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J G Bova

Publications and source records attributed to J G Bova.

At least 37 records · Page 2Linked to original sources
PubMed1990

Review of hepatic imaging and a problem-oriented approach to liver masses.

We believe that imaging of the liver is complicated. The sporadic appearance of incidental benign lesions and variability in scanning techniques, equipment and artifacts add difficulties to the evaluation of liver masses. Therefore we emphasize the need to define the problem for which the patient is being imaged. This information helps in choosing the procedure of choice and the technique needed to give the most expedient, accurate answer. This will also help apply the lowest risk and most cost-efficient care. Imaging algorithms vary depending on the suspected pathological conditions. Dynamic bolus-enhanced CT is the modality of choice in most situations. Tc99m sulfur-colloid liver-spleen scans are helpful in patients with suspected FNH, and Tc99m-tagged-RBC-SPECT scans are recommended to confirm cavernous hemangiomas. Cysts are easily confirmed by US. Although MRI is competitive with CT, it has not become a primary modality because of cost, availability, patient selection and variability of scanner capabilities among the many manufacturers and models. It is hard to predict what future development of imaging techniques will bring. Many feel that significant advances have plateaued. Time and money will more likely be concentrated on improving image resolution, speed of scanning and ability to transfer this information to sites outside of the radiology department. In addition to faster scanning, we expect to soon have available safe intravenous and enteric contrast agents for MRI. Certainly this will lead to a new round of investigations to compare MRI with CT scanning.

Bile Duct Neoplasms↗
PubMed1987

Medication-induced esophagitis: diagnosis by double-contrast esophagography.

Although medication-induced esophagitis is recognized more frequently nowadays, reports of associated radiographic findings are limited. Nine cases of esophagitis associated with various medications were evaluated by using double-contrast esophagography. The usual features were several discrete focal ulcerations localized to a short segment of the proximal half of the esophagus. In seven of the cases, the offending medication was an antibiotic. Symptoms resolved in about 4 days after medication was discontinued. Finding characteristic radiologic abnormalities in the appropriate clinical setting may obviate endoscopy.

Adolescent↗
PubMed1985

Pancreatic phlegmon. Clinical features and course.

The clinical course of 19 patients with pancreatic phlegmon, as diagnosed by computed tomography (CT) and clinical criteria, was assessed retrospectively and compared to that of eight patients with pancreatic abscess diagnosed either at surgery or with percutaneous aspiration. Controls consisted of 55 patients with uncomplicated acute pancreatitis without CT scans and 11 patients with acute pancreatitis in whom CT scans were negative or only consistent with acute pancreatitis (no phlegmon). The age, sex, and presumed etiology of the pancreatitis were not significantly different in the four groups. Patients with phlegmon had a higher incidence of severe pancreatitis as defined by Ranson's criteria, presence of an abdominal mass, as well as a longer duration of fever, abdominal pain and leukocytosis than controls without CT scans. With the exception of a palpable abdominal mass and fever lasting over five days, the results were similar when comparing the phlegmon group and controls with CT scans, although the severity of the disease and prolonged abdominal pain tended to be increased in the former patients. There was no statistically significant difference in clinical or laboratory criteria between the phlegmon and abscess groups, although the latter group had longer hospital stays and periods with no oral intake (npo). Management of patients with phlegmon tended to include TPN, longer npo periods, antibiotics, and longer hospital stay than in controls without CT scans. Controls with CT scans were managed similarly to the phlegmon group because of prolonged amylase elevation and abdominal pain. Percutaneous aspiration was successful in differentiating abscess from phlegmon in five of six cases. Major complications were rare in the phlegmon group and spontaneous resolution was the rule. Pancreatic phlegmon is a distinct clinical/radiologic entity which may be very difficult to differentiate clinically from pancreatic abscess. Early percutaneous thin-needle aspiration of the inflammatory mass (under CT guidance) seems to be the diagnostic procedure of choice. Management is nonsurgical unless complications arise. The role of TPN and antibiotics is unknown, and controlled studies of these therapeutic approaches in pancreatic phlegmon are needed.

Abscess↗
PubMed1985

Renal and perirenal infection: the role of computerized tomography.

Predisposing factors, onset of symptoms to diagnosis interval, computerized tomography findings and the impact of computerized tomography on the outcome were studied retrospectively in 24 patients with renal or perirenal infections. The most common predisposing factors were diabetes mellitus and urinary tract calculi. The mean interval from the onset of symptoms to diagnosis was 6.8 days. The most common computerized tomography findings were thickening of Gerota's fascia, renal enlargement, focal decreased renal attenuation, perirenal fluid and focal gas. Four patients died despite early diagnosis and appropriate therapy. Computerized tomography aided in the diagnosis, assessment of the extent of disease, treatment and followup. Computerized tomography is the most direct method to evaluate patients with suspected renal or perirenal infection, although mortality may not be altered significantly.

Abscess↗
PubMed1985

Adaptation of the ileum in nontropical sprue: reversal of the jejunoileal fold pattern.

Seven cases of nontropical sprue (gluten enteropathy) are described in which there was an increase in the ileal fold pattern depicted on barium examination of the small bowel. In five of these patients there was a decrease in the jejunal fold pattern. This combination created a reversed appearance of the normal small-bowel radiographic pattern. This is a distinctive pattern for nontropical sprue and reflects the chronic inflammation and atrophy of the jejunum and compensatory hypertrophy (adaptation) of the ileum. This usually indicates long standing disease and should heighten awareness to potential malignant complications.

Adult↗
PubMed1985

The normal mucosal surface pattern of the duodenal bulb: radiologic-histologic correlation.

Similar to the stomach and colon, the duodenum also demonstrates a fine mucosal relief pattern on double-contrast radiographic examination. Two patterns may be identified--fine reticular and "small dot." In order to investigate the origin of these patterns, duodenal bulb specimens were obtained at autopsy, and macroscopic and microscopic features were correlated with radiographic patterns. Findings indicate that the surface patterns identified radiographically on cadaveric specimens and in live patient subjects are due to villi and the collections of barium within the intervening sulci. Knowledge of this normal pattern will prevent misdiagnoses, especially when inflammatory disease of the duodenum is being considered.

Duodenum↗
PubMed1984

Diverticulitis of the right colon.

Diverticulitis of the right colon is a relatively uncommon disease that usually mimics acute appendicitis. Most patients are operated on early, and a barium enema is not commonly obtained. Five cases with barium studies are presented. In four of the five cases an intramural mass effect and evidence of involvement of the colonic wall were present. Diverticula of the right colon were found in all five patients. If the diagnosis is made without surgery, medical therapy is usually successful.

Acute Disease↗
PubMed1984

Tuboovarian abscess simulating giant colonic diverticulum.

The plain abdominal film finding of a large air-filled cavity has a differential diagnosis that includes giant colonic diverticulum, volvulus, giant Meckel's or other small-bowel diverticulum, emphysematous cystitis, vesicoenteric fistula, bowel duplication, and mesenteric cyst. The case presented here expands this differential diagnosis to include tuboovarian abscess with fistulous communication to the bowel.

Abscess↗
PubMed1984

Radiologic evaluation before gastric bypass for morbid obesity.

During a 4 year period, 69 patients received gastric bypass with stapling and Roux-Y gastrojejunostomy for morbid obesity. The results of 67 preoperative radiologic evaluations of the gastrointestinal tract were analyzed. Of these patients, 17.9 percent (12 of 67) had previous cholecystectomy for cholelithiasis; 14.6 percent (10 of 67) had cholelithiasis found on preoperative evaluation. This gave an overall incidence of gallbladder disease of 32.8 percent. The upper gastrointestinal examination revealed four patients with hiatal hernia, three with reflux, and one with evidence of reflux esophagitis. Two patients had one duodenal diverticulum each. Ten small bowel follow-through examinations were performed, six of which revealed no abnormalities and four of which were consistent with previous jejunoileal bypass. Results of air-contrast barium enema showed 1 patient with a cecal mass which was subsequently found to be a fatty iliocecal valve and 16 patients had diverticulosis without evidence of diverticulitis. The remainder of the findings of all studies were unremarkable. When all is considered, including radiation dose, difficulty in performing examinations, and cost, we conclude that because of the low incidence of significant abnormalities, routine preoperative evaluation of these patients should only include radiographic or sonographic evaluation of the gallbladder. Other examinations should be obtained if the patients have current symptoms or previous gastrointestinal disease or gastric surgery.

Adult↗
PubMed1984

Bowel obstruction due to infarcted splenosis.

We have presented a case of splenosis (autotransplantation of splenic tissue) after traumatic rupture of the spleen, which produced bowel obstruction. Although rarely symptomatic, these splenic implants must be considered in the differential diagnosis of abdominal pain with or without intestinal obstruction in all postsplenectomy patients. When an incidental finding at exploratory celiotomy, these implants should be preserved as a means of retaining splenic function and preventing the complication of postsplenectomy sepsis.

Adult↗
PubMed1983

Radiographs obtained during upper gastrointestinal fluoroscopy. Adequacy and comparison to postfluoroscopy images.

The usefulness of full-size radiographs obtained with the overhead tube following fluoroscopy was evaluated based on an analysis of 306 biphasic upper gastrointestinal studies that included follow-up postfluoroscopy views. In 32 studies with abnormal findings, the postfluoroscopy images were normal. In one case, the postfluoroscopy images revealed an abnormality not seen on spot views. The confidence levels rose in only 19 cases (6.2%) when postfluoroscopy images were used. In the appropriate setting, routine postfluoroscopy views after an upper gastrointestinal series are of little value. Nonetheless, in a teaching hospital, these images should be obtained when fluoroscopy is performed by junior residents.

Barium Sulfate↗