Michael J. McLoughlin

Percutaneous fine needle aspiration biopsy of the pancreas following endoscopic retrograde cholangiopancreatography.

Fine needle aspiration biopsies were performed in 9 patients with suspected pancreatic malignancies demonstrated and localized by endoscopic retrograde cholangiopancreatography (ERCP). The biopsies were positive in 7 of 8 patients with pancreatic carcinoma and there were no complications. ERCP is an accurate method for diagnosing pancreatic cancer which may be confirmed safely and easily by fine needle aspiration biopsy.

The Routine Lateral Aortogram and the Celiac Compression Syndrome

ABSTRACT-Routine lateral aortograms were obtained from 152 patients undergoing abdominal angiography. Celiac artery stenosis was found in 49%. Four types of celiac stenosis are described. Type I, the type associated with celiac artery compression, was the most common (31%). Celiac compression was common in all age groups and in both sexes. Many patients were asymptomatic; although this does not necessarily invalidate the syndrome, it does indicate that great care should be taken in the selection of patients for surgery.

Focal nodular hyperplasia of the liver. Angiography and radioisotope scanning.

Abstract Seven examples of focal nodular hyperplasia of the liver have been demonstrated angiographically in 3 young women and 19-year-old girl. Six of these lesions were small and highly vascular, and appeared remarkably similar. One large solitary lesion was supplied by enlarged hepatic artery branches, contained a mass of abnormal, tortuous, irregular vessels and caused a dense, well-defined tumor stain. The angiographic differential diagnosis of these highly vascular, benign lesions is discussed and the radionuclide studies in these patients described.

Angiographic Findings in Multiple Bile-Duct Hamartomas of the Liver

The angiographic appearance in a patient with multiple bile-duct hamartomas of the liver is described. The lesions showed abnormal vascularity, consisting of grapelike clusters of small rings, which could be confused with other benign and malignant conditions demonstrable by angiography; however, it may ultimately prove to be characteristic of this uncommon lesion. The angiographic differential diagnosis is discussed.The angiographic appearance in a patient with multiple bile-duct hamartomas of the liver is described. The lesions showed abnormal vascularity, consisting of grapelike clusters of small rings, which could be confused with other benign and malignant conditions demonstrable by angiography; however, it may ultimately prove to be characteristic of this uncommon lesion. The angiographic differential diagnosis is discussed.

Hepatic venography in the surgical assessment of hepatic tumours

Hepatic venography was performed on 80 patients with hepatic tumours for the pre-operative assessment of resectability. Sixty-six patients subsequently underwent laparotomy, 27 undergoing hepatic resection. Forty-two patients had metastases from colo-rectal primaries, 19 hepatocellular carcinoma and 19 a variety of other tumours. The type and frequency of the abnormalities shown on venography were noted for each tumour category and for their hepatic segmental distribution. The results of venography were compared with those of arteriography, computed tomography and ultrasound and with the findings at laparotomy. Displacement was the commonest abnormality seen while encasement or obstruction occurred less frequently and tumour invasion was rare. The sensitivity of venography in correctly identifying the segmental distribution of tumour deposits was 41%. Sensitivity was poorest with tumours in the left lobe (31%) and bilobar tumours (0%). Venography was most sensitive in detecting tumour involvement of the major segmental hepatic veins and inferior vena cava (100%). Peripheral colo-rectal metastases frequently produced no venographic abnormality. Hepatic venography provides no additional information to arteriography, computed tomography or ultrasound in patients with peripheral or bilobar tumour deposits. Some additional information may be obtained with central tumours and venography is the most accurate means of detecting tumour involvement of the major segmental hepatic veins.