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Biomedical subjects

M J Landay

Publications and source records attributed to M J Landay.

26 records · Page 2Linked to original sources
PubMed1980

Visible muscle of the diaphragm: sign of extraperitoneal air.

Epiphrenic air collections may be difficult to compartmentalize. The air may be in the peritoneal cavity, extraperitoneal or extrapleural spaces, or in a pleural cavity. Extraperitoneal and extrapleural air usually comes from a pneumomediastinum, but it may arise from an intraabdominal source, such as a ruptured second part of the duodenum. Pneumoperitoneum is frequently the only radiographic sign of a perforated hollow viscus. The radiologist is confronted with an important differentiation. A pneumoperitoneum may indicate a need for abdominal surgery and a pneumothorax may require surgical aspiration; but extraperitoneal and extrapleural air require no specific treatment, assuming that the source of the air can be ascertained and the quantity does not compromise respiration. A new sign is described to assist in the recognition of extraperitoneal and extrapleural air. When the muscle bundles of the diaphragm are outlined by air, the air must be between the parietal peritoneum and parietal pleura and thus be extraperitoneal and/or extrapleural in location. This sign was observed in five patients.

Adolescent↗
PubMed1978

Pancreatic pseudocysts: unusual ultrasound features.

Three unusual cases of pancreatic pseudocyst are described in which primary renal or splenic pathology was simulated on ultrasound imaging. When an abnormal fluid collection is imaged in a patient with a history of alcoholism, a pancreatic pseudocyst should be considered and an amylase determination should be obtained on any aspirated fluid.

Adult↗
PubMed1978

Sonographic "parallel channel" sign of biliary tree enlargement in mild to moderate obstructive jaundice.

The criteria for the diagnosis of minimal obstructive jaundice (i.e., bilirubin less than 11.0 mg/100 ml) using sonography have not been established. A reliable diagnosis of obstructive jaundice with mild dilation of the bile ducts can be made by sonography when the "parallel channel" sign is seen. This sign is due to the simultaneous imaging of the dilated right or left main hepatic duct and the adjacent contiguous main portal vein branch. A prospective study of 86 patients showed this to be a highly reliable means of differentiating obstructive from nonobstructive jaundice when minimal duct dilation is present.

Adult↗
PubMed1978

Buckling of the innominate artery simulating a right apical lung mass.

A tortuous retroflexed innominate artery can simulate a right apical mass. Four cases are presented to illustrate the four fairly distinct appearances which can result. When the innominate artery buckles posteriorly and laterally, it occasionally impresses deeply into the lung and becomes almost completely surrounded by air. The artery will then look like a pulmonary mass on frontal radiographs. The lower margin of the mass is always more crisply defined than the upper margin, and the appearance on the lateral film is fairly characteristic. Aortography is recommended when the radiographic picture is equivocal. In a survey of 200 randomly selected patients over 50 years old, only one had an innominate artery that presented as an apparent pulmonary mass.

Aged↗
PubMed1978

Pulmonary manifestations of acute aspiration of gastric contents.

Radiographic manifestations of aspiration of gastric contents were reviewed in 60 patients. The findings were extremely variable, and there was no typical or characteristic appearance. Confluent and acinar infiltrates, as well as infiltrates composed of small irregular shadows, occurred singly or in a variety of combinations; the third pattern predominated in the majority of cases. Distribution was most commonly bilateral and multicentric and usually favored perihilar or basal regions, but localized or atypical densities were also observed. Patients with the most extensive radiographic abnormalities on initial studies tended to have the worst prognosis; however, mild early pulmonary infiltrates occasionally progressed to life-threatening abnormalities, and extensive initial involvement was frequently followed by a benign clinical and radiographic course. Radiographic changes often worsened for several days in uncomplicated cases, but improvement was generally manifested within the first week after aspiration. Worsening of infiltrates after initial improvement was associated with the development of bacterial pneumonia, the adult respiratory distress syndrome, and pulmonary embolism. In the appropriate clinical setting, aspiration of gastric contents should be an important diagnostic consideration in the presence of a wide variety of radiographic changes.

Adult↗
PubMedDate not supplied

"Hyperdense" aortic wall: potential pitfall in CT screening for aortic dissection.

Opacity of the aortic wall as compared with the nonopacified blood in the lumen has been utilized as one of the criteria for the diagnosis of aortic dissection. It has also been suggested that this finding may be indicative of severe anemia. We evaluated the frequency and implications of aortic wall hyperdensity in 107 consecutive chest CT examinations in patients with no indication of aortic dissection clinically or by other imaging modalities, and whose hematocrit was known. The density of the wall correlated with the patient's age and presence of calcification. Presence or absence of anemia was not a statistically significant factor, although marked conspicuousness of the wall below the age of 60 years did suggest anemia. Atherosclerosis is the most likely explanation for wall visibility in nonanemic patients.

Aortic Dissection↗