Thomas C. Beneventano

Computed Tomography in Crohn Disease

Twelve patients with Crohn disease were studied by computed tomography. Characteristic findings of small intestinal involvement include symmetrical bowel wall thickening, a “double halo” appearance on cross section of the diseased bowel segment, and an associated mesenteric fat mass. Computed tomography provided crucial diagnostic information in the management of some of the intestinal and extraintestinal complications of the disease.

Cytomegalovirus colitis in acquired immune deficiency syndrome: Radiologic spectrum

Six cases of cytomegalovirus (CMV) colitis are described. The radiographic manifestations of this colitis are nonspecific and usually mimic the findings of ulcerative colitis with diffuse mucosal ulceration or granulomatous colitis with aphthous ulceration and skip areas. Terminal ileal involvement was noted in 1 patient. Nonspecific edema was present in 2 other cases. One patient demonstrated unusual cecal and ascending colonic nodularity due to pseudomembranes and, in another, large flat discrete ulcerations were identified. Angiography, in 1 case, demonstrated marked hypervascularity and identified a site of hemorrhage in the ascending colon.With the radiographic identification of colitis in an immunocompromised patient, particularly a patient with acquired immunodeficiency syndrome (AIDS), CMV colitis must be strongly considered in the differential diagnosis. Endoscopic biopsy is the most effective method of establishing the diagnosis.

Squamous cell carcinoma of the esophagus in patients with Acquired Immunodeficiency Syndrome

Two patients with Acquired Immunodeficiency Syndrome (AIDS) and infectious esophagitis developed squamous cell carcinoma of the esophagus. The clinical, radiographic, and endoscopic presentations in both cases were atypical. One patient developed a focal flat lesion that imitated segmental esophagitis, and the other patient developed a superficially spreading carcinoma that mimicked diffuse esophagitis. In the setting of AIDS, a changing radiographic or endoscopic mucosal pattern requires biopsy to exclude the possibility of a superimposed squamous cell carcinoma.

Radiologic demonstration of important gastrostomy tube complications

Complications of gastrostomy tubes have been reported principally in the surgical literature and primarily affecting infants and children. Recent reports in the radiologic literature draw attention to the role of the radiologist in the evaluation of these complications.

Experimental management by nonoperative adrenergic stimulation of simulated common duct stones.

The effects of β-receptor stimulation by isoproterenol on ampullary flow and passage of intracholedochal foreign bodies were evaluated in dogs. Flow rates for saline across the ampulla were unchanged by β stimulation except for the earlier appearance of flow in association with a decrease in sphincteric resistance. The mean irrigation pressures required for the passage of a foreign body into the duodenum decreased by 46% from control values when isoproterenol was infused. Stimulation of β receptors may thus serve as a valuable adjunct in the management of patients with retained choledochal calculi by decreasing ampullary resistance. The ineffectiveness and hazards of previously utilized agents is discussed.

The physiological effect of acute vagal section on canine biliary dynamics.

Abstract The effects of acute vagal section upon canine biliary dynamics are reported. The most important dynamic change is the decrease in passage pressure at both the cystic duct sphincter zone and the choledochal duodenal junction sphincter.

The influence of extrabiliary peritonitis on cholecystography

Abstract 1. 1. The problem of biliary visualization in the presence of peritonitis of extrabiliary origin is investigated in the dog. 2. 2. Extrabiliary peritonitis of three types was produced in this experiment: sterile, colonic, and pancreatic. 3. 3. Each animal was studied by intravenous cholecystography. 4. 4. Gallbladder visualization occurred in all animals regardless of the extent and duration of peritonitis. 5. 5. Visualization of the gallbladder by intravenous cholecystography is therefore a reliable method of eliminating the gallbladder as the source of experimentally induced peritonitis.