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.
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Portable films were monitored for 10-day periods in 1979 and 1982. Information was gathered on the indications for the examinations, the number of positive findings and their relation to the clinical condition of the patient, and whether or not the examination was properly performed as a portable or emergency examination. There were positive radiographic findings in 45.4% of the examinations. The most common indication for requesting an examination was to monitor a known lesion including daily routine films; surprisingly, 37% of these examinations demonstrated new radiographic findings even though the patients demonstrated no change in their clinical status. Portable technique was indicated in 94% of the cases, while only 56% should have been ordered as an emergency.
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This study tested the hypothesis that the density of gallbladder and common duct visualization is dependent on the total amount of contrast material present (i.e., concentration and volume, rather than simply concentration). Finger cots (simulating gallbladders) and straws (simulating bile ducts) containing measured amounts of contrast material, were radiographed in a water phantom using standard radiographic factors. The films were classified by several radiologists as to their clinical usefulness. The concept that the gallbladder can be seen with lesser concentrations of iodine than the common duct, because the gallbladder is the thicker organ, was verified and is discussed.
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