sphincter of Oddi demonstrates unique phasic contractions that are altered by enteric hormones given intravenously. These phasic SO contractions may have an important role in regulating biliary and pancreatic duct employing.

Adult↗
PubMed1979

Biliary and pancreatic duct pressures measured by ERCP manometry in patients with suspected papillary stenosis.

Papillary stenosis is an imprecisely defined clinical syndrome which eludes definitive diagnosis. In this study we evaluated 26 patients with suspected papillary stenosis by manometric examination of the sphincter of Oddi done during ERCP examination. Basal pressure in the sphincter of Oddi was elevated in 14 of the patients. Of these 14 patients, 10 underwent sphincterotomy and all experienced improvement in clinical symptoms after their surgery. We suggest that ERCP manometry is a useful procedure for identifying patients with papillary stenosis who may benefit from sphincterotomy.

Ampulla of Vater↗
PubMed1979

Desirability of roentgen esophageal examination immediately after pneumatic dilatation for achalasia.

Although infrequent, esophageal rupture is a serious complication of pneumatic dilatation for the treatment of achalasia. Because of an experience with delayed recognition of esophageal perforation in a patient with achalasia, we now examine the esophagus using a water-soluble contrast medium immediately following every pneumatic dilatation. This technique allows immediate detection of esophageal perforation.

Adult↗
PubMed1979

Predictability of rectal incontinence on barium enema examination.

The aim of this study was to determine if digital assessment of anal sphincter tone predicts whether a rectal balloon is needed to prevent incontinence during a barium enema examination. During an 8 month , 306 patients scheduled for barium enema examination were evaluated. Immediately before each examination as good, fair, or poor. The barium enema was then performed in a conventional manner. Leakage of even small amounts of barium was scored as rectal incontinence. Ability to retain the barium enema correlated closely with the strength of rectal bone, regardless of patient sex or age. For different sphincter tones the incidence of rectal incontinence was: good, 2%, fair, 30%; and poor, 90%. From these findings it is recommended that, irrespective of patient age and sex, the use of rectal balloon catheters be limited to patients with poor or fair rectal tone.

Adult↗
PubMed1978

Responses of feline esophagus to cervical vagal stimulation.

We used an in vivo feline model to study striated and smooth-muscle esophageal responses to cervical vagal stimulation (VS). Circular esophageal contractions were measured by intraluminal pressure sensors and longitudinal contractions by a force transducer. Responses to VS were recorded before and after giving succinylcholine, atropine, or both. Circular contractions characteristic of striated and smooth muscle were recorded from the mid- and distal esophagus, respectively. With increases in VS frequency, the striated muscle showed rapid, repetitive twitches progressing to tetany. These fast contractions had a square-wave configuration at VS greater than or equal to 10 Hz and were abolished by succinylcholine. In contrast, the slow-twitch circular responses of smooth muscle showed no repetitive twitches and had a bell-shaped configuration. Two types of circular smooth-muscle contractions were observed: 1) A wave "on contractions" occurred 0.5-1.0 s after VS onset, regardless of stimulus length, and 2) infrequent B wave "off contractions" occurred only after stimulus cessation. The longitudinal esophageal contractions had a compound wave form with both striated and smooth-muscle components. Atropine abolished the slow component of the longitudinal contraction, the circular A wave, and peristalsis in the distal esophagus. We conclude that cholinergic motor neurons are an important pathway for eliciting peristalsis in feline esophageal smooth muscle.

Animals↗
PubMed1977

A comparison of colonoscopy and roentgenography for detecting polypoid lesions of the colon.

This study compares the effectiveness of the roentgen and colonoscopic examination of the colon for detecting polypoid lesions. We evaluated the findings in 64 patients with suspected or known polypoid lesions who received the same colon cleansing regimen for both examinations, and were studied by examiners of similar expertise. As in other studies, the endoscopist had the advantage of knowing the roentgen findings, and the colonoscopic findings were often taken to indicate whether or not a lesion was present. In about half the patients, however, a second roentgen examination, repeat colonoscopy, or surgical specimen provided additional information for scoring. For example, a filling defect of the same size and location on two roentgen examinations, but not demonstrated at colonoscopy was scored as a false negative colonoscopic finding. The study results indicate that 54% of small polyps less than or equal to 0.9 cm in size were missed on roentgen examination, whereas no proven misses for lesions of this size were shown for colonoscopy. This absence of colonoscopic false-negative findings for small polyps, however, may be partially explained by a relative insensitivity of the roentgen method. For larger lesions greater than or equal to 1.0 cm in size the miss-rate for the two examinations was similar: 15% for roentgen examination and 12% for colonoscopy. We conclude: (1) Colonoscopy is a more sensitive method than roentgen examination for detecting small polyps of the colon, and (2) Performance of the two examinations may be comparable for demonstrating lesions 1.0 cm or larger in size.

Colonic Neoplasms↗
PubMed1977

Endoscopic electrosurgical papillotomy and manometry in biliary tract disease.

Endoscopic papillotomy was performed in 13 patients after cholecystectomy for retained or recurrent common bile duct calculi (11 patients) and a clinical picture suggesting papillary stenosis (two patients). Following endoscopic papillotomy, ten of the 11 patients spontaneously passed common bile duct (CBD) stones verified on repeated endoscopic retrograde cholangiopancreatography (ERCP) study. One patient failed to pass a large CBD calculus; one patient experienced cholangitis three months after in inadequate papillotomy and required operative intervention. Endoscopic papillotomy substantially decreased the pressure gradient existing between the CBD and the duodenum in all five patients studied with ERCP manometry. Endoscopic papillotomy is a relatively safe and effective procedure for postcholecystectomy patients with retained or recurrent CBD stones. The majority of CBD stones will pass spontaneously if the papillotomy is adequate.

Ampulla of Vater↗
PubMed1977

Colonic polyp detection: role of roentgenography and colonoscopy.

In order to determine the relative yields of colonoscopic and radiologic examinations of the colon, the following guidelines are suggested: (a) prospective data collection; (b) a standard, effective colon cleansing regimen; (c) colonoscopic and radiologic examiners of comparable expertise; (d) examiners should be unaware of each other's findings; (e) a suitable method for demonstrating false-negative findings and for resolving conflicting findings between the two examinations; and (f) indexing of the study findings as to lesion size, lesion location, quality of colon cleansing, and examiner's level of confidence. The two examinations should be used as complementary diagnostic procedures.

Colon↗
PubMed1977

An evaluation of colon cleansing regimens.

To study the efficacy of colon cleansing regimens, 500 hospital outpatients were randomly assigned to one of four regimens. Two featured castor oil followed by phosphate enema and two used magnesium citrate and bisacodyl. For the 349 patients who completed all components of the regimens, quality of the subsequent barium enema examination was scored by three radiologists in a blind manner. Regimens featuring magnesium citrate and bisacodyl were found to be significantly superior to those featuring castor oil. Calcium bisdiocytl sulfosuccinate did not improve the quality of colon cleansing but appeared to decrease the incidence of abdominal cramping in patients receiving magnesium citrate and bisacodyl. It is hoped that the investigative approach used in this study may serve as a model for future testing of colon cleansing regimens.

Adolescent↗