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Biomedical subjects

N Lamki

Publications and source records attributed to N Lamki.

At least 37 records · Page 2Linked to original sources

Computed tomography of complicated cholecystitis.

Reported are 10 patients with surgically verified acute cholecystitis and its complications. Of these 10 patients, 6 (60%) had atypical clinical presentation so that cholecystitis was not the primary diagnosis being considered before computed tomography. Common computed tomography findings included gallbladder wall thickening (100%), pericholecystic fluid (80%), gallstones (50%), and air in the gallbladder lumen and wall (20%). An awareness of the computed tomography appearances can be helpful in the diagnosis of complicated cholecystitis even when the clinical presentation is atypical.

Acute Disease↗

Sonography in the diagnosis of hepatic artery aneurysms.

In five cases of hepatic artery aneurysms, the findings on sonography suggested the diagnosis or indicated the need for angiography. The intrahepatic aneurysms (four cases) were anechoic, well-circumscribed masses with good through transmission of sound. None were pulsatile, but flow within the mass was observed in one case. An intrahepatic mass adjacent to the aneurysm was identified in every case, representing hematoma in three and postoperative abscess in one. The sonogram in a patient with a common hepatic artery aneurysm (one case) showed a lobulated, pulsatile, anechoic mass within a pancreatic head pseudocyst. Sonography offers a noninvasive means of screening for this abnormality.

Adolescent↗

Computed tomography in pelvic liposarcoma: a case report.

A case of well-differentiated pelvic liposarcoma with unusual presentation of low-back pain and sciatica, due to the herniation through the greater sciatic notch, is described. Computed tomography is invaluable, not only in predicting the histologic diagnosis, but also in outlining the location, extent, and size of the tumor. This allows accurate planning of the surgical approach.

Back Pain↗

A pseudomass on pelvic computed tomography: a pitfall to avoid.

Reported here is a patient with celiac disease in whom a spurious pelvic mass was suggested by computed tomography. This pitfall can be prevented by an awareness of the normal appearance of the small bowel following intravenous contrast enhancement and by monitoring of the examination by a radiologist. Delayed scanning or real-time ultrasound examination will confirm that the initial computed tomography appearance is due to small bowel loops.

Adult↗

Computed tomography in detection of occult hypernephroma.

Five cases in which computed tomography (CT) detected a hypernephroma that had been missed by one or more of the other imaging modalities are reported here. Computed tomography may have an important role in the diagnosis of radiologically occult hypernephroma.

Adenocarcinoma↗

The non-visualized gallbladder by ultrasonography implications and differential diagnosis.

The findings in 42 consecutive patients in whom the gallbladder or its lumen were not visualized ultrasonographically were reviewed retrospectively for evidence of gallbladder disease. The series contains two groups of patients--the larger comprised 32 patients in whom the gallbladder was represented only by a dense echogenic focus, with acoustic shadowing, in the right upper quadrant, thought to be due to cholelithiasis in a small contracted gallbladder. The accuracy of this finding in predicting gallbladder disease was 96%. The smaller group consisted of eight patients in whom the gallbladder was not visualized. In seven patients with follow-up, the accuracy of this finding in predicting gallbladder disease was only 71%. Dense echoes in the right upper quadrant were not always due to cholelithiasis but to emphysematous cholecystitis in one patient, porcelain gallbladder in a second, and agenesis of the gallbladder in a third.

Calcinosis↗

Radiologic investigation of suspected extrahepatic biliary obstruction.

Data for 94 patients clinically suspected of having extrahepatic biliary obstruction who were referred for radiologic investigations were studied to compare the value of various imaging modalities used to detect this condition. Computed tomography emerged as the best indirect, noninvasive technique and percutaneous transhepatic cholangiography as the best direct technique. A standard approach to investigating suspected extrahepatic biliary obstruction is suggested that takes into consideration the interventional radiologic techniques currently used to treat this condition.

Alkaline Phosphatase↗

The role of computed tomography in abdominal and pelvic trauma.

CT findings in 32 patients with abdominal and pelvic trauma are the subject of this report. Four patients had more than one organ involved. The most common abdominal organ to be injured in our series was the pancreas, unlike other series. Findings of pancreatic, splenic, hepatic, renal, and pelvic injuries are described. The role of CT in the investigation of a patient with abdominal and pelvic trauma is discussed and compared with other imaging modalities. CT was found to be superior especially as it is highly sensitive and not organ specific.

Abdominal Injuries↗

Halo around the gallbladder--a prognostic sign?

The implications of the finding of a sonolucent zone around the gallbladder, characterized on ultrasonography by loss of definition of the outer (serosal) aspect of the gallbladder wall with a moderately well defined inner (mucosal) surface in patients with signs and symptoms of acute cholecystitis, are described. Of the nine consecutive patients with this finding, five were found to have gangrenous cholecystitis and/or perforation of the gallbladder at surgery. Four of these patients were operated upon within 24 hours of the ultrasound study, one 19 days later. The pathologic basis for this finding is thought to represent massive thickening of the gallbladder wall, with a possible contribution from adherent edematous omentum in the region of the fundus of the gallbladder. Thus this finding of a sonolucent halo about the gallbladder was important in our series, being frequently an indicator of acute cholecystitis complicated by gangrene with or without perforation of the gallbladder.

Acute Disease↗

HIDA and pseudosplenomegaly in hydatid cyst and amebic abscess of liver.

Tc-99m-HIDA and related compounds have been universally accepted for studying the hepatobiliary system. The authors describe yet another use of HIDA documented by three case reports. HIDA is taken up by the hepatocytes and not by the reticuloenthothelial system. Two patients are described, one with hydatid cyst and the second with amebic abscess of the liver, in whom splenomegaly was diagnosed clinically and confirmed by ultrasonography as well as by Tc-99m-tin colloid scan. HIDA imaging proved the spleens to be normal. A displaced right lobe of the liver in one case, and an enlarged left lobe in the other, led to this erroneous diagnosis, which the authors term "pseudosplenomegaly." In the third patient, HIDA not only clarified the extent of the spleen, but also revealed a "cold" area in the left lobe of the liver. This was missed by the colloid scan because of the position of the "cold" area.

Adult↗

Radionuclide studies of chronic schistosomal uropathy.

Fifty patients with chronic urinary tract schistosomiasis were studied with 99mTc-DTPA. All had a flow study, sequential analog imaging, and digital imaging for 25-35 minutes (20-sec. frames). Time-activity curves (DTPA renograms) were extracted; 12 patients had 131I-Hippuran probe renograms as well. Renal changes included diminished perfusion and structural abnormalities ranging from minor calyceal dilatation to overt hydronephrosis. Ureteral changes included dilatation, tortuosity, and kinking. Marked distortion of the ureterovesical junction was seen in some patients due to periureteral and perivesicular fibrosis, which is a major factor in upper urinary tract damage. Renograms showed varying obstruction and parenchymal damage. Nuclear medicine complements excretory urography and is sometimes preferable for visualization of the ureters. After the initial urogram, sequential DTPA scanning and renography are sufficient for follow-up.

Adolescent↗