Albert Solomon

Computed tomography in adult intussusception

Computed tomographic (CT) changes of intussusception include the early target mass with fascial planes around the mass retained; with progress and bowel wall thickening, the characteristic mass with layering effect occurs (i.e., areas of high density with curvilinear low-density zones). Traction on the associated mesenteric vasculature may be noted. Scattered air-fluid levels indicate the associated presence of bowel obstruction. As edema of the bowel progresses, the layering effect is obscured, and the compromised bowel assumes an amorphous shape surrounded by intraperitoneal fluid. The presence of intramural air is indicative of vascular compromise of the intussuscepting bowel.

Contrast computed tomography in the diagnosis of acute cholecystitis.

Computed tomography (CT) has the ability to deteet small variations in tissue density. Meglumine diatri/oate was given intravenously to four patients with clinical acute cholecystitis as part of the CT scanning procedure. The enhancement of the thick gallbladder wall. together with an enlarged gallbladder and the presence of stones, confirmed the diagnosis of acute cholecystitis. Our present experience indicates that alter contrast medium administration. CT has a distinct place in the assessment of acute inflammation of the gallbladder.

Computerized Tomography in Xanthogranulomatous Pyelonephritis

Computerized tomography offers the means to recognize changes in the kidney associated with xanthogranulomatous pyelonephritis. The preoperative extent of the inflammatory process, reaction of adjacent parenchymal structures, and extension to the muscles and abdominal wall are identifiable on computerized tomography. The presence of obstructing renal stones, thickening of the perirenal fascia and inability of the kidney to handle intravenously injected contrast medium can be assessed with computerized tomography. Low density renal areas measured on computerized tomography may indicate lipid infiltration of the kidney or incorporation of the fat of the renal bed into the tumefactive mass.

The syndromes of pancreatic pseudocysts and fluid collections

The clinical and radiologic spectrum of pseudocysts associated with alcohol-induced pancreatitis is wide and variable. Several illustrative cases which delineate the diversity of syndromes that occur with pseudocysts are presented. A classification is proposed to facilitate a more coherent approach to the concept of pseudocysts and is based on the clinical presentation. Thus, in acute pancreatitisduct disruption and enzyme activation may result in intrapancreatic or extrapancreatic fluid collections. In calcifying chronic pancreatitisduct obstruction may result in pseudocysts of the head, body, or tail of the pancreas, which can enlarge and penetrate into extrapancreatic sites. This subdivision will assist in elucidating the natural history of pseudocysts and pancreatic fluid collections. Furthermore, it may establish new guidelines for diagnosis and therapy.

Computed tomographic air enema technique to demonstrate colonic neoplasms

The use of intravenous glucagon and the judicious introduction of air into a clean colon offer additional help in the confirmation of the larger intracolonic tumors on computed tomographic examination. The procedure is simple and may aid in the differentiation of an intrinsic colonic tumor from other pathologic conditions, particularly those that are extracolonic in origin.

Computed tomographic demonstration of intramural colonic air (pneumatosis coli) as a feature of severe ulcerative colitis

Fast rotational computed tomographic scanning techniques allow an accurate appreciation of the diameter of the colon, the presence of severe necrotizing mucosal change, and the detection of unsuspected intramural colonic air (pneumatosis coli) in cases of severe necrotizing ulcer ative colitis.

Staging cecal and ascending colon carcinoma with computed tomography.

Operable subserosal and transserosal and inoperable cecal and ascending colon carcinomas can be differentiated by computed tomography (CT). Invasion of the posterior peritoneal reflection produces recognizable changes on CT, which, with or without adjacent muscle invasion, are indicative of tumor nonoperability.

The Use of a modified direct coronal computed tomographie technique for assessing thoraco-abdominal problems

A modified simple technique for direct computed tomographic (CT) coronal body scanning is described and illustrated with relevant cases. Problems related to partial volume effect are eliminated and the anatomical relationship of organs are defined with easy compartmentalization of associated pathology. Spatial resolution is better than with multiplanar reformatted images. The method is particularly effective in demonstrating thoraco-abdominal pathology.

Computed tomographic investigation of serosal and intramural gastrointestinal pathology

Various cases are presented demonstrating the role of computed tomography (CT) in the assessment of serosal and bowel wall pathology. Reference is made to the morphology of the lesions. Illustrative examples of tumors, secondary malignant dissemination, irradiation injury to the gut, and intramural gas associated with ulcerative colitis, are all illustrated.

Patulous rectum extension into the ischiorectal fossa: CT findings

Protrusion of the rectum with egress into the ischiorectal fossa was present on computed tomography (CT) in three elderly women. CT demonstration of such rectal redundancy in elderly women will avoid unnecessary bowel damage in the case of misguided clinical assessment of rectal pathology.