Search PubMed⌕ Search

Biomedical subjects

O Ekberg

Publications and source records attributed to O Ekberg.

At least 145 records · Page 8Linked to original sources
PubMed1985

Defective closure of the laryngeal vestibule: frequency of pulmonary complications.

Aspiration and its potential complications, bronchopneumonia and other pulmonary diseases, were studied in 67 fully conscious and mobile patients with cineradiographically verified dysfunction of swallowing. They were compared to a group of 67 patients of similar age with normal swallowing. Bronchopneumonia was found in nine (13%) of the patients with aspiration compared to two (3%) of the patients without (p = 0.05). Chronic pulmonary disease was more frequently observed in patients with aspiration than in those without, seven (10%) and one (1.5%), respectively (p = 0.03). Even though pulmonary complications of defective closure of the laryngeal vestibule are not frequent, swallowing training for fully conscious and relatively mobile patients would seem desirable.

Aged↗
PubMed1984

Barium/air double contrast examination of the small bowel in Crohn's disease.

In patients with Crohn's disease the radiological demonstration of small bowel lesions requires an elaborate and meticulous technique. The barium/air double contrast technique is a method for accurate delineation of normal and abnormal small bowel morphology. By distending the bowel transmural lesions are accurately evaluated. A precise assessment of the axial extension of disease is possible due to an 'en face' presentation which is more sensitive than a 'profile' presentation for detection of superficial lesions.

Air↗
PubMed1984

Are superficial lesions of the distal part of the ileum early indicators of Crohn's disease in adult patients with abdominal pain? A clinical and radiologic long term investigation.

The possibility of early superficial Crohn's disease should be considered when mucosal irregularities without transmural abnormalities are seen in the distal 15 cm of the ileum in young patients with protracted symptoms of abdominal pain and diarrhoea. Radiologic assessment of the small bowel is improved using the barium/air double contrast technique and in this study mucosal abnormalities were categorised as a 'mucosal nodularity pattern', an 'abnormal mucosal fold pattern', and a 'specks of barium pattern'. None of the 21 patients followed prospectively for four to seven years developed established criteria for Crohn's disease, or any other chronic progressive disease of the small bowel. Colon examinations were normal. In comparison 26 patients with histologically proven Crohn's disease of the ileum were studied retrospectively and no similar clinical or radiologic characteristics were present. It is concluded, therefore, that such isolated superficial lesions are not pathognomonic and are not early indicators of Crohn's disease or any other chronic progressive disease of the small bowel.

Abdomen↗
PubMed1984

Herniographic appearance of contralateral inguinal hernia.

In 303 adults (185 men, 118 women) with unilateral groin pain and a normal physical examination, positive contrast herniography was performed. In 32 per cent of the patients a symptomatic hernia (ipsilateral) and in 18 per cent an asymptomatic hernia (contralateral) were found. The type of hernia was indirect, direct, femoral or obturator. Indirect and direct inguinal hernias were significantly more frequent on the ipsilateral side compared with the contralateral in men with right-sided groin pain. In women with left-side groin pain femoral hernias were significantly more frequent on the ipsilateral side compared with the contralateral. The size alone could not discriminate between ipsi- and contralateral hernias. The results indicate that in most patients there is no specific radiographic appearance which can discriminate between symptomatic and asymptomatic hernias.

Adult↗
PubMed1984

Herniography in patients with clinically suggested recurrence of inguinal hernia.

In order to assess the diagnostic effectiveness of herniography in patients with pain in the groin, 49 patients who had been operated upon earlier for inguinal or related hernias in the groin were examined. The patients' history suggested the presence of recurrent hernia but physical examination was inconclusive. In 17 patients herniography revealed one or two hernias on the side of the symptoms: 2 indirect hernias, 9 direct hernias, 1 with both direct and indirect hernias, 1 with a combined hernia, and 4 femoral hernias. An incisional hernia was detected in 2 patients. Eleven of the 17 patients were operated upon. The results indicate that herniography is valuable in the follow-up of patients with possible recurrent inguinal hernia.

Adult↗
PubMed1984

Radiology in primary gastric lymphoma.

Upper gastro-intestinal radiographic studies in 19 patients with primary gastric lymphoma (PGL) were reviewed and compared with studies in matched patients with adenocarcinoma. The very large infiltrating tumour (n = 10) was significantly more often found in patients with PGL, whereas the ulcerative lesion was the predominating feature in patients with adenocarcinoma (n = 15). Furthermore a coarse, irregular mucosal pattern and shallow ulcerations were frequently associated with PGL (n = 18). There was no difference in survival time between the two groups of patients. PGL is a rare disease, with two new cases annually in a population of 230 000, and therefore easily misjudged.

Adenocarcinoma↗
PubMed1984

Herniography in atypical inguinal hernia.

In patients with unclear groin pain herniography has revealed hernia in 36% of the patients with a normal physical examination. Most of the hernias detected on herniography are of indirect, direct or femoral type. The former two are found predominantly among men and the latter among women. These types of hernia are defined herniographically according to their location and shape. Whether or not a hernia is present is usually obvious although small hernias may be obscured by pelvic bone and contrast medium in the inguinal fossae and pouch of Douglas. In most patients the hernias are conspicuous and easy to classify correctly. Problems may, however, arise in the precise definition of some types of hernia. In this respect positive contrast herniography contributes to the pre-operative evaluation in patients with inguinal hernia. The aim of the present report is to describe some less well-known herniographic findings. The clinical impact of the particular findings is discussed.

Adolescent↗
PubMed1983

Epiglottic dysfunction during deglutition in patients with dysphagia.

Among 250 patients with dysphagial complaints, 83 had dysfunction of the epiglottis as revealed by high-speed cineradiography. Nineteen patients had a totally immobile epiglottis and of these 11 had concomitant pharyngeal constrictor paresis. Sixteen of the patients with immobile epiglottis had misdirected swallowing. An absence of the second movement of the epiglottis during deglutition was registered in 53 patients. Thirteen of these had pharyngeal constrictor paresis and 45 had misdirected swallowing. In 11 patients the epiglottis attained an obliquity of 30 degrees to 90 degrees as seen in the anteroposterior projection during its second movement. One of these had a pharyngeal constrictor paresis, while four had misdirected swallowing. The results of this study indicate that epiglottic dysfunction is common among patients with dysphagia and is often accompanied by other functional abnormalities.

Adult↗
PubMed1983

Pharyngeal dysfunction after treatment for pharyngeal cancer with surgery and radiotherapy.

Radiologic examinations of the pharynx were performed in 13 patients presenting with dysphagia following treatment of pharyngeal cancer with excision and radiotherapy. The conventional single-film technique or double-contrast examination was unremarkable, although 2 patients had clinical evidence for local recurrence. The patients were also examined with cineradiography using a film speed of 50 and 100 frames/sec. Various functional abnormalities (pharyngeal paresis, epiglottic dysfunction, dysfunction of the laryngeal vestibule, cricopharyngeal incoordination, and cervical esophageal webs) were found in all but 1 patient. The results indicate that functional abnormalities of the pharynx secondary to radiotherapy and surgery are common in patients who have dysphagia after treatment. These functional pharyngeal disorders are accurately diagnosed with cineradiography.

Adult↗
PubMed1983

Cineradiography in 45 patients with acute dysphagia.

The function of the pharyngoesophageal stage of deglutition was studied by cineradiography in 45 patients with an acute onset of dysphagia. None of the patients had any radiographically detectable foreign body in the pharynx or esophagus. In 34 of the patients (76%) a functional or morphodynamic abnormality was disclosed; a defective closure of the laryngeal vestibule (26 patients), defective movements of the epiglottis (18 patients), uncoordinated relaxation of the cricopharyngeal muscle (14 patients), paresis of pharyngeal constrictor muscles (9 patients), and cervical webs (9 patients). In 21 of the patients more than 1 type of dysfunction was present. The results of this study suggest that cineradiography of the pharyngoesophageal stage of deglutition is useful in patients with acute dysphagia, without a foreign body, as functional abnormalities often can explain the patients' complaints.

Acute Disease↗
PubMed1983

Lateral diverticula from the pharyngo-esophageal junction area.

Conventional single-radiograph technique and cineradiography were used for examination of the pharyngo-esophageal junction area during contrast medium swallowing in 500 patients with dysphagia and in 150 volunteers with no swallowing complaints. Seventeen pharyngoesophageal diverticula were found, emerging in the lateral or latero-anterior direction just below the cricopharyngeal muscle indentation. Of these, 13 had wide openings and seven had narrow openings; these forms differed in shape and in retention of contrast material during the swallowing cycle. The delineation and discrimination of the type and behavior of the diverticula were more accurately done on the cineradiographs than on the single radiographs. Five freshly obtained specimens of the pharynx and esophagus were also dissected; a weak triangular area was found located caudally to the cricopharyngeal muscle (transverse portion) in the lateral and anterior aspect of the pharyngo-esophageal junction area.

Cineradiography↗
PubMed1983

Complications after herniography in adults.

Positive contrast herniography has been used in adult patients with unexplained groin pain for the detection of clinically occult inguinal hernias. Herniography involves puncture of the anterior abdominal wall and injection of an iodine contrast medium. Complications may be encountered from either phase of the procedure and were recorded in 19 (5.8%) of 330 herniographies. Difficulties in puncturing the abdominal wall as well as in injecting the contrast medium were noted in 12 (3.6%); these difficulties included injection into the stomach (one patient), left iliac vein (one patient), colon (three patients), and anterior abdominal wall (four patients). In three patients a painful hematoma developed at the site of puncture. Adverse reaction to the injection of contrast medium (80 ml meglumine metrizoate, 200 mg l/ml) was noted in seven (2.1%) patients. Five of these had a vasovagal reaction and two developed severe abdominal pain within a few hours after the examination. They were hospitalized for 24 hr due to suspected peritonitis. When 52 consecutive patients were asked about pain during or after the injection of contrast medium, 15% described severe pain while 23% admitted moderate pain. As in other invasive examinations, herniography involves a certain risk. This study shows that complications occur with the same or lower frequency than in urography.

Abdomen↗
PubMed1983

Webs and web-like formations in the pharynx and cervical esophagus.

Webs were registered in the hypopharynx and cervical esophagus in 63 out of 500 dysphagial patients (12.5%) examined by radiography (single-film and cineradiography). Of these webs three were located above the level of the cricopharyngeal muscle. All the webs had smooth contours, were distinct and appeared unchanged on repeated swallowings. They were located mostly in the anterior wall, but could be circular. Such webs were found in only 2 of the 150 volunteers (1.3%). Therefore, it is reasonable to assume that these webs may give rise to dysphagia. Another form of mucosal folding on swallowing was registered in the lateral wall of the pharynx at the distal margin of the piriform sinuses in 16 of the 500 dysphagial patients (3.2%) and in 9 of the 150 nondysphagial volunteers (6%). This web-like phenomenon could be reproduced and identified in 5 freshly obtained autopsy specimens in which a mucosal fold was regularly formed on distention at the distal margin of the piriform sinuses due to loosely attached mucosa. This mucosal folding does not seem to have any pathologic significance nor does it cause dysphagia. With the aid of cineradiography it is possible to distinguish true webs from other web-like phenomena that are due to the described insignificant mucosal foldings.

Cineradiography↗
PubMed1982

Pharyngeal constrictor paresis in patients with dysphagia: a cineradiographic study.

Among 250 patients examined by cineradiography because of dysphagia 25 were found to have a more or less pronounced paresis of the pharyngeal constrictor muscle. The paresis included all three portions of the muscle in six patients. A localised lesion was found in 19 patients and included the superior portion of the pharyngeal constrictor muscle in one patient, the middle portion in 16 patients and the middle and inferior portions in two patients. All 25 patients exhibited concomitant cineradiographic abnormalities, including impairment of the tilting down of the epiglottis, dysfunction of the cricopharyngeal muscle and retention of barium in the pharynx. With the aid of cineradiography it is possible to disclose an underlying pharyngeal constrictor paresis in about 10% of patients with dysphagia who are referred for radiographic examination. In most patients suffering from a localised pharyngeal paresis the diagnosis will be overlooked in a routine examination, but will be easily demonstrated with cineradiography.

Aged↗
PubMed1982

Movement of the epiglottis during deglutition. A cineradiographic study.

The movements of epiglottis during swallowing of barium were studied by high-speed cineradiography in 150 volunteers who had no dysphagia. In 137 individuals the epiglottis tilted down in a two-step fashion during deglutition. The first movement from an upright to transverse position was accomplished by elevation of the larynx and approximation of the hyoid bone and thyroid cartilage. This first movement is evidently a passive one and induced by the muscles that lift the hyoid bone. The second movement of the epiglottis, from transverse to an inverted position, occurs later in swallowing and seems related to contraction of the thyroepiglottic muscle. The second epiglottic movement was absent in 7 individuals, and 6 others demonstrated obliquity of their epiglottis (30-90 degrees) when studied in AP projection.

Adult↗
PubMed1982

Colon cleansing regimens. A clinical study in 1200 patients.

The purgative effect of bisacodyl, anthraquinone glycosides (Cascara), and sodium picosulfate, alone or in combination with a saline purge and a tap water enema, was studied in 1200 patients. The cleansing effect was scored with regard to retained fecal residue evident on double-contrast studies of the colon. The combination of a contact laxative and a saline purge produced good cleansing effect in 52%-80% of the patients. With an additional tap water enema given 1 hour before the colon examination, however, 96% of the colons were clean. The taste and the effects of the cleansing systems were tolerated favorably by more than 90% of the patients. However, 17% reported restriction in work capacity on the day of bowel cleansing.

Adult↗
PubMed1982

Dysfunction of the cricopharyngeal muscle. A cineradiographic study of patients with dysphagia.

Of 250 consecutive patients with dysphagia studies by cineradiography, 55 (22%) had dysfunction of the cricopharyngeal muscle, indicated by an indentation of the pharyngo-esophageal junction during swallowing. The indentation measured less than 25% of the esophageal diameter in 29 patients, less than 50% in 18, and greater than 50% in 8 and was transient in 36 patients and continuous in 19. In 35 patients, abnormalities of swallowing were seen, including pharyngeal constrictor paresis [8], epiglottic dysfunction [17], misdirected swallowing [23], and esophageal webs [19]. Cineradiography during swallowing is important in the diagnosis, since dysfunction is often overlooked on a routine examination.

Adult↗