Jack Farman

Effects of radiation on the human gastrointestinal tract.

Radiation therapy directed at the abdomen may damage the digestive tract, the type and extent of injury depending on the dose of the radiation and the radiation sensitivity of the gut. Characteristic early changes are manifest in the mucosa of the gut: for later ulceration, changes in the collagen tissues and particularly in the vascular channels occur. This paper describes and characterizes injuries to the esophagus, stomach, small intestine and colon. It emphasizes the importance of recognizing radiation-induced damage to the gut which may occur early or late after radiation.

Solid and Papillary Epithelial Pancreatic Neoplasm: An Unusual Tumor

Solid and papillary epithelial neoplasms of the pancreas are uncommon. These grow to a large size, are often palpable, and occur most often in young black women. The tumors have a characteristic histologic appearance and a low malignant potential. Heavy tumor calcification is an unusual finding. Two cases with radiologie-pathologic correlation are presented herein.

Radiological manifestations ofStrongyloides stercoralis

Nine patients with radiological changes due toStrongyloides stercoralis (SS) are described. A wide variation in appearance exists ranging from mild edema of the duodenal and small bowel mucosa to grossly enlarged, prominent valvulae conniventes. Small bowel dilatation is significant, and in overwhelming infestation toxic dilatation with paresis results. Spasm, ulceration, and stricture are encountered in addition. The appearances usually improve and reverse with treatment. Ampullary involvement is responsible for reflux of barium into the pancreatic duct and biliary tree through a patulous sphincter. In 1 patient the colonic changes resembled ulcerative colitis.

Focal esophageal candidiasis in acquired immunodeficiency syndrome (AIDS)

When candidiasis involves the esophagus, it usually does so as an extensive and diffuse infection. In our experience, however, esophageal candidiasis in patients with the acquired immunodeficiency syndrome (AIDS) is clinically distinct from the same infection in patients with other immunodeficiency states. Of 25 patients with AIDS and esophageal candidiasis studied radiographically, 4 patients with localized involvement of the esophagus are presented. The clinical and radiologic manifestations of focal esophageal candidiasis in these patients are reviewed and compared to previously described cases of esophageal candidiasis.

Kaposi's sarcoma of the intestinal tract: Roentgen manifestations

Five cases of generalized Kaposis sarcoma are reported with roentgen evidence of involvement of the intestinal tract. In three instances, there was extensive involvement of the small bowel with multiple intramural nodules. The fourth patient demonstrated multiple polypoid lesions of the colon, and in the fifth a constricting lesion of the ileum was present. Two patients with small bowel involvement had significant malabsorption. This latter complication of diffuse Kaposis sarcoma of the small bowel has not been previously reported. The diagnosis of the nature of the roentgen intestinal abnormality can usually be made, because intestinal involvement generally occurs late in the disease, when both extensive cutaneous nodules and edema of the extremities are apparent.

Ischemic disease of the small bowel and colon associated with oral contraceptives.

The widespread use of hormonal contraceptive pills by young women has caused a documented increase in thromboembolic disorders. This article describes yet another of the drug-induced complications namely, the development of ischemic bowel disease in seven cases. The ischemic changes which involved the small intestine in three and the colon in four patients became reversible after conservative management and discontinuance of oral contraceptive agents. The importance of clinical and radiologic consideration of ischemic bowel disease in young females receiving birth control pills is emphasized.

Ulcerative colitis associated with hypertrophic osteoarthropathy

(1) clubbing, (2) periostitis with periosteal new bone formation, (3) synovitis, and (4) autonomic dysfunction as evidenced by increased sweating of the palms and soles. Most commonly osteoarthropathy occurs secondary to pulmonary disease, especially carcinoma of the lung, lung abscess, and bronchiectasis. It is rare for the complete hypertrophic osteoarthropathy syndrome to develop as a consequence of gastrointestinal disease, although clubbing as an isolated manifestation occurs more commonly (2). Osteoarthropathy may also occur in an idiopathic form unassociated with any known disorder or have an hereditary basis for its development. Rarely osteoarthropathy complicates hormonal dysfunction of the thyroid and is then termed thyroid acropachy. A young adult male is reported who had ulcerative colitis and subsequently developed secondary osteoarthropathy. This is the second report of the full syndrome in association with ulcerative colitis.

Pancreatic pseudocysts involving the spleen

Pancreatic pseudocyst involving the splenic parenchyma itself is an unusual complication of pancreatitis. The diagnosis is best established by arteriography, isotopic studies, and sonography. Once confirmed, surgical intervention is mandatory because of the danger of secondary hemorrhage.

Colitis cystica profunda, an unusual solitary tumor: Report of three cases.

SummaryColitis cystica profunda manifests as a nodular or polypoid defect, either localized or diffuse, on barium enema examination. Differentiation from a neoplasm by histologic examination is necessary, as the lesion may resemble a mucoid carcinoma.

Ileal Leiomyosarcoma and Leiomyoma: False-Positive Scintiscans for Meckel??s Diverticulum

Two cases of Heal leiomyomatous neoplasms with positive scintigraphic findings for Meckels diverticulum are presented. The precise mechanism for the abnormal concentration of the Tc-99m pertechnetate is uncertain. Illustrations of the collating barium and computerized tomographic studies are included and the scanning technique utilized is reviewed.