Search PubMed⌕ Search

Biomedical subjects

W M Thompson

Publications and source records attributed to W M Thompson.

At least 91 records · Page 5Linked to original sources
PubMed1983

Aortic graft-enteric and paraprosthetic-enteric fistulas.

Gastrointestinal hemorrhage is often a late manifestation of an aortoenteric fistula. Warning symptoms may include back or abdominal pain, fever, anemia, hematochezia, or melena. This entity results from erosion of the gastrointestinal tract by an adjacent vascular prosthesis. A paraprosthetic-enteric fistula represents a step in the formation of a true aortoenteric communication. Aggressive diagnostic studies, including endoscopy, aortography, barium contrast, computerized axial tomography, and radionuclide scanning, may allow earlier diagnosis and correction than have occurred in the past. Treatment should include graft excision, closure of the bowel defect, appropriate antibiotic therapy, and extraanatomic revascularization if collateral flow is not adequate. Our experience with 21 patients has illustrated the high mortality rate (74 percent) when operative treatment is delayed until massive hemorrhage occurs.

Aged↗
PubMed1983

Esophageal cancer.

The important concepts of carcinoma of the esophagus are reviewed in this article. Pathology of malignant esophageal tumors is described and tumor behavior of squamous cell carcinoma is discussed and illustrated. Various classifications and staging methods are reviewed with emphasis placed on the TNM system. The role of current imaging techniques in patients with esophageal carcinoma is presented. Computed tomography is discussed and illustrated in detail. The relative cost effectiveness of these procedures is presented and an imaging approach emphasizing TNM staging is described for patients with known carcinoma of the esophagus. This imaging approach is integrated with the basic aspects of treatment and both curative and palliative pathways are presented. The final section of the article deals with these same concepts in patients with carcinoma of the gastroesophageal junction. The important differences between adenocarcinoma of the gastroesophageal junction and esophageal carcinoma are described.

Adenocarcinoma↗
PubMed1983

The value of the preoperative barium-enema examination in the assessment of pelvic masses.

The value of the barium-enema examination in the assessment of pelvic masses was studied in 44 patients. Findings from those barium-enema examinations and from pathological specimens from 37 patients who had malignant tumors and seven patients who had endometriosis were retrospectively analyzed to determine if the barium-enema examination is useful in differentiating extrinsic lesions with and without invasion of the colon. None of the 12 patients who had extrinsic lesions had any of the criteria that indicated bowel-wall invasion. These criteria included fixation and serrations of the bowel wall in all patients with invasion, and ulceration and fistulization in those patients who had complete transmural invasion. In patients with pelvic masses, the preoperative barium-enema examination may be useful to the surgeon in planning surgery and in preparing the patient for the possibility of partial colectomy or colostomy.

Adenocarcinoma↗
PubMed1983

High kVp vs. low kVp for T-tube and operative cholangiography.

Based on several considerations, high kVp and high contrast agent concentration should produce better-quality operative and T-tube cholangiograms than the currently recommended low kVp and low contrast agent concentration. To test this theory, two kinds of studies were performed. In a laboratory phantom, the influence of kVp and contrast agent concentration on detectability of different size phantom stones was evaluated. High kVp and high contrast agent concentration (110 kVp, 38% iodine) were also compared with low kVp and low contrast agent concentration (75 kVp, 15% iodine) in 62 patients undergoing operative or T-tube cholangiography. Almost all phantom stones were well shown with all kVps and iodine concentrations. As the kVp was raised there was a mild decrease in stone detectability but this decrease was partially corrected by raising the iodine concentration. Overall stone detectability with high kVp and high contrast agent concentration technique was better than or similar to the currently recommended low kVp and low contrast agent concentration technique. Evaluation of the direct cholangiograms by five radiologists revealed that the high kVp, high contrast agent concentration studies were superior or similar to the low kVp and low contrast agent concentration radiographs in 70% of the cases. Based on these results high kVp (100-110) and a high contrast agent concentration (38%) are recommended for direct cholangiography.

Cholangiography↗
PubMed1983

Pulmonary angiography with iopamidol and Renografin 76 in normal and pulmonary hypertensive dogs.

The cardiovascular response produced during pulmonary angiography performed with the standard ionic agent diatrizoate (Renografin 76) and a new non-ionic agent iopamidol was compared. Nine dogs were evaluated while ventilated on room air and on 10% O2 which significantly elevated pulmonary arterial pressure. Iopamidol produced similar changes in mean aortic and pulmonary arterial pressures compared with normal saline (less than 20% change). Renografin 76, however, produced a significantly greater elevation in mean pulmonary arterial pressure (a 41% increase) and depression in mean aortic pressure (a 40% reduction) than either saline or iopamidol (p less than 0.01). These results were similar for dogs being ventilated with room air and oxygen. The results indicate that iopamidol should be better tolerated and therefore a safer contrast agent for pulmonary angiography than diatrizoate.

Animals↗
PubMed1983

Pancreatic pseudocyst: comparative evaluation by sonography and computed tomography.

Fifty-four patients were referred to rule out pancreatic pseudocyst. These patients underwent both sonographic and abdominal computed tomographic (CT) examinations for the evaluation of suspected pseudocysts. Among the 54 cases were 24 with proven pseudocysts. CT correctly identified 23 of the 24 pseudocysts with one false-negative and two false-positive studies. With sonography, the studies were technically inadequate in 20 of the 54 patients examined. Sonography correctly diagnosed 18 of the 24 pseudocysts; however, in 10 of these 18 cases sonographic findings were incomplete relative to CT findings. There were one false-negative and three false-positive sonographic studies. On the basis of this study, it was concluded that CT is more accurate than sonography in both diagnosing and demonstrating the extent of pseudocysts of the pancreas.

False Negative Reactions↗
PubMed1983

Computed tomography for staging esophageal and gastroesophageal cancer: reevaluation.

A reevaluation of computed tomography (CT) for staging carcinoma of the esophagus and gastroesophageal junction was performed in 76 patients. For comparison 26 patients without carcinoma of the esophagus with a normal mediastinum at surgery were included in the evaluation. Four radiologists evaluated the CT scans without knowledge of the diagnosis. After determining if there was an adequate amount of fat, they were asked to evaluate each case for the presence or absence of local invasion and distant metastases. The radiologists correctly identified all 26 normal patients. Eighteen of the 76 carcinoma patients had a paucity of fat, but only six were thought to have truly indeterminate scans. CT correctly identified 40 of the 44 esophageal carcinoma patients with mediastinal invasion and 11 of the 15 patients without invasion (accuracy 88%). CT correctly identified 15 of 19 patients with distant abdominal metastases and 28 of 30 patients without metastases (accuracy 88%). CT was only 50% accurate in predicting the presence or absence of invasion in the 12 patients with gastroesophageal junction tumors and only 58% accurate in predicting distant metastases. CT correctly staged 46 (94%) of 49 patients with esophageal carcinoma but only five (42%) of 12 patients with gastroesophageal junction tumors. These results confirm that CT should be used as a major staging method in all patients with esophageal carcinoma.

Adenocarcinoma↗
PubMed1983

Pseudosarcoma of the esophagus: barium swallow and CT findings.

Two new patients with pseudosarcoma of the esophagus are presented with the first report of the findings on computerized tomography (CT). The radiographic appearance in the two patients, with 24 previously reported, is reviewed. Barium esophagograms typically demonstrate a large, elongated polypoid mass in the middle or lower third of the esophagus that distends the lumen at the level of the lesion, but does not produce marked obstruction. There are no specific CT characteristics which differentiate pseudosarcoma from squamous cell carcinoma of the esophagus.

Barium Sulfate↗
PubMed1982

Evaluation of intramuscular ceruletide for shortening small bowel transit time.

A double-blind crossover study in 31 normal volunteers showed that intramuscular injection of ceruletide (0.3 microgram/kg) significantly accelerated small bowel transit of barium when compared to placebo. The only adverse effect was frequent pain at the injection site. There was a significant degradation in the quality of small bowel coating and distension in only 10% of the volunteers. Despite these problems, intramuscular administration of ceruletide may become a useful method for decreasing the prolonged time required for most small bowel examinations.

Adult↗
PubMed1982

Study of safety and tolerance of iopamidol in peripheral arteriography.

Iopamidol, a non-ionic contrast agent, was evaluated during peripheral arteriography in 10 patients. All reported a sensation of warmth during injection. One described the procedure as moderately painful. All objectively tolerated the injections well, and there were no significant changes in clinical or laboratory findings. Vessel opacification was good to excellent in all cases. The authors suggest that non-ionic contrast agents replace ionic agents for peripheral arteriography.

Aged↗
PubMed1982

The peroral pneumocolon: its role in evaluating the terminal ileum.

Peroral pneumocolon examination was performed on 40 patients for further radiographic evaluation of the terminal ileum after antegrade small bowel study. Patients were selected because of poor visualization of the terminal ileum on routine study (17 patients), clinically suspected Crohn disease but normal terminal ileum on routine study (ten), abnormal terminal ileum on routine study (seven), and previous ileocolic anastomosis (six). Use of the technique resulted in additional diagnostic information in 20 (50%) of the 40 patients. Its main value was in showing a previously poorly visualized terminal ileum to be normal (eight patients) and in confirming a normal terminal ileum in clinically suspected Crohn disease (six). In addition, it more precisely defined the proximal extent of recurrent ileal Crohn disease in two patients and detected otherwise unrecognized early ileal Crohn disease in one patient. The technique can be carried out immediately after any antegrade small bowel examination, and if reserved for the above indications, is a valuable adjunct to routine compression spot films of the terminal ileum or reflux study of the terminal ileum at barium enema.

Air↗
PubMed1982

CT appearance of focal fatty infiltration of the liver.

Focal fatty infiltration of the liver is an entity that may be confused with liver metastasis on computed tomography (CT). The imaging results and medical records of 16 patients with CT appearance suggestive of focal fatty liver were reviewed, three of whom had the simultaneous presence of metastatic liver disease. Focal fatty liver often has a distinctive appearance with CT, usually with a nonspherical shape, absence of mass effect, and a density close to water. Liver metastases are usually round or oval, and unless cystic or necrotic, they have CT attenuation values closer to normal liver parenchyma than water. A radionuclide liver scan almost always resolves any confusion about the differential diagnosis of focal fatty liver: a well defined focus of photon deficiency is due to neoplasm rather than focal fatty infiltration. Sonography sometimes helps to confirm the CT impression, but may be misleading if the diagnosis of focal or diffuse fatty infiltration is not suspected before the examination.

Adult↗
PubMed1982

Anterior left subphrenic abscess: characteristic plain film and CT appearance.

Abdominal abscesses located in the left upper quadrant may occur in two major anatomic locations, the subphrenic space or the lesser sac. The left coronary or triangular ligament extending from the dorsal aspect of the liver to the diaphragm separates the subphrenic space from the lesser sac. As the ligament usually extends posteriorly, the anterior subphrenic space extends under the dome of the diaphragm, occupying the most superior part of the left upper quadrant. Both the lesser sac and the left anterior subphrenic space extend to the right of midline. The left anterior subphrenic compartment is bounded on the right by the falciform ligament while the lesser sac extends to the right coronary ligament and foramen of Winslow. Therefore, abscesses either in the left anterior subphrenic compartment or lesser sac may extend across the midline into the right upper quadrant. Left anterior subphrenic abscesses will be immediately subdiaphragmatic while lesser sac abscesses extending to the right of midline will not usually extend up to the diaphragm. Six cases are presented demonstrating midline air-fluid levels and soft-tissue masses in the immediate subdiaphragmatic area, characteristic signs of anterior left subphrenic abscesses.

Humans↗
PubMed1982

Radiologic investigation of peptic ulcer disease.

Fiberoptic endoscopy has uncovered some of the weaknesses with the traditional upper gastrointestinal series and has prompted more critical evaluation of the radiographic examination of the stomach. The biphasic examination using gas distention as well as thick and thin barium suspensions incorporates the best features of both single- and double-contrast examinations. The radiologist needs to be aware of the different signs of ulcer disease as demonstrated by the two different types of examinations, and attention to technical details is critical if thick barium coating is really going to produce striking anatomic detail. Knowing the radiographic features of the common and uncommon manifestations of peptic ulcer disease is important for the radiologist performing gastrointestinal studies. By performing technically excellent studies and by recognizing the various manifestations of peptic ulcer disease, the radiologist will continue to play an important role in diagnosing suspected or known peptic ulcer disease.

Duodenal Ulcer↗