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Biomedical subjects

H Herlinger

Publications and source records attributed to H Herlinger.

At least 91 records · Page 5Linked to original sources
PubMed1981

Double-contrast enema examination for detection of rectal carcinoma.

The role of the double-contrast enema examination (DCE) in the detection of rectal carcinoma was evaluated and compared to the proctoscopic examination. Records of 90 consecutive patients with a diagnosis of rectal carcinoma were reviewed. Sixty-six patients had a preoperative DCE. The correct diagnosis was either made or suggested in 91% of these patients. The proctoscopic examination was diagnostic in 86%. The causes of radiologic and proctoscopic error were evaluated. Findings confirm that the DCE is an accurate method for the diagnosis of rectal carcinoma. Careful examination of the rectum should be incorporated in all radiologic studies of the colon since a normal proctoscopic examination does not exclude the possibility of rectal carcinoma.

Barium Sulfate↗
PubMed1980

The gastric cardia in double-contrast study: its dynamic image.

Difficulties in evaluating the gastric cardia are well known and may often be resolved with the double-contrast technique. Special views to show the cardia en face were obtained in 200 double-contrast examinations. Four basic patterns were recognized. Similar appearances could be reproduced by protruding or retracting the lower end of the esophagus during the radiography of intact stomachs obtained at autopsy. Influenced by muscle relaxants, swallowing, or deep breathing, cardia patterns were found to be interchangeable in the same patient and same examination. The disappearance of the protrusion pattern at the cardia in the course of swallowing is an important means of distinguishing normality from a tumor in this area. Any significant deviation from the normal geometry of the cardia as displayed by double contrast indicates an abnormality. Examples of abnormalities are illustrated.

Carcinoma↗
PubMed1979

Bowel wall thickness as a differentiating feature between ulcerative colitis and Crohn's disease of the colon.

The colonic wall thickness was assessed from the plain abdominal radiograph and double contrast barium enema in 33 patients with ulcerative colitis, 28 with Crohn's colitis and 20 with neoplasia. The maximum wall thickness in the control group with neoplasia measured in non-diseased colon, was 2 mm. Accurate measurement was possible from only 34% of the plain films, owing to inadequate gas in the lumen. Measurement was possible in 84% of barium enemas, mainly in the descending colon. The maximum wall thickness associated with ulcerative colitis was 5 mm. In 50% of Crohn's colitis the wall thickness was above 5 mm. Estimation of the wall thickness was a slightly less sensitive index of the presence of colitis than the mucosal changes on double contrast enema. Distinction between the types of colitis was usually possible from the mucosal lesions. Where these could be similar, such as with confluent shallow ulceration, the tendency of Crohn's disease to be associated with a wall thickness in excess of 5 mm was valuable diagnostically.

Barium Sulfate↗
PubMed1978

A modified technique for the double-contrast small bowel enema.

A small bowel enema technique is described which makes it possible to achieve double-contrast images comparable to those routinely obtained in the stomach or colon. It is a biphasic procedure, requiring the transtubal injection of barium sulfate, followed by 0.5% methylcellulose. Adjustment of relative injection quantities and injection speeds can adapt each examination to a patient's individual diagnostic problem. Indications for the examination are discussed.

Barium Sulfate↗
PubMed1978

Angiography in the diagnosis of ileocecal tuberculosis.

Ileocecal tuberculosis is still found sporadically in industrialised countries and occurs commonly in the underdeveloped world. Differentiation from Crohn's disease is a major diagnostic problem on which rational treatment depends. An angiographic appearance demonstrated in two patients is believed to be a useful diagnostic indicator of tuberculous etiology.

Angiography↗
PubMed1978

Angiography of colonic Crohn's disease: the zoning sign revisited.

The zoning sign can be demonstrated in 50% of angiographies in colonic Crohn's disease and provides a reliable differential diagnostic aid against ulcerative colitis. The composition of the sign has been enlarged by the recognition of a zone C. The application of angiography in the radiologic diagnosis of inflammatory disease of the colon is discussed.

Angiography↗
PubMed1978

Arterioportography.

Arterioportography has superseded splenoportography which has given inadequate and at times misleading information. Eighty-two arterioportograms have been done in 78 patients with portal hypertension. The arterial phase may disclose malignancy, pancreatitis, diminished liver perfusion and the venous phase flow reduction, occlusion and the presence of thrombus. Arterioportography should provide evidence of suitability for specific shunts and features relevant to the performance of of a mesocaval or distal spleno-renal shunt are given in detail. An attempt is made to relate arterioportography and transhepatic portal catherisation into a combined function in the management of patients with portal hypertension.

Angiography↗
PubMed1978

Evaluation and follow-up of pancreatic arteriograms. A new role for angiography in the diagnosis of carcinoma of the pancreas.

Of over 300 pancreatic arteriograms done in this hospital group adequate follow-up was possible in only 103 patients, with carcinoma in 35 of them. Based on the prospective report there were three false negatives and seven false positive carcinoma diagnoses, an overall accuracy rate of 90.3%. A retrospective review could eliminate all but one false negative and one false positive diagnosis. Angiographic findings are reviewed separately for periampullary and truely pancreatic carcinoma. Subselective catheterisation and adequate opacification of the arterial network of the pancreas allows the reliable demonstration or exclusion of even 1--2 cm carcinomas, provided the clinical presentation of the patient has not been that of jaundice or pancreatitis. Taking into account the availability of newer non-invasive imaging techniques, clinical situations are listed in which the angiographic diagnosis of carcinoma is no longer required. The new purpose of angiography in pancreas carcinoma diagnosis is the demonstration of small and still curable lesions, the prerequisite for this being a much earlier clinical suspicion of the disease and an earlier referral for angiography.

Angiography↗
PubMed1978

Hepatofugal portal blood flow in hepatic cirrhosis.

A variety of indirect techniques has been claimed to provide evidence of spontaneous reversal of portal blood flow in hepatic cirrhosis but the existence of the phenomenon has been doubted by some who do not accept the validity of the indirect evidence. There are few reports of the demonstration of hepatofugal portal flow by selective hepatic arteriography, which is the only acceptable technique. We report three patients with histologically confirmed cirrhosis in whom hepatofugal portal blood flow was unequivocally demonstrated by arteriography, in whom no surgical portosystemic shunt had been performed and in whom there was no evidence of the Budd-Chiari Syndrome or hepatoma, situations accepted as associated with reversed portal blood flow. Theoretical considerations suggest that shunt surgery for bleeding esophageal varices should not be ruled out on the grounds of hepatofugal portal flow. However, end-to-side portacaval anastomosis and distal splenorenal shunt might predispose to the early redevelopment of esophageal varices when reversed portal flow is present. Side-to-side portacaval and conventional splenorenal shunts might be preferable in having less effect on hepatic parenchyma perfusion than when orthograde portal flow in the case.

Adult↗
PubMed1977

The intrapancreatic anatomy as an index of adequacy of pancreatic arteriography.

Analysis of 100 pancreatic arteriograms in respect of intrapancreatic arteries shown has been performed. The results have been compared with Michels' classic series of 200 cadaveric dissections. Excellent correlation has been found. The degree of demonstration of small intrapancreatic arteries in our view is an index of the adequancy of pancreatic arteriography.

Angiography↗
PubMed1977

An evaluation of the double contrast barium meal (DCBM) against endoscopy.

The diagnostic accuracy of the DCBM and of endoscopy were compared in 50 consecutive patients. Examinations were conducted in comparable circumstances, without any cross information. A percentage score method was evolved to allow a numerically more significant assessment. The potential accuracy of the DCBM was calculated to be 96% of that accorded to fibre-endoscopy.

Barium Sulfate↗
PubMed1975

Urinary tract dilatation in pregnancy.

Two radiologists individually studied 220 intravenous urograms done during pregnancy in patients with apparently normal urinary tracts, and an observer-agreement technique was used to obtain the results. The few cases seen in early pregnancy show that dilatation of the urinary tract is uncommon, or at least mild, before mid term. Shortly thereafter, however, dilatation appears abruptly and remains virtually unchanged both in incidence and degree until full term. After mid term, the right side is dilated in about three-quarters of cases and the left side in about one-third. In only 10 % was the left side fuller than the right; in 86%, the right side was the fuller. Severe dilatation is infrequent, especially on the left. The dilatation never extends into the pelvis. The abdominal ureters are displaced outwards in a minority of cases, more often on the left. Little or no association was found between the dilatation and fetal position, maternal gravidity or urinary infection. These statistically derived conclusions should provide a firmer basis for what constitutes the limits of normality in the intravenous urogram during pregnancy.

Dilatation, Pathologic↗
PubMed1974

Simplified cholangiography using ioglycamide.

Intravenous cholangiograms were performed on 100 unselected nonicteric patients using methylglucamine ioglycamide (Biligram). Fifty patients received 10.5 g of contrast medium and 50 received 5.25 g of medium. The contrast medium was injected evenly over five minutes. Side effects were recorded in only 13% of patients and all were mild. Radiographs were taken 10, 30, 60, 90, and 120 minutes after injection and were assessed without the authors being aware of the dose of contrast medium injected.Better statistically significant results were obtained using the higher dose.In patients in whom the gallbladder is present, films taken at 60 minutes and 90 minutes after injection give the maximum available information in 97% of cases. If the gallbladder has not become opacified by 60 minutes, cystic duct obstruction is indicated. In postcholecystectomy patients, films at 30 minutes and 60 minutes after injection give the maximum available information in 95% of cases.

Adult↗