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At least 127 records · Page 7Linked to original sources
PubMed1994

Effect of cromakalim and glibenclamide on spontaneous and evoked motility of the guinea-pig isolated renal pelvis and ureter.

1. We have investigated the effect of the potassium (K) channel opener, cromakalim, on the spontaneous myogenic activity of the guinea-pig isolated renal pelvis and on myogenic contractions evoked by direct electrical stimulation of the guinea-pig isolated ureter. 2. In the presence of Bay K 8644 (1 microM), electrical stimulation of the guinea-pig ureter (10 Hz for 1 s, pulse width 5 ms, 60 V) produced regular tetrodotoxin-(1 microM) resistant phasic contractions which were suppressed by 3 microM cromakalim. Glibenclamide (0.1-3 microM), 4-aminopyridine (4-AP, 0.1-2 mM) and tetraethylammonium (TEA, 1-10 mM) produced a concentration-dependent inhibition of the effect of cromakalim with the rank order of potency (EC50 in parentheses): glibenclamide (0.64 microM) >> 4-AP (1.11 mM) > TEA (6.6 mM). Apamin (0.1-0.3 microM) was without effect. 3. Cromakalim (0.1-10 microM) produced concentration-dependent inhibition and suppression of spontaneous contractions of the guinea-pig isolated renal pelvis and of evoked contractions of the ureter with EC50 values of 0.71 and 0.47 microM, respectively. 4. Glibenclamide (1 microM) produced a rightward shift of the concentration-response curve to cromakalim in both the renal pelvis and ureter, without producing depression of the maximal inhibitory effect. Glibenclamide did not affect the spontaneous activity of the renal pelvis while it produced a slight enhancement (10-15% increase) of evoked contractions of the ureter. Glibenclamide did not affect the inhibitory action of the adenylate cyclase activator, forskolin, in the renal pelvis or ureter. 5. In electrophysiological experiments (sucrose gap), cromakalim (0.3 and 1 microM) produced hyperpolarization of ureter smooth muscle. Cromakalim also produced a transient suppression of action potentials and accompanying phasic contractions evoked by electrical stimulation. Before suppression of evoked contractions, a shortening of action potential duration was observed concomitant with the developing hyperpolarization produced by cromakalim. A lower concentration (0.1 MicroM) of cromakalim did not affect membrane potential but shortened action potential duration and reduced the evoked contraction.6. Glibenclamide (1 MicroM) inhibited the hyperpolarizing action of cromakalim and prevented its inhibitory action on evoked action potentials and contractions of the ureter. Glibenclamide also produced a slight prolongation of action potential duration and increased the amplitude and duration of the accompanying mechanical response.7. These findings demonstrate that activation of cromakalim- and glibenclamide-sensitive K channels produces a powerful mechanism for regulation of pyeloureteral motility and suppression of latent pacemakers of the ureter in guinea-pig. Glibenclamide-sensitive K channels take part in determining action potential shape and duration in the guinea-pig ureter.

Action Potentials↗
PubMed1996

Xanthogranulomatous pyelonephritis associated with transitional cell carcinoma of the renal pelvis.

Xanthogranulomatous pyelonephritis (XPN) is an uncommon, but not rare, type of bacterial infection of the kidneys. Malignancies originating within the renal pelvis are uncommon. We report a case of XPN associated with a transitional cell carcinoma (TCC) of the renal pelvis in a 70-year-old woman. The pathogenesis of carcinoma of the renal pelvis in the presence of XPN is related to obstruction, chronic inflammation, and mechanical irritation caused by calculi. In the case reported here, obstruction was due to a concomitant TCC of the ureter without the presence of calculi. A review of the twelve published case reports of XPN with TCC of the renal pelvis, including the present case, showed that the frequency of this association is 3.3%, the average age at presentation is 65.3 (range 49-78) years, and that the male:female ratio is 2:1. Moreover, 25% of the patients had TCC of the ureter and 8.3% TCC of the bladder. The combination of XPN, TCC of the renal pelvis, and lithiasis occurred in 33.3% of the cases. XPN must be treated by nephrectomy not only because it is a destructive inflammatory process leading to complete loss of renal function, but also because the kidney may be harboring a malignant tumor.

Adult↗
PubMed1983

Conduction velocity in various regions of the renal pelvis and ureter.

Conduction velocity of excitation in various regions of the canine pelviureter was studied through the simultaneous recordings of electromyograms at four sites of the canine pelvicalyceal preparation. The pelviureteral system was maintained in the condition which was similar to in vivo situation by infusion of oxygenated Krebs-Ringer solution into the renal pelvis at the average flow rate of living dogs. The conduction velocity was slowest in the proximal region of the pelvis where the pacemaker was located, i.e., about 5.8 mm/sec on an average. The velocity gradually increased in the distal region of the pelvis and the ureter. It was suggested that the conduction velocity of excitation was significantly different in the proximal area of the pelvis, the distal area of the pelvis and the ureter.

Action Potentials↗
PubMed1989

Sampling bandwidth and fat suppression: effects on long TR/TE MR imaging of the abdomen and pelvis at 1.5 T.

In MR imaging, the sampling bandwidth is the rate at which the signal is digitized by the analog-to-digital converter. Reducing the sampling bandwidth can decrease noise in long TE images at the expense of increases in the artifacts of chemical-shift misregistration and motion. We compared 39 pairs of axial images with bandwidths of 32 kHz and 8-10 kHz. In 23 of these comparison studies (six female pelvis, seven male pelvis, 10 abdomen), all other variables were held constant, and in 16 comparisons (10 female pelvis, six male pelvis), signal from fat was suppressed in images with reduced bandwidth. Six patients with 11 liver lesions were included in those undergoing abdominal imaging. In three patients, fat was suppressed in images of the abdomen. The contrast-to-noise ratio was greater with reduced bandwidth for urine vs fat (24.5 vs 17.2; p less than .05) and central vs peripheral parts of the prostate gland (34.1 vs 22.7; p less than .02). In the abdomen, the contrast-to-noise ratio was increased between liver and right kidney (36.6 vs 25.2; p less than .01) and between liver and lesion (30.2 vs 18.2; p less than .005), but the motion-induced artifact was worse. An increase in chemical-shift misregistration did not affect the appearance of the internal structure of the uterus, prostate gland, or liver, but it made examination of the ovaries, seminal vesicles, and extrahepatic tissues difficult. The chemical-shift artifact in pelvic images could be eliminated by suppressing signal from fat with frequency-selective saturation pulses, but results were less satisfactory in the abdomen. When reduced bandwidth and fat suppression were combined, the contrast-to-noise ratio was improved for endometrium vs myometrium (22.9 vs 15.2; p less than .05) and central vs peripheral parts of the prostate gland (62.7 vs 28.5; p less than .02). Reduction of the sampling bandwidth is a promising technique for imaging the pelvis with small field of view and long TR/TE, but it currently appears less promising for images in the upper abdomen at 1.5 T. The increased chemical-shift artifact caused by reduced bandwidth can be eliminated by suppressing signal from fat.

Abdomen↗
PubMed2000

[CT findings in fire arm injuries of the pelvis. Personal experience].

PURPOSE: We investigated the yield of CT in firearms wounds with pelvis involvement by evaluating the CT features of pelvis, bone walls, and associated injuries, if any. CT plays a major role, while conventional radiography remains an important integration in the workup of pelvis bone injuries. MATERIAL AND METHODS: We report a retrospective series of pelvis gunshot wounds studied with CT in a 5-year period; the patients were all men, with a mean age of 38 years (range 18-56). When only the pelvis was involved, CT was performed from the transverse umbilical plane to the pubis, in order to include the continuous abdomen. We used an intravenous contrast agent to study the aorta and its iliac branches, pelvic vessels, active hemorrhagic effusions and bladder filling. RESULTS: Penetrating firearms wounds were found in 21 cases and perforating ones in 7. In the penetrating wounds, the bullet course was most frequently (75%) stopped by the pelvic bones, with retention and CT visualization within muscular and bone structures. The incidence of bone injuries, especially crash wounds, was high, with 18 cases (64%). In both types of wounds with anterior course, we demonstrated bladder perforation in 2 cases, vascular damage in 2 and perforation of intestinal loops in 6. DISCUSSION AND CONCLUSION: Paradoxically, pelvic bone fractures may be "protective" for the pelvic content; however the involvement of large arteries and veins and multiple perforations of intestinal loops are no less dangerous than the upper abdominal wounds. CT is an important diagnostic tool that permits accurate and prompt evaluation of pelvic organs such as intestine, bladder and bone structures. Thus, CT permits prompt assessment of pelvic structures involvement by firearms wounds, which provides the clinician with useful imaging findings of bullet damage.

Adult↗
PubMed2001

[Primary adenocarcinoma of the renal pelvis with a pyeloduodenal fistula: a case report].

A 62-year-old woman visited our hospital complaining of fever and right flank pain. On excretory pyelography the right kidney containing three renal stones was not visualized. Retrograde pyelography revealed an irregular filling defect in the right renal pelvis. Computed tomography revealed renal stones and a tumor mass in the right renal pelvis. From these findings, the pelvic tumor of the right kidney complicated by renal stones was diagnosed. Right nephrectomy was performed. Because a fistula between the renal pelvis and the second portion of the duodenum was found in the operation, partial resection of the duodenum was also performed. Pathological diagnosis was adenocarcinoma of the renal pelvis and pyeloduodenal fistula due to chronic pyelonephritis. Postoperative chemotherapy was not given. This is the first case report of adinocarcinoma of the renal pelvis coexisting with a pyeloduodenal fistula.

Adenocarcinoma↗
PubMedDate not supplied

[Does the "fatty pelvis" exist? Quantitative computer tomography studies].

50 Patients weighing between 45 and 114 kg underwent standardized computed tomography of the pelvis. Fat compartments from inside and outside of the small pelvis were assessed quantitatively by means of tracing the fat tissue borders and planimetry. Fat compartments within the small pelvis showed a rather weak correlation with body weight and the so called Rohrer-Index as a weight/height-Index, correlations with the latter being slightly better. From the fat compartments within the single levels the functional reduction of birth channel diameters caused by fat tissue was calculated for. The weight/height-index dependent increase of space demand within the birth channel was rather pronounced at the pelvic brim becoming slighter when reaching mid-pelvis or even pelvic outlet. Hence, the common assumption can no longer be maintained, that adiposity necessarily causes soft tissue dystokia due to larger fat compartments within the small pelvis.

Adipose Tissue↗
PubMed2003

[A case of amyloidosis of the renal pelvis].

We report a case of localized amyloidosis of the renal pelvis and upper ureter arising in a 74-year-old man who presented at our hospital with gross hematuria. The intravenous pyelogram showed right hydronephrosis and stenosis of right renal pelvis and upper ureter. The cystoscopy view was normal, but the right retrograde-ureteropyelogram showed a long irregular stricture of the renal pelvis. Ureteroscopy was performed and rubbing biopsy of edematous, bleeding lesion suggested class IIIb, transitional cell carcinoma. With the diagnosis of a right renal pelvic tumor, right nephroureterectomy was performed. The histology report stated "massive deposits of amyloids are seen in the segment of macroscopically abnormal renal pelvis". Amyloidosis of the renal pelvis is a rare entity and 12 cases were reported in the Japanese and English literature.

Aged↗
PubMed2006

Review of traumatic diaphragmatic hernia associated with pelvis fractures.

OBJECTIVE: To review the epidemiological feature, clinical and diagnostic data of post-traumatic diaphragmatic hernia (TDH) associated with pelvis fracture reported in recent 10 years. METHODS: A 10-year retrospective study was undertaken to analyze the incidence, diagnosis, management, morbidity and mortality of patients with traumatic diaphragmatic hernia associated with pelvis fractures. A total of 46 cases in our country were reviewed. RESULTS: The incidence of TDH associated with pelvis fractures was relatively rare and the diagnosis was often delayed or missed. A total of 72.34% of these patients were diagnosed as TDH associated with pelvis fractures after injury for 36 hours to 1 week. Although the trans-thorax approach was preferred for surgical closure in the acute phase, its mortality still reached 8.51%. CONCLUSIONS: TDH associated with pelvis fractures is difficult to be diagnosed because of its varied clinical and radiological signs and the patients may not present with symptoms for a long time after injury. In clinical, a high index of suspicion with appropriate examination is the mainstay of management, which can be helpful in prognosis.

Adult↗
PubMed1983

Primary adenocarcinoma of the renal pelvis. Report of two cases and brief review of literature.

Two cases of primary adenocarcinoma of the renal pelvis are described. One patient was a 64-year-old female who had multiple papillary tumors in the right ureter and renal pelvis. The other was a 57-year-old male who had diffuse infiltrating carcinoma in the left renal pelvis with calculi. In both cases, the lining of the renal pelvis underwent columnar cell metaplasia and the tumor cells showed mucin production. Forty-six cases reported previously are reviewed briefly. The histogenesis of primary adenocarcinoma of the renal pelvis seems to be closely related to metaplasia of transitional epithelium induced by longstanding chronic inflammation or renal calculi in many cases.

Adenocarcinoma↗
PubMed1996

The effects of K+ channel blockers on the spontaneous electrical and contractile activity in the proximal renal pelvis of the guinea pig.

PURPOSE: The role of various K+ channel populations in determining the time course and amplitude of the spontaneous action potentials and contractions in the smooth muscle cells of the guinea pig renal pelvis were investigated by standard electrophysiological and tension recording techniques. MATERIALS AND METHODS: Electrical recordings in the proximal renal pelvis were used to demonstrate the presence of 3 cell populations based on the waveform of their Ca(2+)-dependent action potentials which we have termed "pacemaker," "intermediate" and "driven" action potentials. RESULTS: Blockade of large conductance (BK) or small conductance (SK) Ca(2+)-activated K+ channels with charybdotoxin (30 to 60 nM.) and tetraethylammonium (TEA) (0.5 to 2 mM.) or apamin (200 nM.) increased the duration of the action potentials recorded in "driven" cells. Tetraethylammonium (2 mM.) and 4-aminopyridine (2 mM.) increased the frequency of action potential discharge in both "driven" and "pacemaker" cells, as well as having a positive inotropic and chronotropic effect on the spontaneous contractions of the renal pelvis. In contrast, glibenclamide (0.1 to 1 microM.), Cs2+ (1 mM.) and Ba2+ (100 microM.) had little effect on either the contractile or electrical activity of the renal pelvis. CONCLUSION: It was concluded that the frequency of contraction in the proximal renal pelvis is determined by the frequency of action potential discharge in "pacemaker" cells. On the other hand, increases in the amplitude of pelvic contractions may well be correlated with membrane depolarization and/or increases in the duration of the action potentials recorded in "driven" cells.

4-Aminopyridine↗
PubMed1977

Dynamics of upper urinary tract. III. The activity of renal pelvis during pressure variations.

In one phase of an analysis of renal pelvis activity in pigs "in vivo," controlled pressure changes were induced in the pelvis and electromyogram registrations were taken from both pelvis and ureter. Animals were anesthetized and the changes in intrapelvic pressure were effected by drainage or infusion via a catheter introduced into the pelvis through the parenchyma of the kidney. Frequency of pelvic activity increased temporarily under pressure increase and reduced temporarily under pressure fall. These phenomena were more emphatic when rapid pelvic pressure rise was induced by infusion. The observations lend weight to previous observations of changing pelvic activity during pressure and diuresis change, and also support the hypothesis that pelvic function is a stretch response, i.e., that the smooth muscle of the pelvis reacts just as does other smooth muscle. Observation of cessation in ureter activity during drainage while pelvic activity continues suggests that, under normal conditions, ureteric activity depends not on conduction of a pelvic impulse alone, but on a combination of such an impulse with a urine bolus.

Action Potentials↗
PubMed1996

Effect of neonatal exposure to diethylstilbestrol and tamoxifen on pelvis and femur in male mice.

BACKGROUND: Permanent abnormalities have been reported in reproductive and non-reproductive organs of mice and humans exposed perinatally to a synthetic estrogen, diethylstilbestrol (DES). Recent studies demonstrated that sex hormones affected the shape of the innominate bone in mice. Therefore, we analyzed the long-term effects of neonatal exposure of DES and tamoxifen, an anti-estrogen, in mouse bones. METHODS: Changes in the pelvis and femur were examined in 1- to 15-month-old C57BL/Tw male mice given 5 daily injections of 3 micrograms DES or of 100 micrograms tamoxifen beginning on the day of birth by measuring contents of calcium (Ca) and phosphorus (P), and the numbers of osteoblasts and osteoclasts. RESULTS: The ash weight of pelvis and femur in neonatally DES- and tamoxifen-treated mice was lower than that in the controls at 2-15 months of age. Contents of Ca and P of pelvis and femur in neonatally tamoxifen-treated mice were lower than in the controls and neonatally DES-treated mice. In neonatally DES-treated mice at 6-12 months, Ca and P contents in the pelvis were lower than in controls, but not different in the femur. The number of osteoblasts per unit length of endocortical surface of the femur in 2- and 3-month-old DES- and tamoxifen-treated mice was lower than that in the controls. The osteoclast number in the femur in DES-treated mice at 2 to 12 months was not different from that in the controls; however, in tamoxifen-treated mice, the number was higher than in the controls. An epiphyseal line was clearly detected in the femur of 12- and 15-month-old DES- and tamoxifen-treated male mice, whereas the line in the controls disappeared after 12 months. CONCLUSIONS: The present results indicate that in male mice, neonatal exposure to DES and tamoxifen induced permanent changes in the pelvis and the femur, and that tamoxifen had a greater effect on bone tissue than did DES.

Age Factors↗
PubMed1995

Natural selection and developmental sexual variation in the human pelvis.

This research examines ontological patterns of change in variation of the human pelvis as a means of identifying regions of differential growth, growth canalization and evidence of selection. Data were derived from pelvic radiogrammetry of 180 8-year-olds and 89 subjects at age 18 who were part of the Fels Longitudinal Growth Study. Coefficients of variation (CVs) and total growth increments were compared between sexes and between ages 8 and 18 for 14 pelvic measures. Sex-specific comparisons of mean size were tested per age using Student's t, whereas coefficients of variation were calculated and compared using the methods suggested by Sokal and Braumann ([1980] Syst. Zool. 29:50-66). The Mann-Whitney U-test was used to test median growth increments between ages 8 and 18. Results of these comparisons show significant sex differences in breadth of the ischium and acetabular regions among 8-year-olds. Most of the sexual dimorphism in the pelvis at age 18, however, develops during the adolescent growth period, during which both male and female pelves undergo growth remodeling of the pelvic cavity. Over the same time period, males show significantly greater incremental growth in the acetabulum, and females show differentially greater growth in the pelvic cavity. At age 18, the pelvis demonstrates a posterior-to-anterior gradient of increasing dimorphism within the inlet and midplane of the pelvic birth canal. As a means of interpreting the effects of natural selection on the pelvis, it is argued that appropriate comparisons are within-sample comparisons of CVs over time, rather than comparisons between sexes of adult coefficients as has been argued by others (Meindl et al. [1985] Am. J. Phys. Anthropol. 68:79-85). Analyses of change in coefficients of variation over time show evidence of concordantly reduced within-sample variation in 7 pelvic dimensions indicating canalization of growth. These results are attributed to the effects of stabilizing selection operating on both males and females and include transverse diameters of the sacrum, inlet, anterior inferior iliac spines, and breadths of the ilium and ischium. Six pelvic dimensions show evidence of increased total sample CVs and discordant change in within-sex comparisons of CVs as well as differential growth between sexes over time. This pattern is indicative of the effects of disruptive selection on the pelvis for interacetabular diameter, breadths of the anterior superior and posterior inferior iliac spines, public length, and ilium height.

Adolescent↗
PubMed1986

Computed tomography of the abdomen and pelvis: documentation of tumor response and progression in disseminated prostate cancer.

Computed tomography of the abdomen and pelvis has been used to stage early prostatic cancer. We investigated its value in monitoring tumor response in more advanced disease. Serial computed tomography of the abdomen and pelvis was obtained along with multiple other staging tests prior to treatment and at 3- to 4-month intervals thereafter in 32 patients with stage D2 tumor treated initially with combination chemotherapy and with hormones at progression. Pretreatment lymphography with follow-up abdominal films was also performed. Initial computed tomography of the abdomen and pelvis showed evidence of node metastases in 35% of patients while lymphography was positive in 54%. Among 19 patients with tumor response and 25 with progression, the results of treatment were objectively documented by improvement or worsening, respectively, in a mean of 5.1 and 5.0 other staging tests, exclusive of computed tomography. Computed tomography of the abdomen and pelvis improved in 85% of responding patients examined. Progression was confirmed by worsening of computed tomography in 32%. Although lymphography was often abnormal prior to treatment, in our hands it was not useful in serial monitoring of tumor status. We conclude that serial computed tomography of the abdomen and pelvis, when initially positive, is a useful test to document objectively tumor response and progression in disseminated prostatic cancer.

Abdominal Neoplasms↗
PubMed2001

Reliability of measurement of angular movements of the pelvis and lumbar spine during treadmill walking.

BACKGROUND AND PURPOSE: Angular movements of the pelvis and lumbar spine are thought to play an important role in walking. However, little is known about the amount of unpredictable variability in measurement of these movements during human walking. The aim of the present study was to determine the retest reliability of measuring the angular movements of the pelvis and lumbar spine during unimpaired familiarized treadmill walking. METHOD: Retest reliability for 26 subjects without pathology was determined over a one-week interval. Subjects walked on a treadmill at self-selected or a slower speed while measurements of the three-dimensional angular movements were taken with a computer-based video analysis system. RESULTS: The frontal plane movements of pelvic list and lumbar lateral flexion (relative to the pelvis) could be measured with high retest reliability at both self-selected and slow walking speeds (intraclass coefficient (ICC) (2, 1) > or = 0.81). In contrast, transverse and sagittal plane movements demonstrated moderate reliability at both speeds (0.37 < or = ICC (2, 1) < or = 0.76). Averaging the measurement over six strides resulted in increased observed reliability (self-selected walking speed summary Pearson's r = 0.71, slow walking speed summary Pearson's r = 0.79) compared to taking the measurement based on a single stride (self-selected walking speed summary Pearson's r = 0.63, slow walking speed summary Pearson's r = 0.67). Unlike pelvic and lumbar movements (relative to the pelvis), the measurement of lumbar movements (relative to the global reference frame) appeared to depend on whether subjects were walking at self-selected or slow speeds. CONCLUSIONS: Measurement of pelvic list and lumbar lateral flexion (relative to the pelvis) could be applied with confidence to hypothesis testing about individuals or groups. Movements in the transverse and sagittal planes are unlikely to be appropriate in hypothesis testing about individuals and hence clinical practice, but may still have experimental applications in hypothesis testing about groups.

Adult↗
PubMed2003

[Significance of physical examination and radiography of the pelvis during treatment in the shock emergency room].

AIM: Physical examination and radiography of the pelvis is part of most routine protocols in the emergency room (ER) management of blunt trauma patients. The purpose of this study was to determine the usefulness of these diagnostic tests with respect to diagnostic accuracy, therapeutic consequences, and prognosis in severely injured patients. METHOD: In a prospective study including all trauma patients admitted to the ER, physical examination and clinical management were evaluated. All patients underwent physical examination of the pelvis and were grouped into two categories: patients without (group I) and with (group II) clinical pelvic instability. A comparison between these two groups was made for standard demographic data, indices of shock, diagnostic and therapeutic procedures, and results. RESULTS: During a 45-month period a total of 1160 patients were enrolled: 979 subjects (ISS 21+/-16) with blunt trauma were included in this analysis. Of these, 929 patients had negative (group I) and 51 (group II) positive examination results for clinical stability of the pelvis. When comparing these two groups, group II patients had a higher injury severity score, higher incidence of shock with a lower initial systolic blood pressure, a lower initial hemoglobin, and a higher rate of associated severe chest and abdominal injuries (AIS > or = 3). Among the 51 patients with abnormal pelvis instability, there were 6 type A, 16 type B, and 27 type C fractures, whereas in two cases no pelvic fracture could be found. Of the 928 patients without positive clinical signs, 866 (93%) had no pelvic fracture. There were 40 type A, 19 type B, and 3 type C fractures missed on clinical examination. The physical examination had a sensitivity of 44% and specificity of 99% for detecting pelvic fracture. A comparison between groups I and II showed the patients with positive physical pelvic examination to have greater transfusion requirements and a higher rate of surgical intervention for pelvic stabilization and blood control. CONCLUSION: The clinical diagnosis of pelvic instability should result in an immediate order for blood products, taking surgical intervention into account. Pelvic radiographs in the ER are required for early surgical management. In patients with negative pelvis examination results, a routine pelvic radiograph is recommended because clinical examination cannot reliably rule out surgically significant pelvic fractures (20%) in the severely injured and intubated blunt trauma patient.

Adult↗
PubMed1994

The variation of small bowel volume within the pelvis before and during adjuvant radiation for rectal cancer.

Prior to adjuvant postoperative radiation therapy for carcinoma of the rectum, 21 consecutive patients had small bowel barium studies to determine whether there was an optimal interval between ingestion of barium sulphate and imaging, and whether the volume of small bowel within the posterior pelvis was constant throughout the course of treatment. It was found that the optimum interval prior to imaging after ingestion of barium was 1.5-2 h. For seven patients there was no, or minimal, small bowel visualised within the posterior pelvis at any time. For six patients there was an apparently fixed loop of bowel within the posterior pelvis at simulation, both before and during treatment. For a further eight, the small bowel was mobile and the volume of bowel within the posterior pelvis was reduced by bladder distension. Seven of these eight patients had repeat studies during the course of treatment and in five the difference between the appearance of the small bowel with the bladder full and empty was lost. It is concluded that the displacement of small bowel from the posterior pelvis by bladder distension may not be reliably maintained throughout a course of pelvic radiation.

Barium Sulfate↗