[THE CLINICAL VALUE OF PERITONEOSCOPY].
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A series of 60 patients with malignant lymphoma was proved by pathology except two with mediastinal lesions. All were admitted for radiotherapy from Oct, 1979 to June 1983 and the abdomen was scanned by CT. There were 29 cases of Hodgkin's disease (HD) and 31 of non-Hodgkin's lymphoma (NHL). The age ranged from 8 to 69 years 5 were scanned before, 32 during and 23 after treatment. The results showed that 18 patients had subdiaphragmatic lesions, of which 10 were HD and 8 NHL. The sites of the 18 positive abdominal scan were 9 lymphatic involvement (para-aortic, coeliac, splenic-hilar, mesenteric, gastric, hepatic-hilar, diaphragmatic posterior group and presacral) and 3 visceral involvement (liver, spleen and adrenal gland). As to the change in clinical staging of malignant lymphoma after CT scan, 5 patients (26%) with stage I were downed to stages II and III; 6 (22%) with stage II to stages III, IV and 1 stage III to stage IV. Altogether 22% of stages I, II and III were down staged. According to our experiences, abdominal CT scan can not take the place of exploration or lymphography because the small lesions in the spleen and liver are not visible on the CT scans using conventional intravenous water soluble contrast media. Lymphography is more accurate in showing the retroperitoneal lymph nodes. The CT scan is valuable in detecting lesions in the upper para-aortic, mesenteric, splenic-hilar, hepatic-hilar and renal-hilar lymph nodes.(ABSTRACT TRUNCATED AT 250 WORDS)
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In hyperlordosis of the lumbar spine, the abdominal aorta becomes well palpable and behaves like a pulsating tumor in the lower abdomen. This normal finding often cannot be differentiated from pathologic changes by clinical investigation alone. Sonography offers a simple method, without risk, for the definitive diagnosis of the abdominal aorta.
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Ninety-two patients with a pulsating abdominal mass and suspected abdominal aortic aneurysm (AAcA) were examined by ultrasonography. We diagnosed 48 cases (52%) of AAA and 5 unexpected lesions ventral to the aorta (5%), but in 39 cases (42%) we were not able to explain the symptom in spite of extensive diagnostic efforts and follow-up. Changes of the aorta or transmission of the pulse by adjacent structures are the main cause of a pulsating abdominal mass. Ultrasound examination appears to be optimal screening method for diagnosing AAA as well as the other symptoms no further diagnostic efforts are necessary after a negative ultrasound study.
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