Killian-Jamieson diverticula: radiographic findings in 16 patients.

OBJECTIVE: The purpose of this study was to reassess the findings of Killian-Jamieson diverticula (i.e., proximal lateral cervical diverticula) on pharyngoesophagograms and to compare the prevalence, clinical findings, and radiographic findings of Killian-Jamieson diverticula with those of Zenker's diverticulum. MATERIALS AND METHODS: A computerized search of radiology files revealed 16 patients with Killian-Jamieson diverticula and 26 patients with a Zenker's diverticulum. The double-contrast pharyngoesophagograms and medical records were reviewed retrospectively. RESULTS: Only three (19%) of 16 patients with Killian-Jamieson diverticula had symptoms attributable to the diverticula (suprasternal dysphagia in two and cough in one), and none had aspiration pneumonia. In contrast, 16 (62%) of 26 patients with a Zenker's diverticulum had suprasternal dysphagia and three patients (12%) had aspiration pneumonia. Twenty Killian-Jamieson diverticula were detected on pharyngoesophagograms in 16 patients, including 12 (75%) with unilateral left-sided diverticula and four (25%) with bilateral diverticula. The Killian-Jamieson diverticula had an average maximal dimension of 1.4 cm. Zenker's diverticulum was nearly four times as common as Killian-Jamieson diverticula and had an average maximal dimension of 2.5 cm. Three patients (11%) with a Zenker's diverticulum had reflux of barium from the diverticula into the hypopharynx with overflow aspiration. Finally, gastroesophageal reflux was detected in nearly twice as many patients with a Zenker's diverticulum as with Killian-Jamieson diverticula. CONCLUSION: Killian-Jamieson diverticula are less common and smaller than Zenker's diverticulum. Killian-Jamieson diverticula are less likely to cause symptoms and are less likely to be associated with overflow aspiration or gastroesophageal reflux than is Zenker's diverticulum.     

Ileal endometriosis: radiographic findings in five cases

PURPOSE: To determine the radiographic findings in five patients with ileal endometriosis. MATERIALS AND METHODS: A search of radiology files revealed five patients with surgically proved endometriotic implants in the ileum at enteroclysis (three patients), at small-bowel follow-through (one patient), and at double-contrast barium enema study (one patient). The radiographic findings were reviewed retrospectively. Clinical, surgical, and histopathologic findings were also reviewed. RESULTS: All five patients were nulliparous women (mean age, 34.4 years; age range, 28-41 years). Four patients presented with abdominal and/or pelvic pain, but only one of these four had cyclic pain that coincided with menstruation. Barium studies revealed endometriotic implants in the terminal ileum within 10 cm of the ileocecal valve in four patients and in the mid-ileum in one. The radiographic findings consisted of extrinsic mass effect with variable spiculation and tethering of folds in two patients, annular lesions with spiculated folds and abrupt or tapered borders in two, and a plaque-like lesion in one. In four patients who underwent double-contrast barium enema studies, associated endometriotic implants were found in the rectosigmoid colon. CONCLUSION: Ileal endometriosis usually involves the terminal ileum within 10 cm of the ileocecal valve and manifests as a spectrum of findings on barium studies. Ileal endometriosis should therefore be considered when these findings are present in young, nulliparous women with abdominal or pelvic pain.     

Lung torsion: radiographic findings in nine cases

Torsion of the lung, although relatively rare, can occur under three sets of circumstances: spontaneously, usually in association with some other pulmonary abnormality; following traumatic pneumothorax; and as a complication of thoracic surgery. Nine cases of pulmonary torsion were analyzed. The radiographic findings are a collapsed or consolidated lobe that occupies an unusual position at plain radiography, at plain or computed tomography, at angiography, or at bronchography; hilar displacement in a direction inappropriate for that lobe; alteration in the normal position and sweep of the pulmonary vasculature; rapid opacification of an ipsilateral lobe following trauma or thoracic surgery; marked change in position of an opacified lobe on sequential radiographs; bronchial cutoff with no evidence of a mass; or lobar air trapping. Mortality is high if the torsion goes unrecognized and surgical fixation is delayed.     

Nocardiosis of the lung: chest radiographic findings in 21 cases

Pulmonary manifestations of nocardial infection were present in 21 patients, with microbiologic proof in all and pathologic proof in 12. An analysis of the findings in these patients, combined with a review of previous reports of nocardiosis, suggests several important conclusions for radiologists. First, nocardiosis may occur in otherwise healthy persons but is most common in compromised patients, especially those being treated with anti-inflammatory agents, particularly corticosteroids, for chronic obstructive pulmonary disease and other systemic diseases. As pathologic manifestations are both suppurative and granulomatous, the chest radiographic manifestations are pleomorphic and not specific. Consolidations and large irregular nodules, often cavitary, are most common; nodules, masses, and interstitial patterns also occur. Pleural effusions are quite common, and lymph nodes may be enlarged. Difficulty and slowness of culture growth, along with the lack of a serologic test for nocardiosis, necessitate its inclusion in the differential diagnosis for both compromised and noncompromised patients in whom an apparent pulmonary infection cannot be rapidly diagnosed.     

尿毒症患者胸部X线表现60例分析

目的探讨尿毒症患者胸部X线表现的特征。方法分析60例尿毒症患者胸部X线平片的表现。结果肺纹理改变32例;肺水肿54例;心脏增大26例;胸腔积液38例;胸膜增厚40例。结论正确分析尿毒症患者胸部X线平片表现,区别与其他原因引起的胸部X线表现,有助于对此病制订合理的治疗方案。     

112例胸片阴性X线表现的咯血性疾病分析

引起咯血的疾病，大部分经X线胸片检查能作出病因诊断，但也有不少咯血患者X线胸片表现为正常，医生难以诊断，必须根据病史进一步检查。本文收集从1995年1月至2006年6月，112例X线胸片表现阴性的咯血性疾病患者后经CT及纤维支气管镜（纤支镜）检查确诊的病例进行回顾性分析。     

Gout: radiographic findings mimicking infection

Objective: To describe radiographic features of gout that may mimic infection. Design and patients: We report five patients with acute bacterial gout who presented with clinical as well as radiological findings mimicking acute bacterial septic arthritis or osteomyelitis. Three patients had delay in the appropriate treatment with the final diagnosis being established after needle aspiration and identification of urate crystals under polarized light microscopy. Two patients underwent digit amputation for not responding to antibiotic treatment and had histological findings confirming the diagnosis of gout. Conclusion: It is important for the radiologist to be aware of the radiological manifestations of acute gout that can resemble infection in order to avoid inappropriate diagnosis and delay in adequate treatment. The definitive diagnosis should rely on needle aspiration and a specific search for urate crystals. Received: 11 April 2000 Revision requested: 5 May 2000 Revision received: 9 April 2001 Accepted: 10 April 2001     

Latissimus dorsi cardiomyoplasty: radiographic findings

Left latissimus dorsi muscle cardiomyoplasty is a surgical procedure in which the muscle is mobilized as a pedicled flap, moved into the left pleural and mediastinal cavities, and used for surgical repair and/or mechanical augmentation of a failing left ventricle. Chest radiographs in four patients who had undergone this procedure were evaluated. In all four patients, there was bandlike or diffuse increase in density in the left midhemithorax with loss of the left heart border. These findings, which could be misinterpreted as lung disease, represent the transposed muscle flap. CT showed the exact anatomic position of the flap in relation to the intrathoracic structures. Familiarity with the postoperative radiographic appearance of this type of myoplasty is important to avoid misinterpretation.     

Cowper's glands duct: radiographic findings

Lesions of Cowper's glands duct are uncommon findings in a urethrogram. Three types of anomaly are described in 11 patients. The most frequent type is a slightly dilated duct, which is usually asymptomatic, with or without associated urethral pathology. The other less common types are perforate Cowper's duct and retention cyst, which are usually symptomatic and not associated with other urethral pathologies.     

Adult Hirschprung disease: radiographic findings

Hirschprung disease is usually diagnosed in infancy. Occasionally patients reach adulthood without diagnosis or treatment. Four cases of adult Hirschprung disease are described. The principal radiographic findings are a markedly dilated, feces-filled colon above the zone of transition; a narrowed rectum; a cone- or funnel-shaped zone of transition; and a mosaic colonic pattern caused by collapsed redundant mucosa after colonic cleansing. In an adult, identification on a barium enema examination of an abrupt, smooth transition zone in the rectum with proximal colonic dilatation, in conjunction with an appropriate clinical history, should suggest the diagnosis of adult Hirschprung disease.     

Oral tuberculosis: unusual radiographic findings

Oral tuberculosis and its radiographic findings are not commonly encountered in an oral and maxillofacial radiology practice. Literature has occasional mention of the radiographic findings of oral tuberculosis, which are still ambiguous. When affected, it is manifested majorly in the oral mucosa and rarely in the jaw bones. Here, we report certain unusual radiographic findings of oral tuberculosis which have been rarely mentioned in the literature. Four illustrative cases describe bony resorption, condylar resorption, resorption of the inferior border of the mandible and rarefaction of the alveolar bone as radiographic findings of oral tuberculosis. Follow up of the first case demonstrated regeneration of the condylar head after anti-Kochs therapy was completed, a hitherto unreported phenomenon. The importance of including tuberculosis in the differential diagnosis of some of the unusual radiographic manifestations is emphasized.