Arthur R. Clemett

Roentgen Aspects of Primary Appendiceal Intussusception

The authors present 3 cases of symptomatic appendiceal intussusception, showing several types, and they also discuss its radiological aspects. Barium enema studies disclosed 4 cases of a new syndrome in asymptomatic subjects. It is characterized by incomplete intussusception which goes on to complete reduction during the same or a subsequent barium enema examination. Clinically, the cecal mural defect on the radiographs may be mistaken for an intracecal neoplasm and lead to unnecessary surgery.

Differentiation of Acute Nonspecific Jejunitis from Mechanical Small Bowel Obstruction

Acute nonspecific jejunitis is a self-limiting abdominal illness of unknown etiology which has been confused with mechanical small bowel obstruction. Laparotomy in 4 patients revealed increased peritoneal fluid and a distended, congested, thick-walled, edematous jejunum without evidence of bowel obstruction. Abdominal distension was the most prominent symptom in the 8 patients described, and pain patterns were atypical for small bowel obstruction. Disproportionate jejunal distension and jejunal edema in some cases help distinguish jejunitis from obstruction. Positive contrast examination is desirable in questionable cases to exclude atypical or strangulating intestinal obstruction.

Colonie Polyp Detection: Role of Roentgenography and Colonoscopy

In order to determine the relative yields of colonoscopic and radiologic examinations of the colon, the following guidelines are suggested: (a) prospective data collection; (b) a standard, effective colon cleansing regimen; (c) colonoscopic and radiologic examiners of comparable expertise; (d) examiners should be unaware of each others findings; (e) a suitable method for demonstrating false-negative findings and for resolving conflicting findings between the two examinations; and (f) indexing of the study findings as to lesion size, lesion location, quality of colon cleansing, and examiners level of confidence. The two examinations should be used as complementary diagnostic procedures.

An Evaluation of the “Clean Colon” Technique

The “clean colon” technique for barium enemas (hydration, lowresidue diet, magnesium citrate, and oral and rectal bisacodyl) was compared to a simpler routine preparation consisting of a liquid diet and castor oil. There was no significant difference, and neither preparation was entirely satisfactory when used routinely.