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Biomedical subjects

P Pelckmans

Publications and source records attributed to P Pelckmans.

28 records · Page 2Linked to original sources
PubMedDate not supplied

Polypoid and pseudopolypoid lesions of inflammatory bowel disease: diagnosis on double-contrast enema.

The radiological and pathological features of ulcerative colitis (UC) and Crohn's disease (CD) are well known for most radiologists and gastroenterologists but on double-contrast enema, polypoid and pseudopolypoid manifestations of inflammatory bowel disease (IBD) often remain a source of major confusion. Inflammatory polyps project above the level of the surrounding mucosa. Pseudopolyposis is seen when extensive ulceration of the mucosa down to the submucosa results in scattered circumscribed islands of relatively normal mucosal remnants. Postinflammatory polyps reflect a non-specific healing of undermined mucosal and submucosal remnants and ulcers, and are mostly multiple. They have no malignant potential. Patients with long-standing UC and CD are at increased risk for developing colorectal carcinoma. Dysplasia is a precancerous histologic finding and is frequently seen in colitic colons at high risk for carcinoma. Dysplasia may be found in a radiographically normal appearing mucosa or it may be accompanied by a slightly raised mucosal lesion, a so-called dysplasia-associated lesion or mass (DALM lesion) and as a consequence radiographically detectable. Because differentiation of adenocarcinoma and dysplasia from inflammatory or postinflammatory polyps is sometimes difficult or impossible on double-contrast enema, endoscopy and biopsy are necessary for making a final diagnosis.

Barium Sulfate↗
PubMedDate not supplied

The value of medical imaging in uncomplicated and complicated Barrett's esophagus.

Barrett's esophagus is an acquired condition characterized by a progressive columnar metaplasia of the distal esophagus caused by longstanding gastroesophageal reflux and reflux esophagitis. Barrett's esophagus is a premalignant condition associated with a significantly increased risk of developing esophageal adenocarcinoma. The purpose of this article is to provide an overview of the radiologic aspects of Barrett's esophagus and esophageal adenocarcinoma. Review of the literature shows that some findings on esophagography that are relatively specific for Barrett's esophagus are not sensitive, while others that are sensitive have a low specificity. Specific radiologic features allowing a confident diagnosis of Barrett's esophagus are a high esophageal stricture or ulcer associated with a hiatal hernia and/or gastroesophageal reflux. A reticular mucosal pattern is a relatively specific sign particularly if located adjacent to a stricture and is highly suggestive of Barrett's esophagus. Unfortunately, these findings are only present in a minority of cases. More common but nonspecific findings include gastroesophageal reflux, hiatal hernia, reflux esophagitis and/or peptic stricture in distal esophagus. These findings may also be present in patients with uncomplicated reflux disease. Barrett's esophagus carries a risk of malignant change. Early adenocarcinoma may appear as a plaque-like lesion or with focal irregularity, nodularity, and ulceration of the esophageal wall. Invasive adenocarcinoma may be seen as an infiltrating ulcerated mass. The radiologic diagnosis of Barrett's esophagus is limited by lack of criteria that are both sensitive and specific. The major value of double-contrast esophagography is its ability to classify patients into high risk (high stricture, ulcer or reticular pattern), moderate risk (esophagitis and/or distal peptic strictures), and low-risk (absence of esophagitis or stricture) for Barrett's esophagus determining the relative need for endoscopy and biopsy. Endoscopy and biopsy are generally advocated to make a definitive diagnosis. Endoscopic ultrasound plays a role in the early detection of invasive carcinoma and the staging of proven carcinoma but has no role in the surveillance of Barrett's esophagus.

Adenocarcinoma↗
PubMedDate not supplied

The use of ursodeoxycholic acid in patients with primary biliary cirrhosis: sense or nonsense.

Ursodeoxycholic acid is the most widely evaluated drug for the treatment of primary biliary cirrhosis. The results of the first randomized controlled trials are very discordant in terms of survival benefit. This, however, can be explained by differences in methodology and insufficiently long period of treatment and follow-up. It has clearly been demonstrated that serum bilirubin levels and histological parameters such as piecemeal necrosis and fibrosis are validated predictors of prognosis in PBC. We re-analyzed the already published data using these parameters as surrogate endpoints. This analysis reveals that there is a significant positive effect of treatment of PBC with UDCA on serum bilirubin levels as well as on the progression of piecemeal necrosis and fibrosis. We therefore conclude that UDCA has a positive effect on the prognosis of PBC and can slow down the progression to end stage liver disease.

Bilirubin↗
PubMedDate not supplied

Autoimmune pancreatitis with evolution to cholangitis: a case report.

We report the case of a 47-year-old Caucasian male patient who presented with obstructive jaundice and mild epigastric pain. Autoimmune pancreatitis was diagnosed based on magnetic resonance imaging, biopsy and clinical evolution, and the patient was successfully treated with corticosteroids. However, a few months later ERCP showed an image compatible with sclerosing cholangitis. Again, treatment with corticosteroids was given, after which the bile ducts became normal. A few months later, again there was a relapse and azathioprine was started. After decreasing the dose of immunesuppression, we saw relapses of cholangitis and pancreatitis, with eventually evolution to chronic calcifying pancreatitis. The aim of this report is to describe autoimmune pancreatitis as a cause of obstructive jaundice, and to illustrate that evolution to an immunesuppression-responsive cholangitis, with evolution to chronic calcifying pancreatitis is possible. Also, our patient had a small fluid collection, possibly a pseudocyst, an unusual finding in autoimmune pancreatitis, which disappeared during treatment.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Meckle's diverticulum in association with Crohn's disease.

Although it is not uncommon to encounter a Mecklel's diverticulum in a patient with Crohn's disease, the involvement of this diverticulum by Crohn's disease is less common. A well performed radiological small intestinal study strongly suggests the diagnosis, which is definite after histologic examination of the reported.

Adult↗
PubMedDate not supplied

Transrectal ultrasonographic examination of the anal sphincter.

Transrectal Ultrasonography (TRU) provides an excellent imaging of the rectal wall, the perirectal structures (1) and especially of the anal sphincter (2,3). We used a rigid endorectal probe with a linear and a radial ultrasonic window, and with a frequency of 5 MHz (model IUV 5060; Toshiba, Japan). The linear scanning provided a better imaging of the anal sphincter and was preferred to the radial scanning, especially when measuring the sphincter dimensions.

Anal Canal↗