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Biomedical subjects

R A Bloom

Publications and source records attributed to R A Bloom.

At least 37 records · Page 2Linked to original sources

Small bowel phytobezoars: detection with radiography.

The authors reviewed the radiographic findings in 19 patients with phytobezoars of the small bowel. The most common predisposing causes were previous gastric outlet surgery and persimmon ingestion. Twelve patients underwent contrast material-enhanced studies of the upper gastrointestinal tract, and one patient underwent a barium enema study. These examinations revealed four gastric, two duodenal, and eight small bowel phytobezoars in 10 patients. The obstruction caused by small bowel phytobezoars frequently occurred in the jejunum or proximal ileum, more proximally than has been reported in previous series. Barium studies are useful in differentiating obstruction due to postoperative adhesions from obstruction caused by bezoars. In addition, barium studies enable the detection of residual gastric bezoars. This information has important implications in patient treatment because bezoar obstruction is unlikely to respond to conservative treatment, and concurrent gastric bezoars must be removed to prevent recurrent bowel obstruction.

Barium Sulfate↗

The tooth-root sign: a characteristic appearance of distal ureteric calculi.

Diagnostic accuracy in identifying calculi in patients with ureteric colic is poor. Lower ureteric calculi may be confused with other pelvic calcific opacities. A characteristic appearance of some larger lower ureteric calculi is described and likened to the root of a tooth. It is hoped that the tooth-root sign will be of assistance in the diagnosis of distal ureteric stones.

Humans↗

Sonographic demonstration of hepatic venous gas in mesenteric arterial thrombosis.

Hepatic portal venous gas is an ominous prognostic sign in bowel necrosis from mesenteric arterial occlusion. Ultrasonic examination is a sensitive and accurate method of demonstrating portal venous gas. We describe a case where the ultrasonic diagnosis of portal venous gas led to the rapid diagnosis of bowel infarction. Ultrasound is an appropriate emergency examination in all patients with suspected mesenteric artery occlusion.

Aged↗

Widespread Castleman disease: CT and US findings.

The widespread form of Castleman disease is a rare condition that has been recognized only recently as a disease with an aggressive, often malignant course. The authors present computed tomographic (CT) findings in six patients with this condition and ultrasound (US) findings in four of the six. CT demonstrated splenomegaly and retroperitoneal lymphadenopathy in all six patients. In one patient, CT also showed additional widespread mesenteric and peripancreatic lymphadenopathy, a large mesenteric mass adherent to the descending colon in another, and mediastinal lymphadenopathy in a third. Three patients had peripheral axillary or inguinal lymphadenopathy. Enlarged lymph nodes were 1-4 cm in diameter, and none displayed contrast enhancement on CT scans obtained with drip infusion of contrast media. On US scans, the nodes were poorly echogenic in all four cases. In no case was focal liver or splenic infiltration seen on either CT or US scans.

Adolescent↗

Mediastinal lymph node metastases from gastrointestinal carcinoma.

Mediastinal and hilar lymphadenopathy secondary to gastrointestinal metastases rarely have been reported and have been considered to occur only in conjunction with lymphangitic lung spread. The current report is of 15 cases of hilar and mediastinal metastases secondary to pancreatic, gastric, and colonic primary tumors. In only three of these cases was lymphangitic lung involvement noted. Possible pathways of spread of these tumors to the mediastinal lymph nodes are discussed.

Autopsy↗

Metastatic tumours of bones of the hand and foot. A comparative review and report of 43 additional cases.

Metastases in the bones of the hands and feet are rare. The literature relating to these tumours has been reviewed, and 43 new cases are reported. In the cumulative total of cases, metastases to the hand outnumber those to the foot 2:1 (196 cases as against 94). Bronchial carcinoma is the most common neoplasm metastasising to the hand. Subdiaphragmatic neoplasms such as gastrointestinal, vesical, renal and uterine malignancies, metastasize more frequently to the foot. A possible explanation for this latter finding is the retrograde spread of tumour emboli from the vertebral venous plexus down incompetent leg veins.

Adult↗

The periosteal sunburst reaction to bone metastases. A literature review and report of 20 additional cases.

The periosteal sunburst reaction is an unusual response to metastatic bone tumours. Fifty such cases are reported in the literature, and 20 additional cases are reported in this study. The most common primary tumour showing this response is prostatic carcinoma, and the majority of cases are associated with osteoblastic metastases. Twenty percent of sunburst metastases occur in bones distal to the elbow and knee, a much higher prevalence than is found overall in bone metastases.

Adolescent↗

Spondylolysis in the upper lumbar spine. A study of 32 patients.

Reports of spondylolysis in vertebrae other than those of the lower lumbar spine are rare. We report 32 patients with upper lumbar spondylolysis who have been studied clinically, radiologically and scintigraphically. Twenty patients had bilateral lesions, and seven of those with unilateral lesions had structural changes or anomalies in the opposite posterior arch. Positive scans were found to be associated with a short clinical history, and indicated stress-related lesions. Our findings suggest that mechanical factors may play a role in the aetiology of spondylolysis in the upper lumbar spine similar to that which they play in the lower lumbar spine, and that local structural anomalies may contribute to abnormal loading of these vertebrae.

Adolescent↗

The assimilated os sustentaculi.

The assimilated os sustentaculi is a projection of bone from the medial aspect of the sustentaculum tali which is surmounted by a similar projection from the medial tubercle of the talus. The accessory joint so formed may develop secondary osteoarthritis changes. This congenital anomaly is very rare. The present report is of 2 additional cases.

Adult↗

Hypertrophic osteoarthropathy and primary intestinal lymphoma.

Hypertrophic osteoarthropathy (HOA) in association with primary bowel disease is rare, but is usually seen in patients with chronic diarrheal states, such as Crohn's disease and ulcerative colitis. We record the first case of HOA associated with primary intestinal lymphoma in a patient who presented with chronic diarrhea.

Adult↗

Evaluation of the excretory urogram in adult enuresis.

Excretory urograms in 216 primary enuretic adult males aged between 18 and 20 years were retrospectively evaluated. In no patient was there a finding considered relevant to the complaint. It is considered that, in the absence of urinary infection or other urological complaint in a patient with normal neurological status, excretory urography is a non-contributory examination in the investigation of adult male enuresis.

Adolescent↗

Renal sonography in American Burkitt lymphoma.

Renal involvement is a common finding at necropsy in patients with American Burkitt lymphoma, but its in vivo sonographic features have received little attention in the literature. Of 29 patients with American Burkitt lymphoma who underwent sonography, 10 were found to have renal involvement. The 10 patients demonstrated a range of abnormalities, notably renomegaly (nine patients), diffuse increase in cortical echogenicity (six), and focal renal masses (three). The focal infiltrations were, unexplicably, hypoechoic in two patients and hyperechoic in one. Hydronephrosis was seen in five patients. One patient had evidence of calcium phosphate renal stones. Response to therapy can be assessed by changes in renal size and cortical echogenicity, as well as disappearance of focal lesions.

Adolescent↗

Relationship of psoas width to osteoporosis.

We have related the radiographic width of the psoas muscle to age, degree of osteoporosis, height, and weight, and to constitution in 234 subjects. The psoas width correlated well with age. When the subjects were grouped according to age, an association was observed between narrowing psoas width and increasing osteoporosis. Narrowing of the psoas was evident some years prior to radiographic evidence of osteoporosis.

Age Factors↗

Preventing osteoporosis: current practices and problems.

A lateral x-ray of the thoracic and lumbar spine should be part of the routine examination of any woman aged 40 or older. Similarly, an anteroposterior x-ray of the hand as a first assessment may suggest a need for further investigation for osteoporosis. Estrogen treatment reduces the incidence of vertebral compression and has proven protective against central as well as peripheral bone loss. However, rapid bone loss after termination of estrogen therapy implies that the protective effect may last no longer than 2 to 3 years.

Adult↗

Prevalence of Paget's disease of bone in hospital patients in Jerusalem: an epidemiologic study.

Epidemiological studies have revealed the widely varied prevalence of Paget's disease of bone. The highest rates have been found in parts of England. The disease has been reported only infrequently in Jews and no previous studies of prevalence have been performed in the Middle East or Asia. In the present study an age- and sex-standardized rate of 1% was found among Jews, which is similar to that in many southern European populations. No case of Paget's disease of bone was found among Arabs in this study.

Aged↗

Bile duct tumours: prolonged survival by radiological management of T-tubes.

Carcinoma of the common bile duct is generally a slow-growing tumour which causes death by hepatic failure and ascending cholangitis secondary to obstruction. Internal drainage by surgical placement of a T-tube bypassing the tumour is widely employed, but survival times are generally short, averaging 9.9 months. The interventional radiologist can offer considerable prolongation of life with reduced hospitalization by means of percutaneous tube cleaning and catheter replacement. A case is presented where survival has been prolonged to 37 months by routine radiological catheter care.

Adenocarcinoma↗