Thomas O. Rumley

Calcified parathyroid glands detected by computed tomography.

Computed tomographic demonstration of single calcified parathyroid glands in two patients corresponded to operative findings of a calcified carcinoma and a calcified adenoma. The CT demonstration of a calcified parathyroid gland should suggest carcinoma, and the operative approach should be planned to permit an en bloc resection.

PIPIDA scan diagnosis of traumatic rupture of the gallbladder

Eighteen days after injury, a patient was evaluated for bilious ascites with a 99mTc-PIPIDA (paraisopropyliminodiacetic acid) scan. A ruptured gallbladder was shown, and this finding was confirmed at exploration. Radionuclide scanning offers a sensitive, non-invasive approach for delineating disruption of the biliary tract, and should be considered when such a defect is suspected.

Self-Administered Bolus Jejunostomy Feeding and Gastric Fluid Reinfusion in Patients with Gastric Atony

Twelve patients with profound gastric atony were taught to administer their own tube jejunostomy bolus feedings and, when necessary, to manage their gastric secretions by connecting their gastrostomy and jejunostomy tubes. These techniques allowed 11 of 12 patients to obtain reasonable nutrient intake and eight of the 12 to successfully reinfuse retained gastric secretions; alleviating the need for intravenous fluid replacement and expediting hospital discharge. Seven patients were able to resume some oral intake at home after resolution of their gastric atony. In the sufficiently motivated patient with gastric atony from multiple causes, these techniques provide alternatives to indefinite hospitalization with cumbersome and expensive intravenous hyperalimentation or constant infusion enteral alimentation.

Case Report: Mediastinal Pancreatic Pseudocyst Presenting with Dysphagia and Odynophagia

ABSTRACT Recent onset of dysphagia and severe odynophagia were the only major presenting symptoms in a 37-year-old man with a mediastinal pancreatic pseudocyst. As a symptom of a mediastinal pancreatic pseudocyst, dysphagia has rarely been reported; this is the first report of odynophagia.