Harvey I. Meyers

Gray-Scale Ultrasonography of Hepatic Amoebic Abscesses

Retrospective analysis of the ultrasonograms of 42 hepatic amoebic abscesses in 34 patients was performed. All lesions were less echogenic than normal liver. All but 1 were contiguous with the liver capsule and had slight distal sonic enhancement. Twenty-three were predominantly homogeneous with fine, low-level echoes. This pattern is highly suggestive of hepatic amoebic abscess. Nineteen abscesses did not show this pattern and could not be diagnosed based on ultrasonographic criteria.

Cholelithiasis: A frequent complication of artificial heart valve replacement

The results of this investigation reveal that 39 per cent of patients in a study group of 46 patients with heart valve prostheses had gallstones if they survived 18 months or longer following valve replacement. In contrast, the prevalence of gallstones in a general population of autopsied rheumatic heart disease patients, including those who had been operated for severe valvular heart disease and had not survived for more than one month, was only 12 per cent. These findings suggest that gallstones are a frequent late complication of heart valve replacement.

Gas in the portal vein of adults with necrotizing enteropathy

Summary Gas in the portal vein has been detected radiologically in twelve adults with necrotizing enteropathy which principally involved the small intestine. The necrosis was not always panmural. Portal venous gas is probably either consequent to enteric mucosal necrosis with passage of luminal gas into portal venous radicles or to a physicochemical alteration in portal venous blood, or to both. Evidence was not detected to support endovascular sepsis as a cause of the portal venous gas. In the majority of these patients it is believed that necrotizing enteropathy was consequent to impaired splanchnic blood flow with enteric ischemia. A primary necrotizing enteropathy cannot be excluded in a few of these patients. Demonstrable mesenteric vascular occlusion was not present in any patient. Three patients survived, two with enteric necrosis which was not panmural and one with panmural necrosis. Usually gas in the hepatic portal venous system is indicative of intestinal necrosis and demands prompt operative treatment.

Multicentric chordoma: Report of a case

This is a case report of a patient with histologically identical sacral and skull base chordomata, apparently of independent origin.

Acute emphysematous cholecystitis: An analysis of ten cases

Summary Ten cases of acute emphysematous cholecystitis are reported. Three patients were treated nonoperatively and seven patients were operated upon. There was one death which occurred postoperatively but was not related to emphysematous cholecystitis per se. More frequent use of abdominal roentgenograms will aid in the early recognition of this entity. The roentgenographic criteria of emphysematous cholecystitis consist of the presence of gas in the lumen of the gallbladder or in the wall or pericholecystic tissues or combinations of these. The initiating factor in the development of emphysematous cholecystitis appears to be obstruction of the cystic duct. Bacteria are of secondary importance. Evidence is presented to support the position that patients with this condition should be treated in the same manner as patients with other forms of acute cholecystitis. Intensive antibiotic therapy should be started as soon as the diagnosis is made and continued until clinical manifestations of the disease have subsided. Surgical treatment is based on the persistence or progression of clinical findings during the course of treatment. Patients doing well during the period of preparation may be treated nonoperatively. This may be also considered for patients with severe coexisting disease.

Preliminary studies using electron radiography for mammography.

An electron radiography mammography system was used for phantom studies and to obtain 230 craniocaudal view patient studies, of which 140 were compared to xeroradiographs for their ability to visualize 7 features of diagnostic importance. The average exposure of the electron radiographs was 89 mR. The technique was considered equal or superior to xeroradiography in 58% of the compared diagnostic features, while patient dose was reduced.

Wire guide and technique for Cantor tube insertion. Rapid small bowel intubation.

A rapid method of small bowel intubation using a specially designed teflon coated 12 foot wire guide and a Cantor tube is described. The method permits rapid decompression of the small bowel. A further application of the technique for immediate small bowel opacification for localization of obstructing lesions is also suggested.

Neonatal fibrous dysplasia.

Summary The first known case of neonatal fibrous dysplasia is reported. The differentiation from congenital pseudarthrosis and simple bone cyst is discussed. Discovery of a case of neonatal fibrous dysplasia supports the theory that fibrous dysplasia represents a congenital disorder of development of the skeleton.

Radiologic Examination of Xanthomas.

Excerpt This Report describes 1 years experience with a radiographic method to detect and measure Achilles tendon xanthomas. Lateral films exposed with tabletop soft-tissue technique to show the e...