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Biomedical subjects

I Laufer

Publications and source records attributed to I Laufer.

At least 163 records · Page 9Linked to original sources
PubMed1976

The radiological demonstraction of colorectal polyps undetected by endoscopy.

In a consecutive series of 800 routine double contrast studies of the colon, 119 polyps were diagnosed radiologically in 78 patients. Follow-up studies were available in 46 patients with 72 polyps. Ultimately, 56 of these polyps were confirmed (55 by endoscopy and 1 by repeat radiology). Six of these polyps had been missed on the initial endoscopic examination. The missed polyps are usually located in the rectum behind a valve of Houston or in any area of the colon where there is sharp angulation. Radiologists and endoscopists should be aware of these as potential endoscopic blind spots. These cases illustrate the importance of higg quality radiological study of the colon and the complementary nature of radiology and endoscopy in the detection of colorectal polyps.

Adult↗
PubMed1976

Endoscopic retrograde cholangiopancreatography in the management of pancreatic and biliary disease.

Endoscopic retrograde cholangiopancreatography is a new and valuable technique in the diagnosis of jaundice, pancreatic disease and obscure upper abdominal pain. Endoscopic sphincterotomy of the sphincter of Oddi and the extraction of stones from the common bile duct are an extension of this procedure already in use in several high-volume centres. Cannulation of the bile ducts and pancreatic ducts in tests of secretion and cytology will become increasingly common applications of the technique. In order to provide dependability and cost-effectiveness, specialists in this procedure must maintain a high volume, necessarily limiting it to a few practitioners. Use of a trained endoscopic technician, a radiologist trained in endoscopy, or an endoscopist trained in fluoroscopy and spot-filming may decrease the manpower costs of this procedure.

Adult↗
PubMed1976

The radiological differentiation between ulcerative and granulomatous colitis by double contrast radiology.

The purpose of this report is to illustrate the value of the double contrast technic for the detection of early changes of colitis and for the differentiation between ulcerative and granulomatous colitis. Fifty consecutive patients with radiologically-diagnosed nonspecific colitis are included and the radiographs, endoscopic and pathologic reports and photographs were reviewed. On radiological grounds ulcerative colitis were diagnosed in 23 patients and granulomatous colitis in 27 patients. There were no radiologically indeterminate cases. Follow-up information was obtained by colectomy in nine patients, colonoscopy in nine patients and sigmoidoscopy in the remainder. In no case did the endoscopic or pathologic diagnosis conflict with the radiological diagnosis. With the double contrast technic, very fine mucosal detail can be seen including features such as granular mucosa, "aphthoid" ulcers and discontinuous disease which are not demonstrable by the conventional single contrast barium enema. This detailed mapping of the nature and extent of disease facilitates the differential diagnosis between ulcerative and granulomatous colitis.

Colitis, Ulcerative↗
PubMed1975

Biliary-bronchial fistula demonstrated by endoscopic retrograde cholangiography.

Endoscopic retrograde cholangiography is valuable in the evaluation of biliary tract disorders. A 50-year-old Italian woman developed biloptysis 1 year after cholecystectomy because of intrabiliary rupture of a hydatid cyst with secondary infection, which resulted in intrathoracic rupture and communication with the bronchial tree. Endoscopic retrograde cholangiography showed the cause and pathway of the fistulous tract by outlining the biliary tree, abscess cavity and communication with the right upper lobe bronchus. This technique appears to be well suited to the investigation of patients with biliary-bronchial fistula.

Biliary Fistula↗
PubMed1975

The value of the fatty meal in oral cholecystography.

A fatty meal was given to 231 patients who had a well-visualized gallbladder with no stones. The radiological diagnoses on fluoroscopic spot films made before and after the fatty meal were compared. Only one case was diagnosed differently after the fatty meal. In 4 patients the post-fat film was useful in confirming a suspected diagnosis. Indications for administration of a fatty meal include (a) overlying gas shadows, (b) differentiation of a stone from a polyp, (c) adenomyomatosis, (d) a distended gallbladder, and (e) suspected common bile duct obstruction. In the absence of these indications, the time, effort, and cost involved in making the post-fat film are not justified by the additional diagnostic information obtained.

Cholecystography↗
PubMed1975

A simple method for routine double-contrast study of the upper gastrointestinal tract.

A technique for routine double-contrast study of the stomach and duodenum is presented. It requires neither nasogastric intubation nor hypnotic drugs. The authors emphasize the technical factors and maneuvers which result in optimal mucosal coating and unobscured double-contrast views of the stomach and duodenum. The radiological error rate was 7% in 190 patients; a marked improvement over results produced by the standard barium study. In a consecutive series of 1,000 patients superficial gastric erosions were demonstrated in 19 patients. It is recommended that such a technique be applied to the routine radiological study of the upper gastrointestinal tract.

Barium Sulfate↗
PubMed1975

The diagnostic accuracy of barium studies of the stomach and duodenum--correlation with endoscopy.

Radiologic and endoscopic diagnoses were compared in 240 patients. In 175 patients examined by a standard barium contrast technique there were 39 radiological errors (22%). The most common causes of error were failure to detect an abnormality on the radiograph and prominent mucosal folds which could either mask or simulate small lesions. In 65 patients examined by a formal double contrast technique using effervescent pills and a thick barium suspension, there were 4 radiological errors (6%). In addition, superficial gastric erosions were demonstrated in 7 patients. Double contrast radiography appears to offer the potential for significant improvements in diagnostic accuracy.

Barium Sulfate↗
PubMed1975

Demonstration of superficial gastric erosions by double contrast radiography.

Superficial gastric erosions were found in 30 of 267 patients undergoing esophagogastroduodenoscopy. In 13 of these patients, and in 7 others not submitted to endoscopy, superficial gastric erosions were demonstrated radiologically by the double contrast technique. These may appear as flat, linear streaks, as dots of barium, or as target-like lesions with a central fleck of barium surrounded by a radiolucent halo. In 1 patient, a ring-shaped density was demonstrated due to a small blood clot adherent to a gastric erosion. Although patients presenting with acute hemorrhagic gastritis should still be examined first by endoscopy, double contrast radiography has been of value in patients presenting after the cessation of bleeding and in patients with vague digestive complaints. Because of our experience with the diagnosis of standard methods, and because of the Japanese experience with diagnosis of superficial gastric carcinoma, it is recommended that this technique be applied more widely to facilitate the detection of early and small lesions in the stomach.

Barium Sulfate↗
PubMed1975

The radiologic demonstration of early changes in ulcerative colitis by double contrast technique.

The double contrast technique can be applied safely to the investigation of patients with suspected inflammatory bowel disease. The early changes of mucosal hyperemia and edema can be detected when the colon has been adequately cleansed. The extent and distribution of disease can be mapped with precision. This is of considerable importance in the differential diagnosis between ulcerative and granulomatous colitis and in the choice of appropriate treatment. Even in early stages of the disease there is a high correlation between the radiographic abnormalities and the endoscopic findings.

Acute Disease↗
PubMedDate not supplied

Greater curvature antral flattening: a radiologic sign of NSAID-related gastropathy.

We have occasionally encountered patients on nonsteroidal antiinflammatory drugs (NSAIDs) in whom double contrast barium studies revealed persistent flattening and stiffening of the distal greater curvature of the stomach. We therefore performed a study to determine the frequency of this finding in patients with NSAID-related gastropathy. Twenty-one cases of erosive gastritis, gastric ulcers, and/or gastric scarring associated with a known history of NSAID use were reviewed by two radiologists who made a joint decision regarding the presence or absence of greater curvature antral flattening. This finding was seen radiographically in five of the 21 patients (24%). Four of the five patients with antral flattening had associated erosions or ulcers in the gastric antrum. The remaining patient had antral flattening as an isolated finding. Our experience suggests that flattening of the greater curvature of the distal antrum, particularly if associated with erosive gastritis or gastric ulcers, is a useful radiologic sign of NSAID-related gastropathy.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMedDate not supplied

Diverticular fecalith in scleroderma simulating colonic neoplasm: report of a case.

This is a report of a patient with the CRST syndrome, a mild variant of scleroderma consisting of calcinosismraynaud's phenomenon, sclerodactyly, and telangiectasia. Typical changes of scleroderma were present in the extremities, esophagus, duodenum and colon. In addition, there was a polypoid filling defect in a colonic diverticulum due to a fecalith. The radiologic appearance at first resembled a colonic neoplasm, although its location within a diverticulum and its speckled appearance suggested the possibility of a fecalith. This was confirmed at colonoscopy, which disclosed numerous wide-mouthed diverticula, with inspissated fecal material projecting from several diverticula. In patients with scleroderma and polypoid filling defects in the colon, the possibility of a fecalith within a diverticulum should be considered. Where the radiologic study is inconclusive, colonoscopy may provide a definitive diagnosis.

Adult↗
PubMedDate not supplied

Cervical esophageal webs: association with gastroesophageal reflux.

BACKGROUND: We investigated whether there is a significant association between cervical esophageal webs and gastroesophageal reflux on pharyngoesophagography. METHODS: We studied 50 patients with cervical esophageal webs on pharyngoesophagrams and 50 control subjects. The control group was matched to the webs group for age, sex, and symptomatology. Patients with cervical esophageal webs and controls were compared to determine the prevalence of gastroesophageal reflux, hiatal hernias, reflux esophagitis, and abnormal esophageal motility. Pearson's chi-square test was used to determine any statistically significant differences in the frequencies of these findings between groups. RESULTS: Thirty-nine (78%) of 50 patients with cervical esophageal webs versus 27 (54%) of 50 patients in the control group had gastroesophageal reflux (p = 0.01). When patients were classified based on degree of gastroesophageal reflux, 22 (44%) of 50 patients with cervical esophageal webs versus 21 (42%) of 50 controls had mild reflux (p = 0.84), whereas 17 (34%) of 50 patients with webs versus six (12%) of 50 controls (p < 0.009) had moderate/marked reflux. Thus, the prevalence of moderate/marked gastroesophageal reflux was significantly greater in patients with webs than in the controls. However, no significant differences were found in the prevalence of mild gastroesophageal reflux, hiatal hernias, reflux esophagitis, or abnormal esophageal motility. CONCLUSION: We found a significant association between cervical esophageal webs and gastroesophageal reflux independent of age, sex, or symptomatology. Radiologists should be aware of this association, so that patients with cervical esophageal webs on pharyngoesophagography are evaluated for gastroesophageal reflux at the time of the barium study or advised to undergo further testing for gastroesophageal reflux disease.

Case-Control Studies↗