Speaking on behalf of nurses. Patients before profits.
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Delivery of Health Care↗
Biomedical subjects
J Farman
Publications and source records attributed to J Farman.
Tc-99m DISIDA hepatobiliary scintigraphy in AIDS cholangitis.
Sixteen patients with documented AIDS cholangitis who underwent Tc-99m DISIDA hepatobiliary scintigraphy were retrospectively reviewed to assess the spectrum of changes observed in this disease. AIDS cholangitis was documented by either ERCP with aspiration/biopsy or the presence of typical sonographic/CT abnormalities with positive stool culture and a minimum of 6 months follow-up. Images were graded as regards parenchymal function (blood pool clearance, peak parenchymal activity, and degree of parenchymal retention), gallbladder visualization, presence of ductal dilatation, and time of intestinal activity. Three patterns were identified: 1) focal ductal dilatation with focal narrowing and focal or diffuse parenchymal retention; 2) ductal dilatation, without narrowing, and diffuse parenchymal retention; and 3) severe diffuse parenchymal retention with or without ductal abnormality. All 16 studies revealed abnormal parenchymal retention. Gallbladder nonvisualization was demonstrated in nine studies and delayed in two. The hepatobiliary scan is a very sensitive technique for evaluating AIDS cholangitis. Although a spectrum of findings may be observed, parenchymal retention with some degree of ductal abnormality is the most commonly observed pattern.
AIDS-Related Opportunistic Infections↗
Cytomegalovirus gastritis: protean radiologic features.
Infection with cytomegalovirus (CMV) is a major feature of acquired immunodeficiency syndrome (AIDS). Gastrointestinal involvement is being seen more frequently. Our collective experience involves nine patients with stomach involvement. Seven patients were intravenous drug abusers or homosexuals with AIDS. One developed CMV gastritis as a complication of leukemia and one patient was a West African with lymphoma and human immunodeficiency virus (HIV) infection. All our patients had biopsy-proven CMV inclusion bodies. The radiographic appearances varied widely. The findings included markedly thickened edematous folds, erosive gastritis with aphthous ulceration, and superficial and deep ulceration. One patient had deep ulceration with fistula formation. Computed tomographic (CT) scans confirmed the greatly thickened gastric wall and coarsened folds in two patients. Associated gastrointestinal infections included candida and herpes, and, in addition, pneumocystis carinii pneumonia (PCP) was present in two patients. CMV gastritis may mimic several other conditions including erosive gastritis, peptic ulceration, lymphoma, and carcinoma. It should be strongly considered in immunosuppressed patients.
Acquired Immunodeficiency Syndrome↗
Gastric duplication cyst communicating with the pancreatic duct: a rare cause of recurrent abdominal pain.
A 41-year-old woman with recurrent attacks of postprandial abdominal pain was found on endoscopic retrograde cholangiopancreatography and subsequent computed tomographic scan to have an enteric duplication within the substance of the pancreas with communication to the pancreatic duct. Celiotomy demonstrated a noncontiguous gastric duplication cyst. Internal drainage was curative.
Abdominal Pain↗
The forgotten surgical foreign body.
Instruments and drains left in the abdomen following surgery may be responsible for bizarre and varied complications. The patient may remain asymptomatic for months or even years. Complications include adhesion formation, intestinal obstruction, abscesses, and erosion into the gastrointestinal tract. We report 3 patients in whom retained surgical material eroded into the duodenum and colon, respectively, and produced unusual radiologic findings and complications.
Adult↗
Duodenal diverticular enterolith. A rare cause of small bowel obstruction.
Complications resulting from duodenal diverticula are relatively uncommon. We describe small bowel obstruction secondary to an enterolith formed in a duodenal diverticulum, probably as a result of habitual ingestion of large amounts of kaolin.
Aged↗
Solid and papillary epithelial pancreatic neoplasm: an unusual tumor.
Solid and papillary epithelial neoplasms of the pancreas are uncommon. These grow to a large size, are often palpable, and occur most often in young black women. The tumors have a characteristic histologic appearance and a low malignant potential. Heavy tumor calcification is an unusual finding. Two cases with radiologic-pathologic correlation are presented herein.
Adult↗
Ileal leiomyosarcoma and leiomyoma. False-positive scintiscans for Meckel's diverticulum.
Two cases of ileal leiomyomatous neoplasms with positive scintigraphic findings for Meckel's diverticulum are presented. The precise mechanism for the abnormal concentration of the Tc-99m pertechnetate is uncertain. Illustrations of the collating barium and computerized tomographic studies are included and the scanning technique utilized is reviewed.
Diagnosis, Differential↗
Focal esophageal candidiasis in acquired immunodeficiency syndrome (AIDS).
When candidiasis involves the esophagus, it usually does so as an extensive and diffuse infection. In our experience, however, esophageal candidiasis in patients with the acquired immunodeficiency syndrome (AIDS) is clinically distinct from the same infection in patients with other immunodeficiency states. Of 25 patients with AIDS and esophageal candidiasis studied radiographically, 4 patients with localized involvement of the esophagus are presented. The clinical and radiologic manifestations of focal esophageal candidiasis in these patients are reviewed and compared to previously described cases of esophageal candidiasis.
Acquired Immunodeficiency Syndrome↗
Anaesthesia and perioperative care for patients with liver disease.
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Anesthesia, General↗
Radiological manifestations of Strongyloides stercoralis.
Nine patients with radiological changes due to Strongyloides stercoralis (SS) are described. A wide variation in appearance exists ranging from mild edema of the duodenal and small bowel mucosa to grossly enlarged, prominent valvulae conniventes. Small bowel dilatation is significant, and in overwhelming infestation toxic dilatation with paresis results. Spasm, ulceration, and stricture are encountered in addition. The appearances usually improve and reverse with treatment. Ampullary involvement is responsible for reflux of barium into the pancreatic duct and biliary tree through a patulous sphincter. In 1 patient the colonic changes resembled ulcerative colitis.
Adult↗
Inoperable gastric lymphosarcoma mistaken for carcinoma: response to radiation with twenty-year survival to date.
With suitable treatment, the potential for long survival with gastric lymphoma is well-documented. However, since these tumors constitute only about 1-3% of gastric malignancies, they may occur only rarely in a particular radiologist's experience. The present report of a remarkable therapeutic response is a reminder that the possibility of lymphosarcoma should be included in the differential diagnosis of every gastric neoplasm.
Carcinoma↗
Pericardial complications of peptic ulceration.
Intrathoracic perforated peptic ulceration is uncommon. Two patients are reported with pericardial fistulization secondary to peptic ulceration. These occurred following colonic bypass surgery as a consequence of peptic esophagitis and hiatus hernia.
Adolescent↗
Primary oesophageal melanocarcinoma.
Three patients with melanocarcinoma of the oesophagus are described. Reasons are given for believing that these were primary tumours. The clinical features and pathology of the condition are discussed.
Aged↗
Effects of radiation on the human gastrointestinal tract.
Radiation therapy directed at the abdomen may damage the digestive tract, the type and extent of injury depending on the dose of the radiation and the radiation sensitivity of the gut. Characteristic early changes are manifest in the mucosa of the gut: for later ulceration, changes in the collagen tissues and particularly in the vascular channels occur. This paper describes and characterizes injuries to the esophagus, stomach, small intestine and colon. It emphasizes the importance of recognizing radiation-induced damage to the gut which may occur early or late after radiation.
Adult↗
Local duodenal metastasis from colonic carcinoma.
The clinical and radiologic appearance of an isolated metastasis to the duodenum may mimic a primary pancreatic or duodenal cancer. As lymphatics from the right colon drain to periduodenal lymph nodes, lymphatic spread from right colon cancer can cause enlargement of the duodenal loop, with ulceration or distortion of the mucosa on the medial aspect of the duodenum. We present three patients with ulcerating metastases in the duodenum from colon cancer whose cases exemplify the problems of diagnosis and management.
Adenocarcinoma↗
Endometriosis with ureteric involvement: preoperative sonographic evaluation.
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Adult↗
Kaposi's sarcoma of the intestinal tract: roentgen manifestations.
Five cases of generalized Kaposi's sarcoma are reported with roentgen evidence of involvement of the intestinal tract. In three instances, there was extensive involvement of the small bowel with multiple intramural nodules. The fourth patient demonstrated multiple polypoid lesions of the colon, and in the fifth a constricting lesion of the ileum was present. Two patients with small bowel involvement had significant malabsorption. This latter complication of diffuse Kaposi's sarcoma of the small bowel has not been previously reported. The diagnosis of the nature of the roentgen intestinal abnormality can usually be made, because intestinal involvement generally occurs late in the disease, when both extensive cutaneous nodules and edema of the extremities are apparent.
Aged↗