M. R. Andress

The venous connections of vulval varices

The radiological technique and findings in 12 patients with persistent vulval varices are described. The varices drain into the sapheno-femoral system and into the internal iliac vein through the internal pudendal and obturator veins. As a result of a radiographic study of a pelvic specimen, a 40° oblique projection is recommended for phlebography. The importance to the surgeon of identifying the internal pudendal and obturator veins is emphasised.

Arterial impressions in pelvic phlebography

Twelve patients whose pelvic phlebograms showed appearances suggestive of arterial impressions were subjected to pelvic arteriography and the two examinations superimposed. By a modified subtraction technique the filling defects in the phlebograms have been shown to be arterial impressions. These filling defects, while of no significance in themselves, may at some sites be an aetiological factor predisposing to venous thrombosis. They may also be confused with extrinsic pressure from masses or intra-luminal thrombosis. Some indication of the relative frequency in the different sites has been given.

Angioma of the Knee Demonstrated by Angiography and Arthrography

Angiomas rarely involve joints. STEVENS et coll. (1969) found 96 cases reported in the literature, most often in the knee, and added one further case also affecting the knee. Articular angiomas are often diagnosed only after a long delay (KARLHOLM & STJERNSWARD 1963, MILLER 1969) and then in many cases only after exploration of the joint. The radiologic investigations, even including angiography and arthrography are often negative, as in the case reported by STEVENS et coll. This paper describes the radiologic appearances of an angioma demonstrated by angiography and arthrography.

Malakoplakia of the bladder demonstrated by double contrast cystography

Malakoplakia is an uncommon disease characterised by the presence of soft raised yellow or grey-brown plaques in the bladder or, less often, in the ureter or renal pelvis. They may be single or multiple and tend to be centrally umbilicated. The histological findings are also characteristic with the presence of large cells with eosinophilic cytoplasm and with bodies containing iron and calcium in and between the cells. These bodies are named Michaelis-Gutmann bodies (or calcospherites) after the two workers who first described the condition in 1902.