Carlos A. Muhletaler

Gastric varices secondary to splenic vein occlusion: radiographic diagnosis and clinical significance.

The radiographic appearance and clinical significance of gastric varices in the absence of esophageal varices and secondary to splenic vein occlusion were studied. Eighteen patients were evaluated through medical records, angiography, and barium studies of the stomach and esophagus. The presence of splenic vein occlusion was determined by arteriography in 18 patients and its etiology confirmed by surgery in 17 patients. This condition should be suspected in patients with chronic abdominal pain, weight loss, and iron deficiency anemia who show fundal polypoid filling defects or prominent gastric folds on an upper GI series.

Infarction after embolization of the ileocolic artery

Treatment of colonic hemorrhage by therapeutic embolization of the involved artery may, rarely, result in bowel infarction. In one patient with angiodysplasia, bowel infarction resulted from a therapeutic embolization of the ileocolic artery. Because of the arterial anatomy of the cecum, occlusion of the cecal branches can result in devascularization of the cecum and appendix, even if the colic and ileal branches are not occluded. Thus, the ileocolic artery may not be a good candidate for therapeutic embolization.

Venography of Peripheral Venous Injuries

Venography is a simple and rapid technique which can be used in the diagnosis of acute penetrating venous injury. Four cases of venous lesions are presented and indications for venography discussed. Findings consisted of bleeding from lacerations and partial or total occlusion from traumatic thrombosis.

Conjugated sodium tyropanoate (Bilopaque) in the bowel: significance of its presence or absence after first-dose oral cholecystography.

Oral cholecystography following the ingestion of 4.5 g of sodium tyropanoate (Bilopaque) was performed in 1,053 patients. The radiographs of 89 patients in whom the gallbladder was either faintly visualized or nonvisualized were reviewed for the presence of conjugated contrast material in the bowel. All 89 of these patients underwent second-dose cholecystography. Oral cholecystography was found to be 100% accurate in the diagnosis of gallbladder disease when conjugated contrast media was found in the bowel in the presence of a faintly visualized or nonvisualized gallbladder. When this combination of findings is seen on the first-dose examination, a second-dose examination is unnecessary. When no conjugated contrast material is seen in the bowel after a first dose, a second dose is helpful only in those patients with normal biochemical liver function tests.