Catheters for barium enemas.
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Biomedical subjects
Publications and source records attributed to M L Janower.
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In patients with pseudomembranous colitis, the colonic wall has a characteristic appearance on computed tomographic scans of the abdomen: it is diffusely thickened and the ascending or descending colon viewed on end has a donut-like appearance. It is important to recognize the possible association of such findings with pseudomembranous colitis in order to make an accurate diagnosis in patients experiencing an acute abdominal catastrophe.
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One hundred sixty-seven members of the Society of Gastrointestinal Radiologists, three major commercial suppliers of barium preparations, and the Food and Drug Administration were surveyed about the incidence of hypersensitivity reactions after the administration of barium for stomach or colon examinations. The American literature was also reviewed. Twenty-seven radiologists reported 42 reactions, the companies reported 41 reactions, and the FDA documented 11 cases. An additional 12 cases were found in the literature, giving a total of 106 reactions. Of all the cases, 61% involved the skin, 8% were respiratory in nature, 8% of the patients lost consciousness, and one patient experienced an extraordinary migraine headache. Of the 42 cases reported by the radiologists, half occurred after stomach examination and half after a barium enema examination; the single-contrast technique had been used in only nine of the cases. Glucagon had been used in 11 of the 42 cases. Hypersensitivity reactions can occur after the administration of barium products and are caused by one of the many additives. These reactions are extremely unusual.
Idiopathic chronic ulcerative enteritis (ICUE) is considered by some physicians to be a variant of sprue. Two patients being treated at our hospital for nonspecific abdominal symptoms had abnormal findings from a small-bowel series; at surgery, an ulcerating process involving the jejunum was found. Clinical, radiological, and pathological findings in these cases suggest that ICUE is a distinct entity.
Routine fluoroscopy was performed using 100- and 105-mm spot film cameras. Radiation dose was reduced to between 30% and 43%, and cameras were acceptably reliable. Cost for film and holders was high.
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Respiratory arrest occurred in a patient undergoing cervical myelography in the Trendelenberg position. Autopsy revealed infiltration of the phrenic nerves by metastatic breast cancer resulting in diaphragmatic paralysis. Though this is a very rare complication of myelography, it is suggested that more attention be paid to the respiratory function of patients with neurological conditions prior to myelography.