Use of a Macro as Nudge Factor in Communication Between Radiologists and Referring Physicians.

Introduction/methods: Radiologists provide value through communication of imaging findings. We outline a quality improvement effort using a dedicated dictation macro as a behavioral nudge to increase direct communication between radiologists and referring physicians. Use of the macro was encouraged by departmental leadership and publicised widely prior to implementation.

The diagnostic yield of superior mesenteric angiography: correlation with the pattern of gastrointestinal bleeding.

In an attempt to evaluate the usefulness of mesenteric angiography in relation to the nature and rate of gastrointestinal bleeding, we reviewed the records of all patients hospitalized at Montefiore Medical Center between 1983 and 1986 who had mesenteric angiography as part of their diagnostic evaluation for gastrointestinal bleeding. Fifty-eight patients were classified according to the pattern of blood loss: 14 patients with chronic occult, 28 patients with recurrent acute, and 16 patients with acute bleeding. The sensitivity and specificity of mesenteric angiography for each group was: chronic occult, 40% sensitivity and 100% specificity; recurrent acute, 30% sensitivity and 100% specificity; acute, 47% sensitivity and 100% specificity.

Hemorrhage from ileal varices: a delayed complication after total proctocolectomy in a patient with ulcerative colitis and cirrhosis.

A 60-year-old woman presented with recurrent ileostomal hemorrhage 29 years after proctocolectomy for ulcerative colitis. Ileal varices were demonstrated by selective mesenteric angiography, and a portasystemic shunt was performed with control of the bleeding. Stomal varices typically present with repeated episodes of bleeding at and proximal to the mucocutaneous junction of the ileal stoma and attempts at local corrective measures generally meet with only temporary success.

Follow-up of patients after nephrectomy for renal cell carcinoma.

Follow-up of patients after nephrectomy for renal cell carcinoma is often inadequate. The sooner secondary lesions are identified and treated the better. Routine annual admission of these patients is urged for abdominal angiography, bone scan, chest roentgenograms, and specialized diagnostic procedures as indicated.