Sidney C. Henderson

Ultrasound Diagnosis of Common Bile Duct Dilatation

The use of ultrasound in the differential diagnosis of obstructive jaundice has been previously reported. Although common bile duct dilatation has been demonstrated, criteria for its accurate identification have not been stressed. This report describes findings and relationships helpful in recognition of a dilated common bile duct. It is important to identify this structure, since it could otherwise be confused with surrounding vessels.

Percutaneous aspiration biopsy of renal allografts using ultrasound localization

Percutaneous aspiration of renal allografts was done employing ultrasound localization and the Jamshidi renal biopsy needle-syringe. Adequate tissue for pathologic assessment was obtained in 19 of 20 biopsy attempts. There were no complications. Ultrasound provides a convenient, nonradiologic means of renal localization for allograft biopsy. The aspiration needle-syringe is well suited for percutaneous transplant biopsy.

Ultrasound appearance of spontaneous rupture of renal transplant.

Abstract The ultrasound appearance in 2 cases of spontaneous rupture of renal transplants is described. In our experience an echogenic mass at the convex margin of the transplant with good demarcation is suggestive of this entity. In the proper clinical setting this finding should suggest the diagnosis, even in the absence of corroborating evidence by nuclear medicine.

Endoscopic retrograde cholangiodilatation: a preliminary report.

Figure 3. Sequential films of Fogarty balloon passing through a strictured common bile duct: (a) proximal to stricture, (b) entering stricture, (c) deformed by stricture, and (d) distal to stricture. common duct stones endoscopically has been reported.a The positioning of an indwelling catheter at the time of endoscopy has been described.°Recently, Burhenne3 presented nonsurgical dilation of a common bile duct stricture through aT-tube To our knowledge, an attempt to dilate a common bile duct stricture endoscopically has not been reported. To share our initial experience is the purpose of this communication. CASE REPORT A 65-year-old woman with obstructive jaundice had a choledochoduodenostomy 23 years earlier. Endoscopic retrograde cholangiography demonstrated a tight stricture of the common bile duct (Figure 1). Using a 5 French Fogarty catheter outrigged to a front-viewing Olympus GIF-D panendoscope (Figure 2), the common bile duct was cannulated, and the inflated balloon was pulled through the stricture several times. At fluoroscopy, the Fogarty balloon was observed to deform as it passed through the stricture (Figure 3). Its compressibility did not allow it to achieve maximum dilatation. The patient experienced no discomfort or complication. At the time, a satisfactory balloon catheter was not available. The stricture was treated surgically 2 weeks later. DISCUSSION Strictures in the biliary ducts are not uncommon and may be associated with calculi, previous surgery, cholangitis, or pancreatitis. Sphincteroplasty or choledochoduodenostomy are often performed to correct the obstruction. Analysis of the surgical literature reveals that these procedures are often performed on elderly, poor risk patients who have had multiple previous biliary or pancreatic operations.,7,1l,15 Postoperative complications are Timothy G. Lee, MD* Ronald Katon, MD Patrick C. Freeny, MD Sidney C. Henderson, MD Marcia K. Bilbao, MD University of Oregon Health Sciences Center Departments of Radiology and Internal Medicine (Division of Gastroenterology) Portland, Oregon

Computed Tomography and Ultrasound of Retained Placenta from Abdominal Pregnancy

The computed tomographic (CT) and ultrasound findings in a case of retained placenta from an abdominal pregnancy are presented. To our knowledge, this is the first published report of CT findings in retained placenta of abdominal pregnancy. The complementary role of CT and ultrasound in managing this disorder are discussed.

Ultrasound Diagnosis of Renal Angiomyolipoma

Renal angiomyolipomas (AML) are hamartomas, only half of which are found in patients with tuberous sclerosis. More important clinically, because less often suspected, are angiomyolipomas in patients without tuberous sclerosis.

Intravenous Renal Angiography Revisited

A non-catheter technique to visualize the renal arteries during conventional excretory urography is re-emphasized. By rapid injection of the contrast agent and immediate filming satisfactory visualization can be obtained in many cases. This technique is useful in the evaluation of vascular impressions and other urographic findings when intra-arterial catheter examination is not indicated.