Robert D. Sparks

Congenital dilation of the intrahepatic bile ducts

Abstract Five additional patients with congenital dilation of the intrahepatic bile ducts are described. This disorder is still generally unrecognized but may be the explanation for certain unusual cases, associated with intrahepatic stones.

Hepatic Angiography in the Selection of Patients with Hepatomas for Hepatic Lobectomy

A system for angiographic staging of hepatomas which appears to be useful in selecting or rejecting patients for hepatic lobectomy is presented. This system may also aid in evaluating patients as candidates or noncandidates for liver transplants.

Splenic cyst diagnosed by percutaneous needle aspiration and splenography: Report of a case

SummarySplenic cyst was demonstrated preoperatively by percutaneous splenic aspiration and splenography. This technique has been employed in a number of previously reported cases.The procedure has been found to be helpful in the preoperative diagnosis of splenic cysts, exposes the patient to little risk, and thus far has been free from complications. The procedure should be included in the diagnostic evaluation of patients with splenomegaly of obscure origin.

Ectopic spleen mimicking an intrinsic fundal lesion of the stomach

SummaryThis report describes the case of an elderly man with severe pulmonary disease, who had radiographic evidence of a mass involving the fundus of the stomach, which was thought to be a neoplasm that was growing slowly. Abdominal exploratory operation was obviated when a combination of newer technics for study of the upper gastrointestinal tract revealed that the defect was was produced by the impingement of the patients spleen, which was normal except for its ectopic position. Selective abdominal angiography revealed that the blood supply to the mass was provided by the splenic artery and vein. Scintillation scanning demonstrated that injured red blood cells were sequestered in the mass, a normal function of the spleen. A flexible fiberoptic gastroscope permitted visualization of the mucosa in the fundic and cardioesophageal regions of the stomach and demonstrated that there was no neoplasm of the gastric mucosa in the region of the defect demonstrated in the fundus of the stomach.

A study of the Appearance of Altered Sulfobromophthalein Human Serum

Summary An extraction procedure was used for studying sulfobromophthalein sodium conjugation in the serum of normal human subjects and patients with hepatic disease. Altered sulfobromophthalein sodium appeared quite rapidly and in high concentrations during the first 15 minutes after sulfobromophthalein sodium administration in normal subjects. This substance was markedly decreased in certain patients with liver disease. Multiple sulfobromophthalein sodium clearances were obtained in 3 patients during the course of their hepatic disease. Progression of the curves was strikingly similar in all 3 patients despite dissimilar etiologies for their hepatic disease.

Clinical analysis of reflux esophagitis in symptomatic patients

Mucosal atrophy is a criterion of reflux esophagitis but requires histologic confirmation. Pinch biopsies often are inadequate for fine diagnosis; suction biopsies yielded better specimens. Meticulous histologic technic is essential.