In a prospective study of 123 patients with clinical signs of acute intestinal inflammation, the sensitivity of ultrasonography in diagnosing acute colonic diverticulitis was 84.6% and the specificity 80.3%. The predictive value of a positive and a negative sonogram was 76.0% and 87.7%, respectively. Of the 52 patients with subsequently proven acute colonic diverticulitis, 44 presented sonographically with a thickened (greater than 4 mm) hypoechoic bowel wall. In 15 patients, enlarged fluid-filled bowel loops were also present. Air-containing diverticula were demonstrated in 3 patients, abscesses in 8 patients, and colovesical fistulae in 2 patients. Eight large abscesses were successfully treated without emergency surgery by percutaneous sonographically guided evacuation. The described sonographic abnormalities strongly suggest acute colonic diverticulitis, particularly when localized in the left lower abdomen.

Acute Disease↗

PubMedDate not supplied

Sonographic detection of infiltrating gastric lesions.

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Humans↗

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[Surgical therapy of uremic pericarditis (author's transl)].

During a five year period (January 1975 - September 1980) 33 patients, in a population of 262 chronic hemodialysis patients, were treated for uremic pericarditis. They all underwent a pericardiostomy either through a lateral (15 cases) or through a subxiphoid approach (18 cases). Immediate clinical relief occurred in all but one patient who showed a progressive cardiac failure even after drainage. Operative mortality was absent and complications were minimal. There were two recurrences of pericardial effusion after an initial lateral approach through thoracotomy. A subsequent partial pericardectomy was successful in both cases.

Adult↗

PubMedDate not supplied

Ultrasound-guided puncture of the gallbladder for acute cholecystitis.

We performed a US-guided aspiration of the gallbladder in 27 patients with an acute cholecystitis and severe concurrent disease, not responding to IV antibiotics and supportive therapy. Twenty six of the 27 patients improved after the procedure. One patient died 7 days after the procedure due to multi organ failure; in the others immediate surgery could be avoided. Three patients experienced local pain after the procedure; no other puncture related complications were encountered. Long-term results (mean follow up 18 months; range 2-36 months) were excellent in 20/26 survivors with no biliary complications or need for elective cholecystectomy. Six of the 26 patients needed subsequent cholecystectomy for relapse or incomplete cure.

Acute Disease↗