Virgil R. Condon

Mycotic aneurysms of the pulmonary artery and aorta.

The clinical presentation and characteristic radiographic and angiographic findings in 6 patients with mycotic aneurysms of the pulmonary artery of aorta are presented. Radiographic findings that may suggest a mycotic aneurysm of the pulmonary artery include a rapid change in its coutour, which may be aneurysmal in character, and multiple septic pulmonary emboli or bacterial pneumonia. Patients with mycotic aneurysms of the descending thoracic aorta may have a middle or posterior mediastinal mass in close association with the aorta, and a pulmonary infiltrate may be seen surrounding the aneurysm. A barium swallow will often demonstrate esophageal displacement by the extrinsic mass.

Intrarenal Reflux and Renal Damage

The retrograde flow of dye from the calices into the collecting tubules (intrarenal reflux) seen during cystrography in children and its effect on the kidneys were evaluated. A retrospective analysis was made of 175 patients with excretory urograms revealing cortical atrophy. Of these patients 68 per cent had cystograms revealing vesicoureteral reflux. Intrarenal reflux was seen in 8 patients less than 6 years old, an incidence of 13.5 per cent in that age group. There was a high correlation, 7 of 8 or 87.5 per cent, between the areas of intrarenal reflux, and associated renal cortical atrophy and calicectasis. Intrarenal reflux provides a pathway by which bacteria and hydrostatic pressure may produce injury to the renal parenchyma. The presence of intrarenal reflux is an absolute indication for ureteroneocystostomy.

Peritoneographic Demonstration of Femoral Hernia

Four cases of congenital hernia demonstrated by positive-contrast peritoneography are reported. Its differentiation from indirect inguinal hernia is described.

Epiphyseal involvement in polyostotic fibrous dysplasia. A report of two cases.

Two cases of polyostotic fibrous dysplasia with epiphyseal involvement are presented. Epiphyseal involvement occurs prior to closure of the epiphyseal growth plate. Radiographically, these lesions are lucent with fine sclerotic margins and may bridge the epiphyseal growth plate. Typical changes of fibrous dysplasia were present in the adjacent portions of the involved bones in both cases. The etiology of fibrous dysplasia may be a defect in bone formation which develops at the epiphyseal growth plate. Demonstration of extension across the epiphyseal growth plate supports this hypothesis.

Congenital complete heart block. Radiographic findings in 13 patients without associated defects.

The radiographic findings in 13 patients with congenital complete heart block without associated anomalies are presented to illustrate characteristic features. Findings related to the increased stroke volume in these patients include: (a) simulated shunt vasculature; (b) pulmonary venous pypertension with redistribution of blood flow to the upper lungs, and, in one patient, peribronchial edema; (c) cardiomegaly with right ventricular, pulmonary artery, left atrial, left ventricular, and aortic enlargement; and (d) variation in cardiac size on serial examinations. Less commonly seen were findings related to atrioventricular dissociation with transitory marked pulmonary venous hypertension present in one patient when left atrial contraction occurred during ventricular systole when the mitral valve was closed.