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Biomedical subjects

J S Wills

Publications and source records attributed to J S Wills.

17 recordsLinked to original sources
PubMed1990

Traumatic lumbar hernia: CT diagnosis.

A lumbar hernia usually involves protrusion of extraperitoneal fat or bowel through an area of weakness in the posterolateral abdominal wall bounded superiorly by the 12th rib, inferiorly by the iliac crest, posteriorly by the erector spinae muscle, and anteriorly by the posterior border of the external oblique muscle. Most are due to an acquired nontraumatic or congenital cause. Acute blunt abdominal trauma is a rare cause of lumbar hernia; to our knowledge, the CT diagnosis of this variety has not been reported. Since 1985, approximately 850 patients have undergone emergent abdominal CT for evaluation of acute abdominal trauma at our hospital; in seven of these patients, a traumatic lumbar hernia was diagnosed prospectively. In three patients, CT showed a flank hematoma with herniation of bowel through the lumbar triangle. CT showed pelvic fractures in three other patients, accompanied by herniation of bowel in one patient, herniation of extraperitoneal fat in another, and herniation of extraperitoneal fat and blood in the third. One patient had both a flank hematoma and a pelvic fracture with herniation of bowel. Acute traumatic lumbar hernia is a rare but significant abnormality that should be considered in patients with blunt abdominal trauma, especially in those with large flank hematomas and pelvic fractures. The hernia contents, associated injuries, and disrupted muscle layers are all well demonstrated on CT.

Abdominal Injuries↗
PubMed1989

Identification of avascular necrosis in the dysplastic proximal femoral epiphysis.

Bilateral radiographic irregularities and deformities of the proximal femoral epiphyses are features of both multiple epiphyseal dysplasia and bilateral idiopathic avascular necrosis. In the past these entities have been difficult to differentiate. This report documents radiographically the occurrence of avascular necrosis in 10 patients with multiple epiphyseal dysplasia by recognizing the super-imposition of sclerosis and subchondral fissuring on pre-existing symmetrically irregular proximal femoral ossification centers. Scintigraphic (photopenia) or magnetic resonance (loss of signal) criteria of avascular necrosis confirm its added presence and help to establish an imaging scheme to identify avascular necrosis superimposed on multiple epiphyseal dysplasia.

Adolescent↗
PubMed1979

Renal papillary adenocarcinoma.

Papillary adenocarcinoma of the kidney is an uncommon variant of renal tubular carcinoma, which on radiographic and ultrasonographic evaluation presents characteristically as a predominantly solid hypovascular or avascular mass. Surgery is required to distinguish this lesion from other solid renal lesions, which differs from the more common form of renal tubular carcinoma in several important respects.

Adenocarcinoma, Papillary↗
PubMed1979

Pyloric channel ulcers and the air-contrast examination.

Three patients with pyloric channel ulcers presenting a diagnostic challenge on double-contrast gastrography are reported. These ulcers might have been overlooked had not films of the pyloric region been obtained when the ulcer was filled with barium. The air contrast examination of the distal stomach should be supplemented by the components of the conventional examination likely to show a pyloric channel ulcer as a barium-filled crater.

Air↗
PubMed1978

Radiographic features of ureteral endometriosis.

The urographic findings in seven patients with ureteral endometriosis were reviewed. These consisted of short strictures (0.5-2.2 cm) located for the most part in that portion of the pelvic ureter projected within 3 cm of the inferior margin of the sacroiliac joint. Although the appearance is judged to be nonspecific, the diagnosis of ureteral endometriosis should be considered in any female patient of child-bearing age who has obstructive uropathy attributable to extrinsic obstruction of the pelvic portion of the ureter.

Adult↗