Biomedical subjects
Publications and source records attributed to R J Rust.
During the examination of a young patient with acute renal failure, bone imaging was performed for evaluation of possible osteomyelitis. Marked soft tissue activity was seen on the bone scan. The patient admitted to recent intravenous cocaine use. Vasoconstriction from cocaine use was thought to induce rhabdomyolysis, which led to acute renal failure with myoglobulinuria.
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Ninety-four abdominal CT examinations of 91 patients with intraperitoneal fluid were reviewed, and in 25 scans (27%) triangular fluid collections were found within the leaves of the mesentery or adjacent to bowel. In a control group of 30 patients without CT evidence of intraperitoneal fluid, no triangular densities were identified. Triangular fluid collections were visualized in a higher percentage of patients when the quantity of intraperitoneal fluid was moderate to large, IV contrast was given, good bowel opacification was obtained, the amount of mesenteric fat was moderate to large, and the abdominal CT examination included cuts through the pelvis. A triangular fluid collection was reproduced in a cadaver by intraperitoneal infusion of saline. Percutaneous needle aspiration confirmed that the saline collection was responsible for the CT findings. The CT appearance of this new triangle sign is demonstrated.
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The effects of saline and 3 contrast media, Amipaque, Gastrografin and barium, were evaluated for 24 hours following intratracheal instillation in rabbits. Respiratory rates, serial chest films, and pathologic examination of the lungs demonstrated that Amipaque induced significantly less respiratory distress than the other 2 contrast media whereas inflammatory reactions were comparable for all of the media. Significant pulmonary edema occurred with both Amipaque and Gastrografin but was greater with Gastrografin. Both of these media were cleared from the lung within 24 hours, however barium continued to obstruct bronchi and fill alveolar air spaces. It is concluded that in comparison to Gastrografin and barium, Amipaque is relatively innocuous in the lung.
The appearances of intraperitoneally injected Amipaque and the absorption rate are described. At 30 min after injection the peritoneal concentration was decreased and the urinary tract began to fill. At one hour, almost all Amipaque had disappeared from the peritoneal cavity and the urinary tract was well demonstrated. As absorption of Amipaque from the gastrointestinal tract is minimal, bowel perforation is thus indicated if, after oral administration, it appears in either the peritoneal cavity or the urinary tract.
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