Appendicitis: the impact of computed tomography imaging on negative appendectomy and perforation rates.

Objectives: The purposes of this study were to investigate the use of computed tomography (CT) imaging in patients with suspected acute appendicitis and to evaluate the impact of CT on negative appendectomy and perforation rates. In patients clinically diagnosed of acute appendicitis the reported overall negative appendectomy rate is about 15-20%; 10% in men and 25-45% in women of childbearing age. This is associated with a perforation rate of 21-23%.

Intestinal ischemia in patients in whom small bowel obstruction is suspected: evaluation of accuracy, limitations, and clinical implications of CT in diagnosis.

Purpose: To determine the accuracy of computed tomography (CT) in diagnosis of intestinal ischemia in patients with possible intestinal obstruction and the limitations and clinical implications of use of CT.

Materials And Methods: In 100 patients in whom intestinal obstruction was suspected clinically, CT findings were correlated with surgical findings in 77 patients and with follow-up clinical findings after nasogastric suction in 23 patients. The interval between CT and surgical exploration in patients with ischemic bowel was 1-98 hours (mean, 13 hours).

CT of small-bowel lymphoma in immunocompetent patients and patients with AIDS: comparison of findings.

Objective: The purpose of this study was to describe and analyze the CT features of small-bowel lymphoma, compare those features with the radiographic presentation in immunocompetent patients and patients with AIDS, and discuss the role of CT in the initial detection and evaluation of this disease.

Materials And Methods: Abdominal CT examinations of 42 consecutive patients with proven small-bowel lymphoma were retrospectively reviewed. In 19 patients, small-bowel examinations were also available for review.

CT evaluation of infradiaphragmatic air in patients treated with mechanically assisted ventilation: a potential source of error.

Objective: The purpose of this study was to describe the CT features of infradiaphragmatic air that may develop in patients after mechanically assisted ventilation, its location, its pathway of transdiaphragmatic dissection, and its extension into the abdomen.

Materials And Methods: We retrospectively evaluated six consecutive adult patients with pneumomediastinum associated with positive end-expiratory pressure therapy who developed intraabdominal air and were imaged with CT in our institution-between 1993 and 1995. Abdominal CT examinations were reviewed and correlated with the clinical findings, follow-up examinations, and exploratory laparotomies in four patients.

CT in patients with scirrhous carcinoma of the GI tract: imaging findings and value for tumor detection and staging.

Objective: The purposes of this study were to analyze the CT features of scirrhous carcinoma of the gastrointestinal (GI) tract and to assess the usefulness of CT in detecting and staging these lesions.

Material And Methods: This is a retrospective evaluation of 31 proven cases of scirrhous carcinoma (linitis plastica) of the GI tract imaged in our institution from 1986 to 1994. Twenty-two patients had primary gastric carcinoma, and nine had carcinoma of the colon (rectosigmoid in eight and right colon in one).

Necrotizing Candida enterocolitis in AIDS: CT features.

An unusual case of necrotizing enterocolitis secondary to invasive candidiasis in acquired immunodeficiency syndrome is reported. Computed tomography showed significant small bowel dilatation, high density intestinal contents, extensive ileal pneumatosis intestinalis, and air in the intrahepatic branches of the portal vein. Mucosal ulcerations and extensive transmural necrosis associated with invasive candidiasis were detected in the distal ileum and right colon in the resected pathology specimen.

CT of Clonorchis Sinensis pancreatitis.

Clonorchis Sinensis infestation can involve the pancreatic duct and induce attacks of acute pancreatitis. Ct findings in a case of Clonorchis Sinensis pancreatitis revealed significant enlargement of the pancreas with compression and obstruction of the common duct. Medical treatment leads to resolution of the clinical and CT findings.

Left-sided omental infarction with associated omental abscess: CT diagnosis.

The CT findings of two patients with left-sided omental infarction associated with acute inflammation and abscess formation are described and illustrated. The patients presented with lower abdominal pain, fever, and leukocytosis, and they exhibited a poorly defined heterogeneous low-attenuated mass containing fat in the anterior left lower abdomen. Although segmental omental infarction is usually a self-limiting condition that may resolve spontaneously, necrosis associated with secondary infection and abscess formation may develop occasionally.