Use of single percutaneous endoscopic gastrostomy in management of gastric volvulus in three patients.

Gastric volvulus is a rare condition that occurs when the stomach twists either in an organoaxial or mesenteroaxial direction. In patients with recurrent episodes of volvulus, standard therapy is surgical correction. Many patients, however, are not candidates for surgical therapy because of comorbid conditions or advanced age.

Colorectal cancer. Clinical and pathologic features.

Despite an improved understanding of the pathogenesis of colorectal cancer and the technical ability to alter its natural history in a large proportion of average and high-risk patients, this cancer remains deadly. There has been no significant change in incidence or survival rates over the past 40 years. This indicates a continued need for earlier detection of polyps and cancers, aggressive surgery for the primary tumor, and improved multimodality treatment for metastatic disease.

Small bowel cancer. Clinical and pathologic features.

Although the small bowel constitutes over 75% of the length and 90% of the mucosal surface of the alimentary tract, it is the site of only 1% of gastrointestinal cancers. Despite their rarity, it is important to diagnose small bowel tumors early to maximize patient survival. This article focuses on the clinical and pathologic findings of small bowel adenocarcinomas and carcinoids.

Gastric cancer. Radiologic diagnosis.

The development and refinement of double-contrast barium techniques over the past two decades have dramatically improved the radiologist's ability to detect gastric cancer and characterize gastric ulcers. This article presents the radiologic findings of both early and advanced gastric cancer and offers guidelines for differentiating benign versus malignant gastric ulcers.

Gastric cancer. Clinical and pathologic features.

Gastric cancer is one of the leading causes of cancer mortality worldwide. Very little progress has been made in improving the dismal cure rate of gastric cancer over the last 30 years in the United States. Unless major breakthroughs develop in chemotherapy or radiation therapy, the only way to improve survival rates rests with earlier recognition and prevention.

Esophageal cancer. Clinical and pathologic features.

Carcinoma of the esophagus remains one of the most lethal of all cancers. In the past, squamous cell carcinomas accounted for over 95% of esophageal malignancies. Over the past two decades, however, there has been a dramatic increase in the incidence of adenocarcinoma arising in columnar cell-lined Barrett's mucosa, accounting for up to 34% of all esophageal cancers in some areas.

Spinal headaches after myelograms: comparison of needle types.

Objective: We compared traditional bevel-tip end-hole spinal needles and pencil-point-tip side-hole needles for the incidence, severity, and duration of spinal headaches in subjects who had myelograms. Age, sex, and myelographic findings were examined.

Subjects And Methods: We studied 138 subjects referred for myelograms.

Detection of occult esophageal narrowing with a barium tablet during chest radiography.

Dysphagia is a delayed symptom of esophageal constriction and often appears after the luminal diameter is reduced to less than 10 mm. Earlier diagnosis of benign or malignant strictures while clinically silent would be desirable; hence we investigated the detectability of occult esophageal lesions with the aid of an ingested barium tablet during routine chest radiography. We prospectively examined 300 patients older than 40 years, who were referred for chest films because of indications unrelated to the upper gastrointestinal tract.

Carcinoma arising in urinary bladder diverticula: imaging findings in six patients.

Objective: Carcinoma arising within urinary bladder diverticula has a poorer prognosis than do neoplasms that originate within the main bladder lumen as a result of early transmural tumor infiltration. Imaging plays an important role in diagnosing and staging the disease. We describe the radiologic findings in six patients with pathologically proved diverticular carcinomas.

Disappearing breast calcifications: mammographic-pathologic discrepancy due to calcium oxalate.

We have reported a case in which breast biopsy was done to study suggestive microcalcifications that were confirmed by specimen radiography but were not evident with standard light microscopy. Examination of the specimen under polarized light revealed calcium oxalate crystals. Awareness of this potential pitfall should minimize the number of radiologic-pathologic discrepancies.

Appendices epiploicae of the colon: radiologic and pathologic features.

Appendices epiploicae are adipose structures protruding from the serosal surface of the colon. They can be seen with abdominal radiography and cross-sectional imaging if the colonic wall is surrounded by intraperitoneal contrast material, ascites, or blood. Normal appendices epiploicae appear as lobulated masses of pericolic fat, usually 2-5 cm long and 1-2 cm thick.

Evolution of pulmonary pseudolymphomas: clinical and radiologic manifestations.

Solitary or multifocal pulmonary pseudolymphoma developed in two men and two women between 59 and 76 years of age. The lesions were detected incidentally in three patients and following a respiratory infection in the fourth. Follow-up radiographs and chest CT revealed gradual expansion of the opacities without cavitation, calcification, or pleural involvement.

Diverticulitis of the jejunum: clinical and radiological features.

This article describes three cases of jejunal diverticulitis in elderly women, who had presented with pain and tenderness in the periumbilical region or the left side of the abdomen, low-grade fever, anemia, and weight loss. The findings were initially attributed to possible inflammatory or neoplastic lesions of the colon. However, gastrointestinal barium studies and computed tomography (CT) of the abdomen proved crucial in establishing the preoperative diagnosis of jejunal diverticulitis and its associated abscess in the adjacent mesentery or abdominal wall.

Percutaneous-endoscopic biliary stenting in patients with occluded surgical bypass.

Purpose: The purpose of this investigation was to test the feasibility of using a recently developed technique of placing internalized biliary stents into patients who have had reobstruction after initial surgical bypass.

Patients And Methods: Seven men and three women, 46 to 85 years of age (eight with pancreatic carcinoma, one with metastatic colon, and one with metastatic ovarian carcinoma), all had reobstruction after initial surgical bypass palliation. Subsequent attempts to place stents via endoscope failed in five patients; a pair of 7-Fr stents placed in one patient failed to drain well.

Heterotopic gastric mucosa in the duodenum: radiographic findings.

Heterotopic gastric mucosa in the duodenal bulb was detected by endoscopic examination in 25 adult patients and was confirmed by biopsy in 17 of these patients. The endoscopic findings were correlated with the radiographic features of the lesion on upper gastrointestinal barium studies. On radiographs, this entity usually presented as clusters of 1- to 3-mm plaques raised above the smooth and featureless duodenal mucosa; this was seen in 17 (68%) of 25 patients.