Biomedical subjects
Publications and source records attributed to L R Goodman.
Splenic hamartoma is a benign, primary neoplasm which usually causes a mass in the left upper quadrant of the abdomen. If radionuclide studies show a space-occupying lesion in the spleen that appears solid on the ultrasonogram, and selective abdominal arteriography reveals a richly vascular splenic tumor, hamartoma of the spleen should be the preoperative diagnosis.
Unilateral pulmonary edema developed in a 48-year-old woman following intrapleural nitrogen mustard instillation. Despite progressive infiltration, the patient's symptoms resolved spontaneously.
A malpositioned endotracheal tube is a potential hazard to the intubated patient. Ideally, the tube tip should be 5+/-2 cm from the carina when the head and neck are in neutral position. In 92 of 100 patients studied, the carina overlay T5, T6, or T7 on portable radiographs. Therefore, even when the carina is not visible, it can be assumed that a tube tip positioned at the level of T3 or T4 is safe. The degree of neck flexion or extension at the time of radiography may be determined by evaluating the position of the mandible relative to the vertebral bodies.
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Dissecting aortic aneurysms and pseudoaneurysms of the ascending aorta can occur secondary to clamping of the ascending aorta, incision of the great vessels, or secondary to aortic cannulation for cardiopulmonary bypass. Contrast-enhanced CT offers an excellent means of distinguishing between aortic pathology and other causes of mediastinal widening following cardiac surgery. Five cases are reported in which iatrogenic vascular lesions were identified on CT as the cause of postoperative mediastinal widening.
Computed tomographic findings in 18 patients with pulmonary thromboembolism are retrospectively reviewed. In the majority of patients, thromboembolism was not suspected clinically. The CT findings can be divided into two groups: vascular and parenchymal changes. The most frequent vascular findings is an intraluminal filling defect or defects due to thrombus. The most frequent parenchymal finding is a triangular (wedge-shaped) pleural-based soft tissue attenuation lesion. Although CT is not a primary diagnostic tool in the evaluation of pulmonary thromboembolism, CT may be helpful in diagnosis of pulmonary embolism, when evaluating an undiagnosed parenchymal density.
A unique combination of CT findings is reported in a rare case of aortic dissection with intimointimal intussusception. The CT showed a wind sock-like appearance in the contrast column of the aortic arch, which was felt to be characteristic of the intussuceptum. Complementary CT findings, including proximal flap in the dilated root of the aorta, no mid-ascending aortic flap, a descending aortic flap, and pericardial effusion, enabled establishment of the preoperative diagnosis.
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