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Biomedical subjects

M I Burrell

Publications and source records attributed to M I Burrell.

At least 37 records · Page 2Linked to original sources
PubMed1984

Strategy for the use of biliary scintigraphy in non-iatrogenic biliary trauma.

Biliary scintigraphy was used to examine 21 patients who had suspected non-iatrogenic biliary trauma. Seven patients (33%) had scintigraphic evidence of biliary leakage. Ultimately, surgical biliary repair was required for only three of these patients. Visualization of the gallbladder did not occur in eight trauma patients, but only one patient was shown to have cholecystitis. In this series, 16 patients had Tc-99m sulfur colloid scans that offered no significant advantage over cholescintigraphy in the detection of hepatic parenchymal defects. Biliary scintigraphy provides clinically useful information in cases both of blunt and penetrating trauma.

Adult↗
PubMed1984

Hepatobiliary scintigraphy and sonography in early biliary obstruction.

The authors examined 139 patients thought to have early, partial, or intermittent biliary obstruction, using sonography, hepatobiliary scintigraphy, and in selected cases contrast cholangiography. Of 125 patients with a well-established final diagnosis, sonography and scintigraphy disagreed in 29 (23%). Scintigraphy revealed early or low-grade obstruction in 13 patients who had no evidence of dilated ductules, while 7 patients with dilatation from prior stone passage or biliary surgery showed normal clearance. The authors conclude that in a preselected population in whom early or low-grade biliary obstruction may be present, disagreement between sonography and scintigraphy is not rare, and the absence of sonographically detectable dilatation does not exclude obstruction.

Adult↗
PubMed1984

The intrahepatic and extrahepatic bile ducts in surgical jaundice: radiological evaluation and therapeutic implications.

Many invasive and noninvasive imaging modalities are available to image the biliary tract in suspected surgical jaundice. Technical advances in existing techniques and development of new techniques allow biliary obstruction to be detected in its earliest stages. Criteria for the presence of biliary obstruction include anatomic visualization and measurement of both the intrahepatic and extrahepatic portions of the biliary tree. These criteria will be reviewed and potential diagnostic pitfalls discussed. Anicteric dilatation, disparate dilatation, and segmental obstruction of the biliary tract will be discussed as these entities pose a diagnostic as well as therapeutic challenge. The newer endoscopic and percutaneous interventional techniques will be considered and placed in perspective.

Carcinoma↗
PubMed1982

Ultrasonography and hepatobiliary scintigraphy in the assessment of biliary-enteric anastomoses.

Twenty-three patients with surgical diversion of the biliary tract were serially studied with ultrasonography and hepatobiliary scintigraphy using 99mTc-HIDA or 99mTc-disofenin. Refluxed biliary air resulted in nondiagnostic sonograms in 14% of cases. Persistent postoperative dilatation was present in five patients (22%). Scintigraphy allowed differentiation of biliary dilatation with obstruction from nonobstructed dilatation. By coordinating the noninvasive imaging results, those patients requiring study using direct injection of contrast material may be selected.

Adult↗
PubMed1981

Diagnostic utility of cholescintigraphy and ultrasonography in acute cholecystitis.

When faced with a patient with possible acute cholecystitis, technetium-99m-HIDA scintigraphy should be the primary diagnostic procedure performed. If scintigraphy reveals a normal gallbladder, acute cholecystitis is excluded. If the scintigram fails to visualize the gallbladder, ultrasonography is deemed advisable to exclude potential false-positive scintigrams and confirm the presence of cholelithiasis.

Acute Disease↗
PubMed1981

Disparate dilatation of the intrahepatic and extrahepatic bile ducts in surgical jaundice.

Intrahepatic biliary dilatation on ultrasound has been reported as an early sign of biliary obstruction. This paper reports 12 patients with extrahepatic biliary obstruction in whome the extrahepatic biliary system was increased in caliber despite a normal appearance of the intrahepatic ducts. The bile ducts in all of these patients were evaluated with ultrasound and percutaneous transhepatic cholangiography. Computed tomography was performed in one case. The causes of obstructive jaundice included stricture, choledocholithiasis, and neoplasm. The common bile duct provides a sensitive indicator of biliary obstruction, and its demonstration by noninvasive or invasive means is mandatory even when the intrahepatic ducts appear to be normal.

Adult↗
PubMed1980

Ultrasound demonstration of anicteric dilatation of the biliary tree.

This report presents eight patients with dilatation of the biliary tree, six of whom had no clinical or laboratory evidence of biliary tract disease except for elevated levels of serum alkaline phosphatase. In two patients, dilatation was caused by obstruction of only one hepatic duct; in three, it was caused by a pancreatic tumor; and in three, it was associated with gallstones which exercised a ball-valve effect, producing intermittent obstruction. The elevation of the alkaline phosphatase level in six of these patients suggests that it is a more sensitive indicator of biliary tract obstruction than the serum bilirubin level is. The recognition of biliary dilatation in one or both lobes of the liver should lead to a careful examination, with ultrasound or another modality, of the porta hepatis, common bile duct, and pancreas.

Aged↗
PubMed1979

Diagnostic imaging procedures in acute pancreatitis. Comparison of ultrasound, intravenous cholangiography, and oral cholecystography.

To evaluate the role of intravenous cholangiography (IVC), ultrasound andoral cholecystography in the diagnosis of gallstone pancreatitis, 20 patients with acute pancreatitis were studied during the first three days of an attack. The IVC successfully demonstrated the common bile duct and gallbladder in 17 (85%) 20 patients. The ultrasound studies showed the gallbladder in all 18 patients in whom the gallbladder was present. The common duct was not seen by ultrasound in any patient and the pancreas was abnormal in all patients. In the three patients with gallbladder stones these were identified on both IVC and ultrasound. Common duct stones in three patients were seen only by IVC (two of these patients had concurrent gallbladder stones and one after cholecystectomy). Oral cholecystography was of limited usefulness, although the 50% visualization rate was higher than the literature suggests.

Acute Disease↗
PubMed1978

Acute colitis related to penicillin and penicillin derivatives.

5 cases of acute transient colitis associated with the ingestion of ampicillin, an ampicillin derivative, and penicillin are discussed. The clinical presentation, course, and radiographic and sigmoidoscopic findings are distinct from those in pseudomembranous colitis. The colonic changes may be related to an allergic reaction in the intestine which results primarily in transient ischaemia. The presenting symptom is blood diarrhoea, and barium enema is the most productive diagnostic examination.

Administration, Oral↗
PubMed1978

Borderlands in the diagnosis of regional enteritis: trends in overdiagnosis and value of therapeutic trial.

Our regional experience in the state of Connecticut indicates that Crohn's disease is being overdiagnosed. Six patients with disorders mimicking regional enteritis are presented, one of whom had an atypical clinical course and the remainder had atypical therapeutic responses. The radiologist should be aware of clinical responses and make reassessments if necessary, in order not to overlook surgically treatable conditions.

Adolescent↗
PubMed1978

The protean gastrointestinal manifestations of metastatic breast carcinoma.

Metastatic breast carcinoma commonly remains silent for many years following initial diagnosis and mastectomy, and then appears as metastases at various locations. Gastrointestinal involvement is not uncommon and includes any site along the whole length of the gut, the liver, and the biliary tree; it occasionally simulates other diseases and causes difficulty in diagnosis. The radiographic features and differential diagnoses are discussed.

Adult↗
PubMed1977

Wandering spleen--the radiological and clinical spectrum.

Eight cases of wandering spleen demonstrate that this rare entity has a characteristic constellation of findings which, though nonspecific, are highly suggestive of the diagnosis. Angiography or isotopic imaging specific for the spleen confirms the diagnosis. Asymptomatic patients may be carefully observed, with the institution of splenectomy should signs of torsion develop.

Adult↗
PubMedDate not supplied

Toxic dilatation in Crohn disease with CT correlation.

We describe the CT appearance of toxic dilatation in a patient with Crohn disease. The CT manifestations of this uncommon but important entity have not been previously described. The involved portion of the colon was mildly dilated and demonstrated pseudopolyp formation. Bowel wall thickening in this segment was minimal as expected in toxic dilatation. Intramural gas was identified representing pneumatosis intestinalis, an ominous sign in this condition.

Adult↗