Abdominal wall endometrioma.
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Biomedical subjects
Publications and source records attributed to G L Melson.
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Fifty patients with a total of 56 renal masses discovered on routine excretory urography or abdominal plain films and with ultrasonographic diagnoses of definite or probable benign cysts underwent computed tomography (CT) prior to cyst aspiration with cytologic study. All lesions met strict criteria for the CT diagnosis of benign cyst and subsequently proved to be benign cysts. In addition, CT scanning detected 11 other renal masses, only one of which could be retrospectively diagnosed on the original urogram. It is suggested that renal cyst aspiration need not be performed when lesions meet all CT criteria for a benign cyst.
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Computed tomography (CT) easily and accurately demonstrates both the normal and abnormal adrenal gland. The normal adrenal gland can be seen in almost 95% of patients. With this technique, 29 of 29 proved adrenal masses were demonstrated; one case of bilateral adrenal hyperplasia could not be recognized, another showed equivocal enlargement. CT is an excellent screening and often definitive radiologic test of evaluating the adrenal gland.
Selective intraarterial infusion of vasopressin was performed in 32 patients for 35 episodes of gastrointestinal bleeding. Active bleeding was from esophageal varices in 11 cases and from an arterial site in 22 (stomach 11, duodenum 1, jejunum 2, colon 7, liver 1), including a jejunal diverticulum and a colonic ulcer in Behcet's disease. Two patients, not actively bleeding, were infused for portal decompression before an elective mesocaval shunt. Active bleeding was controlled in 64% of patients with variceal hemorrhage and in 59% of those with arterial sources. Infusion periods ranged from 15 minutes to 70 hours. There were no significant complications directly attributable to this therapy.
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Plain-film abdominal changes in 5 patients with severe antibiotic-related pseudomembranous colitis were found to be strikingly similar and distinct from those seen in other colitides. These consisted of moderate gaseous distension of the colon and unusual wide transverse bands of thickened bowel wall associated with giant "thumbprinting" which was universal in distribution, with minimal or absent small-bowel abnormalities. While the radiographic findings were not pathognomonic, they were highly suggestive of advanced pseudomembranous colitis when combined with the clinical data. Prompt recognition of this entity by the radiologist is extremely helpful in management, since such patients frequently present with physical findings of an acute abdomen requiring surgery.
A patient with tuberous sclerosis and angiomyolipoma of both kidneys is described in whom both tumors demonstrated associated calcification. This finding has not been previously stressed in the literature and is important in that ignorance of its occurence in this tumor might result in an error of diagnosis and nephrectomy in a patient who can ill-afford the loss of renal parenchyma.
The radiographic, colonoscopic, and pathologic findings in this case of Behcet's colitis differ completely from ulcerative or granulomatous colitis as well as from other, less commonly seen inflammatory colitides. Discrete, peptic-type ulcers, with normal intervening mucosa and normal overall configuration of the colon, are seen on radiography and endoscopy. The angiographic features are not diagnostic but differ considerably from findings in other inflammatory colitides. No tortuous arterioles, mucosal hyperemia or early venous filling was encountered.
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Three patients with cavernous hemangiomas of the kidney all presented with hematuria. In each there was found a poorly defined renal medullary mass with displacement of the calyces and renal vessels and paradoxical hypovascularity of the mass. This rare, benign tumor of the kidney should be considered in the presence of this characteristic clinical picture.
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