Biomedical subjects

I Suramo

Publications and source records attributed to I Suramo.

150 records · Page 9Linked to original sources

PubMedDate not supplied

Ultrasonic guidance for percutaneous puncture and drainage in acute cholecystitis.

Thirteen patients presenting with acute cholecystitis and considered high surgical risks were treated with a percutaneous needling procedure under ultrasonic guidance. The gallbladder was drained following simple needle puncture in six cases while a drainage catheter was inserted in seven. A premedication of 0.5 mg of atropine and 50 mg of pethidine was given. The gallbladder became decompressed in all cases, and pain was instantly relieved. Impacted stones were freed from the cystic duct in two cases and from the papilla of Vater in another two cases. The patients' condition improved and elective cholecystectomy was performed in four cases, while a further three patients await surgery. In five cases the acute stage of the disease subsided; surgical treatment was refrained from because of gallbladder carcinoma with metastases in one patient and other diseases in the remainder. One patient died of gastric carcinoma. One patient with ischemic heart disease had systemic hypotension for six hours after the drainage and one had slight haemorrhage for four hours. No other complications were noted. In addition, the procedure was also carried out as a diagnostic study in one patient in whom the site of bile leakage was determined by filling the biliary tree with contrast medium from the gallbladder. Guided aspiration and percutaneous drainage of the gallbladder is helpful in patients with severe acute cholecystitis attended with a high surgical risk.

Aged↗

PubMedDate not supplied

Sonography in differential diagnosis of deep venous thrombosis of the leg.

The lower extremities of 60 consecutive symptomatic patients were examined first by ultrasound (US) and then by phlebography. Deep venous thrombosis was found in 17 patients by means of venography. A hematoma was detected by US in six legs without thrombosis. A popliteal cyst was observed by US in five cases; one patient had a concurrent deep venous thrombosis. It was concluded that symptomatic patients with a negative phlebography should be examined by US for correct diagnosis and treatment, although US cannot replace phlebography.

Adult↗

PubMedDate not supplied

Ultrasonography in carcinoma of the gallbladder.

Cholecystosonography in approximately 40,000 patients over five years in two university hospitals revealed 30 (75%) of the 40 macroscopic primary carcinomas. In 3 cases the carcinoma was obscured by gallstones with shadowing, in 3 cases the origin of a tumour mass was misinterpreted, and in 4 cases the neoplastic growth mimicked gallbladder inflammatory changes or sludge. Malignancy was incorrectly diagnosed or suggested in 25 patients. The most frequent cause of a false positive report was acute or chronic inflammation, found at surgery in 16 gallbladders. Four carcinomas of the pancreatic head were believed to be gallbladder tumours. Cirrhosis with marked gallbladder wall thickening, gastric carcinomas with metastases, a common duct carcinoma, and two cases of sludge (with normal control studies) caused a false suggestion of gallbladder carcinoma. The most frequent ultrasonographic finding in gallbladder carcinomas was a mass filling the gallbladder (15 diagnosed cases), followed by wall thickening (9 cases), and polypoid or fungating tumour (6 cases). Real-time ultrasonography is a useful method for the preoperative diagnosis of gallbladder carcinoma, but considerable diagnostic problems in the differentiation from inflammatory diseases may be encountered.

Adenocarcinoma↗

PubMedDate not supplied

Ultrasonography in acute gallbladder perforation.

The files of patients with acute cholecystitis from two large university hospitals from the years 1978-1985 were employed to find the cases with acute gallbladder perforation for this study. Only those patients (n = 9) were selected for the analysis of sonographic signs of acute gallbladder perforation who had less than 48 hours of symptoms before sonography, and were operated upon within 24 hours of the sonography. Patients (n = 10) with non-complicated acute cholecystitis and identical in regard to the duration of the symptoms and the timing of the sonography and the operation formed a control group. The sonographic findings in patients with gallbladder perforation were pericholecystic fluid collections, free peritoneal fluid, disappearance of the gallbladder wall echoes, focal highly echogenic areas with acoustic shadows in the gallbladder, and an inhomogeneous, generally echo-poor gallbladder wall.

Acute Disease↗

PubMedDate not supplied

Ultrasound in renal pyogenic infection. Imaging and intervention.

A series of 34 patients with renal or perirenal pyogenic infection (18 with pyonephrosis, 10 with renal abscess and 6 with perirenal abscess) is presented to evaluate diagnosis with ultrasound and treatment with percutaneous ultrasound guided aspiration/drainage. Specific findings, defined as sediment echoes or dispersed internal echoes in a hydronephrotic renal collecting system, were noted in 39 per cent of pyonephrosis cases. Abscesses were mainly round or oval hypoechoic lesions measuring from 2 to 15 cm in diameter. Two abscesses were multilocular and one showed a septum. The appearance suggested tumor in 25 per cent. Because of this non-specificity of ultrasound we recommend diagnostic aspirations and further radiologic and other examinations in difficult cases. Four patients were treated by conservative means only, 13 with percutaneous aspiration or drainage, 9 with a combined drainage procedure and surgery, and 8 surgically. The length of the mean hospital stay was shortest in the group with the percutaneous drainage procedure (PDP) although the difference was not statistically significant. PDP was not effective in 12 per cent and surgery was used in these two cases to ensure cure. Complications occurred more often in the PDP group than in the surgery group but the most serious complication was a post-operative one. The different modes of treatment are discussed. The overall mortality was 5.9 per cent.

Abscess↗

PubMedDate not supplied

Late silent complications after treatment of uterine cancer.

Forty-one symptom-free women treated by operative and irradiation therapy for gynecological cancer 24-108 months previously were examined by small bowel barium meal, large bowel barium enema, intravenous urography and renography in order to determine whether there were any silent complications present after the therapy. It was possible to demonstrate intestinal or urologic damage by roentgenological examinations in 12 patients. Small bowel changes were found in five and large bowel changes in six patients, while eight had changes in urography and 18 in renography. Two intestinal and four urological changes were moderate or severe. These findings indicate that a careful follow-up programme regarding complications and recurrences is necessary.

Adult↗