Jovitas Skucas

Hypotonic colon examination with glucagon.

In a clinical double-blind crossover study, the effects on barium enema examinations of intramuscular injections of a placebo, glucagon, atropine sulfate, and glucagon plus atropine sulfate were compared in 12 male volunteers for a total of 48 studies. With either atropine sulfate or glucagon there were decreased colon tonicity and increased comfort during the examination. Number and intensity of side effects were less with either placebo or glucagon than with atropine sulfate alone or combined with glucagon. The subject is more comfortable, the colon and small bowel more relaxed, intracolonic pressure less, and the examination more quickly completed after glucagon than after placebo or atropine sulfate.

CT in upper gastrointestinal tract perforations secondary to peptic ulcer disease

Computed tomographic (CT) scans of 11 patients with perforations of the stomach or duodenum were reviewed to determine the variety and relative conspicuity of findings. Five patients had de novo presentation due to perforation of peptic ulcers, two had perforations at ulcer repair sites, and the remaining four patients had ulcer perforations following unrelated surgery. CT allowed recognition of at least one component of bowel perforation, such as extragastroinestinal gas and/or contrast, in most patients. In only three patients (27%), however, could these findings be specifically related to a perforation of the stomach or duodenum from the CT scans alone.

Whole-Gut Irrigation as a Means of Cleaning the Colon

The authors describe a whole-gut irrigation method of cleaning the colon. Normal volunteers drank an irrigant solution at varying rates, and all but one achieved a radiologically clean colon within several hours. This method is proposed for use in the occasional study where a clean colon must be obtained in a relatively short period of time.

Bowel cancer characteristics in patients with regional enteritis

We report 10 carcinomas in 8 patients with regional enteritis. Five of the cancers were in the ileum, 4 in the right colon, and 1 in the rectum. The visualized small bowel cancers appeared as benign strictures in small bowel involved by regional enteritis. Most were poorly differentiated. The colon cancers had a more typical radiographic appearance of malignancy. In some patients with small bowel cancer the malignancy was discovered only on histologic evaluation; the malignant nature of the lesion was not appreciated by radiography or gross examination at surgery.

Comparative imaging of gallbladder cancer

We reviewed various imaging approaches in 22 patients with gallbladder cancer. Nineteen had had ultrasonography and nine computed tomography performed. A gallbladder mass or diffuse wall thickening was seen by ultrasonography in 42% and computed tomography in 33% of patients. A significant number of patients had no gallbladder wall abnormality detected by ultrasonography (37%) or computed tomography (56%). Performing both ultrasonography and computed tomography improved the diagnostic rate; in this subgroup the detection rate was 51%. Cholelithiasis, dilated biliary ducts, the liver metastases were associated findings. Percutaneous cholangiography in jaundiced patients revealed the level of bile duct occlusion and often suggested the diagnosis. Radionuclide hepatobiliary imaging simply revealed non-visualization of the gallbladder.

An Evaluation of the Nissen Fundoplication

The characteristic radiological findings which follow a Nissen fundoplication are reviewed. The esophagus may be narrowed but is intrinsically normal. A pseudotumor at the medial aspect of the fundus is generally present. The history and radiographic findings can normally differentiate this defect from neoplasm or a nonoperated hiatal hernia. Postoperative clinical evaluation has shown this procedure to be very valuable in the amelioration of symptoms.

The Effect of Barium on Blood in the Gastrointestinal Tract

The effect of various commercial barium sulfate preparations on blood coagulation, flocculation, and hemolysis was studied. There was considerable variation not only among different barium products but also among different concentrations of the same product. There is no good experimental evidence that barium enemas do stop bleeding. It is probably best to avoid the use of any enema in attempting to control major colonic bleeding; but if an enema is given for this purpose, a tap-water enema is better, as it contains no anticoagulants and is more effective in producing clot formation than most barium suspensions.

The Routine Air-Contrast Examination of the Esophagus

An air-contrast technique of the esophagus is described. It is simple to perform routinely prior to an upper gastrointestinal study, can reveal unsuspected small lesions, does not lead to excessive dilution of the barium, and can be done just prior to obtaining air-contrast views of the stomach.

An Evaluation of Screen-Film Speed Characteristics

The relative speeds of six commercially available screen-film combinations were evaluated. There is a nonlinear relationship throughout the kVp range between the calcium tungstate, barium strontium sulfate, and rare earth screens. The speed of the last two types falls off considerably at lower kVp levels.

Esophageal obstruction following administration of "aged" barium sulfate tablets--a warning.

Esophageal obstruction was encountered in 2 patients following the adminstration of a barium sulfate tablet. The tablets did not disintegrate for over three hours. They had been stored in the radiology department for at least three years. In vitro tests showed that the old tablets did not disintegrate for three hours while fresh tablets disintegrated within 30 minutes.