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Biomedical subjects

I Vujic

Publications and source records attributed to I Vujic.

At least 37 records · Page 2Linked to original sources
PubMed1985

Hemiazygous continuation of a left inferior vena cava: misleading radiographic findings in chest trauma.

A widened mediastinum was found on chest radiography following blunt chest trauma. Aortography alone could not adequately determine the etiology of the radiographic findings; on computed tomography (CT) benign mediastinal widening was confirmed owing to accessory hemiazygous continuation of a left inferior vena cava (IVC), with communication to the left brachiocephalic vein through an enlarged left superior (highest) intercostal vein. This unusual anatomic variant and its radiographic findings are reviewed, as well as the complementary role of CT in the evaluation of the traumatized thoracic aorta and mediastinum.

Aortography↗
PubMed1985

Hemodynamics of portal blood flow shown by CT portography. Work in progress.

Computed tomography and arterial portography were combined in 12 patients for studies of the anatomy and hemodynamics of the portal venous system. This technique was found to be more sensitive than conventional venous-phase angiograms of the superior mesenteric and splenic arteries for evaluation of the anatomy of the portal venous system and extent of thrombosis in patients with cavernous transformation and also facilitated recognition of subtle evidence of hepatofugal flow and portosystemic shunts. CT portography can be employed when conventional angiograms fail to show the portal vein adequately.

Adult↗
PubMed1985

Hepatic rupture associated with pregnancy: treatment with transcatheter embolotherapy.

Spontaneous rupture of the liver associated with pregnancy is a rare and very serious complication, usually occurring in association with eclampsia or preeclampsia. Survival has generally been dependent on early recognition of characteristic signs and symptoms and prompt surgical intervention. Even with surgery, maternal mortality approaches 40% and fetal mortality is even higher. The diagnosis can usually be firmly established based on the clinical and radiographic findings presented in this article. Reported is a patient with hepatic rupture successfully treated by transcatheter embolization of the hepatic artery. It is the authors' belief that if such a patient is clinically stable enough to undergo angiography, then transcatheter embolotherapy is a reasonable alternative to surgery.

Adult↗
PubMed1984

Treatment of acute embolus of the superior mesenteric artery by topical infusion of streptokinase.

Two patients with sudden onset of acute abdominal pain caused by embolic disease of the superior mesenteric artery (SMA) were evaluated angiographically. In one patient, the study was performed soon after the clinical onset of symptoms, and successful treatment with low-dose topical streptokinase infusion produced total lysis of the clot over a period of 30 h. In the second patient, the angiogram was obtained 6 days following the initial episode of pain. Radiographic and clinical findings indicated advanced gastrointestinal ischemia with bleeding which contraindicated the use of fibrinolytic therapy. Surgical resection of infarcted intestine was required. Early angiographic detection of acute mesenteric thrombus or embolus is crucial for the selection of patients for fibrinolytic therapy. Our cases suggest that with early diagnosis, streptokinase infusion is an alternative to surgical management of selected patients with acute mesenteric ischemia.

Acute Disease↗
PubMed1984

Computed tomography as an angiographic aid in evaluation of intraabdominal hemorrhage.

The role of computed tomography in the evaluation of patients with intraabdominal hemorrhage in the absence of trauma history has received little attention. Representative cases are presented demonstrating how preangiographic, postangiographic, and combined computed tomography-angiography can aid in the diagnosis and localization of obscure causes of intraabdominal and gastrointestinal bleeding.

Adult↗
PubMed1984

Peritoneovenous shunt occlusion. Etiology, diagnosis, therapy.

Electronic pressure testing of every LeVeen valve has practically eliminated mechanical malfunction as a cause of shunt failure. Nonetheless, failures do occur and in a series of 240 cases, early or late shunt failure occurred in 29 patients. Thirty-five additional cases of failures were either referred by other physicians over a period of 6 years or information and x-rays were accumulated by direct contact. Shunt failure becomes manifest by a sudden reaccumulation of ascites in patients with a previously functioning shunt. In immediate failure, the ascites may fail to disappear after surgery or reaccumulate if removed. Ideally, caval clotting should be first excluded by x-ray visualization of the superior vena prior to injection of the shunt with contrast agent. Shuntograms are done with fine-bore needles. The venous pressure is also measured. The entry of contrast into the vena cava without pooling indicates a patent venous limb. The contrast will empty from the venous tubing with forceful inspiration if the entire system is patent. The venous tube will not clear if the valve or peritoneal collecting tubes are blocked. Only the valve and collecting tube need then be replaced if contrast enters the cava but does not leave the venous tubing. Occluded valves must not be flushed to restore patency since inflammatory exudate and cellular debris are erroneously identified as "fibrin flecks." Histology and culture are mandatory. Immediate and early failure are often caused by malposition of the venous tubing. Malplacements can often be diagnosed simply by chest x-rays. Intraoperative injection of methylene blue into the venous tubing establishes a satisfactory washout prior to wound closure. Fresh clots in the vena cava can be dissolved by the slow injection of streptokinase into the venous tubing. Other patent veins are chosen for access. Patients having repeat surgery after clotting must be heparinized to prevent a similar recurrence. Flushing blood clots from the cava can be fatal.

Ascites↗
PubMed1984

Pancreatic and peripancreatic vessels: embolization for control of bleeding in pancreatitis.

Bleeding associated with pancreatitis has a high mortality rate. Angiographic demonstration of uncontrollable bleeding or large pseudoaneurysms is an indication for emergency surgery. We have encountered a group of patients with obvious clinical gastrointestinal hemorrhage out of proportion to angiographic findings. Vessel abnormalities included areas of encasement, small pseudoaneurysms, and occasional extravasation without a clearly defined source. With the high risk of mortality in such patients, embolization is a viable method of therapy. Three patients are described who had different angiographic presentations and in whom hemorrhage was safely controlled with embolic therapy using nonpermanent occlusive materials.

Adult↗
PubMed1984

Routine preoperative biliary drainage: effect on management of obstructive jaundice.

The routine application of preoperative percutaneous transhepatic biliary drainage (PTBD) to patients who have obstructive jaundice has a significant effect on overall morbidity, mortality, and patient survival by allowing selective application of the most appropriate therapeutic modality. Surgical patients who undergo PTBD were compared with those for whom PTBD was not available. The surgical complication rate was 44% for those who did not undergo PTBD and 15% for those who did. The surgical procedure-related mortality rate was 30% for those who did not undergo PTBD and 12% for those who did. These differentials may have been due either to a beneficial effect of presurgical decompression or to the fact that only more favorable candidates were selected for operative internal bypass. There was an overall increase in length of survival following the application of PTBD, especially in those patients who were surgical candidates.

Adult↗
PubMed1984

Interventional radiologic procedures in the renal transplant.

Percutaneous interventional procedures can be valuable in the evaluation and treatment of urologic complications of renal transplantation. Thirty-three patients underwent percutaneous procedures, including relief of obstruction by catheter nephrostomy, diagnostic antegrade pyelography with Whitaker testing, aspiration of various fluid collections (lymphocele, hematoma, urinoma, and abscess), and renal artery angioplasty, during a three year period at three institutions, to provide temporizing treatment and anatomic data. Surgical intervention was sometimes avoided, but more often it could be deferred to allow the patient to stabilize prior to surgery. Complications that required surgery occurred in two patients.

Adolescent↗
PubMed1984

Thoracic biopsy: CT guidance of thin-needle aspiration.

CT-guided percutaneous thin-needle aspiration biopsy of 23 mediastinal and 27 other thoracic masses was performed in 40 patients over a 2-year period. Although biplane fluoroscopy is considered the optimal guidance mechanism for thoracic biopsy, CT was required in this group of patients to ensure accurate needle placement within the lesions or within the most appropriate subsegment of necrotic lesions. A specific diagnosis was obtained in 34 cases, an overall diagnostic accuracy of 85%. Although CT guidance allowed an extrapleural needle trajectory in 23 patients, five of the remaining 17 patients sustained a pneumothorax for which two required tube thoracotomy.

Biopsy, Needle↗
PubMed1984

Radiofrequency thermotherapy, local chemotherapy, and arterial occlusion in the treatment of nonresectable cancer.

Localized radiofrequency thermotherapy (RFTT) has been effective by itself in debulking cancers but has not accomplished total eradication by itself. Occlusion of the regional artery supplying the tumor drastically reduces the arterial pressure distal to occlusion and further impairs tumor blood flow leading to an accentuation of the temperature differentiation achieved by the normal tissue and tumor. Radiofrequency thermotherapy with vascular occlusion is combined with direct injection of an effective chemotherapeutic agent into the tumor. Radiofrequency thermotherapy is performed after injection of chemotherapy using bleomycin and mitomycin C for squamous cell cancers and Adriamycin and mitomycin C for adenocarcinoma. There are no adverse systemic responses to the small dose of chemotherapy used and the combination therapy is effective in destroying the tumor.

Antineoplastic Agents↗
PubMed1983

Evaluation of biliary cystadenoma and cystadenocarcinoma.

Biliary cystadenomas and cystadenocarcinomas are among the rare neoplasms of the biliary ductal system. This article presents 3 adult patients in whom such large multiloculated biliary tumors were diagnosed. The characteristic features noted on ultrasonography, computed tomography, and angiography of the liver are illustrated and the literature is reviewed.

Aged↗
PubMed1983

Angiographic demonstration of gastrointestinal neurofibromas in von Recklinghausen's disease.

Two cases of intestinal neurofibromas which were demonstrated during mesenteric arteriography are described. In 1 patient, tumors located in the jejunum and distal ileum were the apparent source of gastrointestinal bleeding. In another case, a neurofibroma of the proximal jejunum was an incidental finding during evaluation for severe pancreatitis and bleeding from esophageal varices.

Adult↗
PubMed1983

Computed tomographic demonstration of hemobilia.

A patient with hemobilia presumably due to a small hemangioma in the liver is presented. The condition was diagnosed by computed tomography (CT) done immediately following hepatic arteriography and confirmed by hem-positive duodenal aspirates on two occasions.

Aged↗