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Biomedical subjects

R J Stanley

Publications and source records attributed to R J Stanley.

At least 73 records · Page 4Linked to original sources
PubMed1985

Pancreatic imaging.

Methods now available for evaluating the pancreas include computed tomography, ultrasound, angiography, endoscopic retrograde cholangiopancreatography, and percutaneous fine-needle aspiration. Computed tomography is best for initial evaluation of the patient with suspected pancreatic disorders as it is technically adequate and provides detailed anatomic information. Ultrasound also provides detailed information and survey capabilities but examinations are often technically unsatisfactory. Angiography, endoscopic retrograde cholangiopancreatography, and fine-needle aspiration provide important diagnostic information but are more invasive and require considerable operator skill. These techniques are secondary tests not indicated for the initial evaluation of every patient. No single test will always provide all necessary diagnostic information, and the appropriate utilization of each method requires an understanding of its strengths and weaknesses.

Acute Disease↗
PubMed1985

Lymphoepithelioma (undifferentiated carcinoma) of the laryngohypopharynx.

Lymphoepithelioma (World Health Organization type 3, undifferentiated carcinoma of the nasopharyngeal type) is an extremely rare cancer in the laryngohypopharyngeal regions. We found reports of only 6 such tumors in the English language medical literature; 1 of the 6 was from our institution. We report four additional cases seen at the Mayo Clinic. Radiotherapy controlled disease at the primary site in three of the four cases. The neoplasm has a propensity for early, widespread dissemination. Three of our four patients died of extensive visceral and nodal metastases. One patient has survived eight years without a recurrence.

Carcinoma, Squamous Cell↗
PubMed1985

Allergic reaction to Hulka clips.

Hulka clip sterilization has become a popular method of tubal occlusion. A case is presented in which the gold covering the Hulka clip resulted in an allergic reaction, evidenced by sterile abscess formation and resulting in exploratory laparotomy for removal of the Hulka clips, sterile abscess, and resultant adhesions. To the authors' knowledge, no previous case has been presented of this type of gold allergy. It would appear that careful screening for gold allergy should be undertaken before tubal sterilization with Hulka clips.

Abscess↗
PubMed1984

Inverted papilloma in a 10-year-old boy.

Inverted nasal papillomas are rare tumors in children. Four large series include only a single patient (of a total of 269) younger than 20 years. We report the occurrence of an inverted nasal papilloma in a 10-year-old boy; this tumor exhibited clinical and histopathologic features identical to those of similar neoplasms in adults. Inverted papillomas in children should be treated by wide local excision, usually using a lateral rhinotomy approach. The rationale for such aggressive surgery is based on the high rate of recurrence (25% to 75%) and a propensity for the development of carcinomas (5% to 15%) as associated lesions.

Child↗
PubMed1984

Carcinoma of the ampulla of Vater presenting as acute pancreatitis.

The presentation of ampullary carcinoma as acute pancreatitis has been documented only in scattered reports but may be more common than is generally appreciated. More typically this uncommon gastrointestinal neoplasm presents with obstructive jaundice, weight loss, anorexia, and nonspecific abdominal pain. A case of ampullary carcinoma is presented in which the clinical features and computed tomographic appearance were those of relapsing, acute pancreatitis. Only after various clinical and radiographic features indicated on ampullary lesion was the etiology of the pancreatitis finally established and a curative resection performed.

Adenocarcinoma↗
PubMed1984

CT appearance of Mirizzi syndrome.

Mirizzi syndrome consists of extrinsic compression of the common hepatic duct by gallstones in patients with cholecystitis. Computed tomography done with techniques that optimize spatial resolution may aid diagnosis by permitting identification of the precise level of and the extrinsic nature of the obstruction.

Adult↗
PubMed1984

Abdominal tuberculosis: CT findings.

The computed tomographic (CT) characteristics of intraabdominal tuberculosis are not specific. A recent article from South Africa proposed a set of criteria that included high density ascites and mesenteric involvement, consisting of thickening and adenopathy, as possible criteria for the diagnosis of tuberculous peritonitis by CT. Review of three additional cases of abdominal tuberculosis showing these findings supports the criteria defined in the earlier study. Although not definitive, these findings in the appropriate clinical setting should suggest the possibility of tuberculosis.

Adult↗
PubMed1984

CT diagnosis of segmental pulmonary artery embolus.

A patient with pathologically proven pulmonary embolism that was diagnosed on computed tomography (CT) is presented. The clot in an artery with a diameter less than 1 cm was clearly demonstrated as was an associated pulmonary infarct, which appeared hyperdense on contrast enhanced scan. The potential of CT to noninvasively demonstrate pulmonary embolism, particularly in smaller arteries, is discussed.

Acute Disease↗
PubMed1983

CT of the thorax in patients with achalasia.

The computed tomographic appearance of achalasia of the esophagus is described in three patients. The CT findings should enable one to suggest the diagnosis of achalasia even in those patients in whom this condition is not suspected. The final diagnosis can be confirmed by esophagography and manometric studies.

Adult↗
PubMed1983

Computed tomographic features of biliary obstruction.

A retrospective review of CT scans in 69 consecutive patients with proven biliary obstruction due to both malignant and benign causes was performed to define and differentiate CT changes. Abrupt termination of a dilated extrahepatic biliary duct was characteristic of a malignant process in the absence of a mass. Gradual tapering of a dilated duct was specific for benign disease. Other findings, such as degree of intra- or extrahepatic duct dilatation and presence or absence of a dilated pancreatic duct were not reliable in distinguishing benign from malignant causes. The authors also found CT to be accurate in detecting common duct stones with a sensitivity exceeding 80%.

Adult↗
PubMed1983

Advances in the radiology of jaundice: a symposium and review.

New radiologic imaging and interventional techniques have transformed the clinical management of biliary obstruction. Selected aspects of their application were reviewed in a symposium conducted at the 12th annual meeting of the Society of Gastrointestinal Radiologists held recently at Banff, Alberta, Canada. There is a consensus that sonography is the preferred initial screening procedure for bile duct dilatation because of its accuracy and sensitivity although computed tomography more precisely displays the level and cause of obstruction. Transhepatic drainage provides effective decompression for malignant obstruction, but the high rate of postprocedure catheter dysfunction suggests that an indwelling endoprosthesis may be more suitable for short-term palliation. Endoscopic papillotomy has proven to be successful nonoperative therapy for choledocholithiasis and also permits retrograde placement of transpapillary stents. Communication and collaboration among the radiologist, endoscopist, and biliary surgeon are essential if these new methods are to be applied optimally to the various clinical problems encountered with bile duct obstruction.

Bile Duct Diseases↗
PubMed1983

CT appearance of sclerosing cholangitis.

Ten cases of sclerosing cholangitis, both primary and secondary forms, were found to have similar abnormalities within the liver on CT examinations. These changes are different from those seen in cases of biliary obstruction due to tumor, stone, inflammatory mass, or other focal process. The finding of focal, discontinuous areas of minimal intrahepatic biliary dilatation without associated mass lesion seems to be highly suggestive of sclerosing cholangitis. Only the rare, diffuse form of cholangiocarcinoma would be likely to produce a similar CT appearance.

Cholangitis↗