共查询到20条相似文献,搜索用时 15 毫秒
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Imaging of obstructed defecation 总被引:1,自引:1,他引:0
Ganeshan A Anderson EM Upponi S Planner AC Slater A Moore N D'Costa H Bungay H 《Clinical radiology》2008,63(1):18-26
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E. K. Lang 《European radiology》1998,8(3):461-465
The efficacy of transcervical recanalization of obstructed postoperative Fallopian tubes was evaluated in 29 patients who
were referred for recanalization. Nineteen had strictures at the site of Fallopian tube reconstruction, and five had strictures,
three had fistulae, and two had fistulae and strictures at the site of reversal surgery. A 0.014-inch highly flexible guidewire
was passed through the obstruction into the ampullary segment, followed by a 1.1–2.2 Fr bougie catheter to dilate the stricture.
After recanalization, the distal tube was studied by selective salpingography. The method was technically successful in 17
of 19 patients with underlying inflammatory disease and resultant postoperative strictures. The tubes remained patent in 12
patients for a period of 12–48 months; three patients conceived, all delivering healthy babies. Significant disease of the
distal tubes was present in seven patients. The technique succeeded in three of five patients with postoperative strictures
following reversal surgery. One patient subsequently conceived and delivered a healthy baby. The technique failed in all five
patients with fistulae complicating reversal surgery. Transcervical recanalization is thus recommended in the management of
patients with postoperative strictures with underlying inflammatory obstruction and strictures complicating reversal surgery.
Received 16 October 1995; Revision received 25 January 1996; Accepted 15 September 1997 相似文献
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Steven K. Teplick M.D. Pamela H. Haskin Constantinos A. Pavlides Robert C. Goldstein 《Cardiovascular and interventional radiology》1985,8(3):164-167
In five patients with bile duct obstruction, a previously inserted endoprosthesis became occluded. After repeat percutaneous
biliary drainage, the prostheses were mechanically unclogged, removed, or removed and replaced. No patient required surgery,
and no prosthesis reoccluded. We discuss technique for deoccluding and, if necessary, removing and replacing obstructed stents. 相似文献
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Computed tomography (CT) has been found to make a valuable contribution to the diagnosis of the etiology of ureteral obstruction when routine urography and pyelography have not been diagnostic. We believe CT can replace more invasive techniques such as antegrade pyelography and even retrograde pyelography in the evaluation of many of these cases. This presentation will summarize our experience with the use of CT to evaluate the etiology of ureteral obstruction, indicate those disease processes likely to be encountered, emphasize the limitations of the technique, and indicate the place CT has in the study of these patients. 相似文献
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Percutaneous cholangioscopy in obstructed biliary metal stents 总被引:2,自引:0,他引:2
Klaus A. Hausegger Hans J. Mischinger Radenko Karaic Guenther E. Klein Cristian Kugler Robert Kern Martin Uggowitzer Dieter Szolar 《Cardiovascular and interventional radiology》1997,20(3):191-196
Purpose To reevaluate the reasons for the occlusion of self-expanding biliary metal stents, on the basis of cholangioscopic findings.
Methods Percutaneous transhepatic cholangioscopy (PTCS) was performed in 15 patients with obstructed biliary Wallstents. The reason
for stent insertion was a malignant obstruction in 14 patients; 1 had a benign biliary stricture. Conventional noncovered
stents had been inserted in 12 patients; in 3 cases a polyurethane-covered prototype Wallstent had been used. Stent occlusions
occurred after 1–55 months. PTCS was performed with a 2.3-mm endoscope through an 11 Fr sheath. Biopsies were taken via the
working channel of the endoscope.
Results In all patients with noncovered stents the inner surface of the stent was highly irregular with seaweed-like protrusions (biopsy-proven
granulation tissue). Stent incorporation varied from absent (n=1) to subtotal (n=8), but was always incomplete, no matter how long the stent had been in place. Tumor ingrowth was histologically proven in
2 patients. One patient had a large occluding concrement at the proximal end of the stent. In patients with covered stents,
the inner surface appeared more regular; however, viable granulation tissue was found inside two stents and tumor ingrowth
in one of them.
Conclusion PTCS showed that incorporation of the stent is virtually always incomplete. The factors contributing most to stent occlusion
are the buildup of granulation tissue, bile sludge, and tumor overgrowth. Stone formation and tumor ingrowth can also be important,
although less common causes of occlusion. A polyurethane stent covering could not prevent tumor ingrowth in one patient and
the buildup of viable granulation tissue inside the stent in two further patients; mean stent patency in the three patients
with such a stent was 3 months. 相似文献
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A criticism of the use of an endoprosthesis for relief of biliary obstruction has been the difficulty of removing or exchanging the endoprosthesis if it becomes obstructed. We present a simple method of removal that has been successful in four of five patients who presented with an obstructed endoprosthesis 3-7 months after placement. 相似文献
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Ultrasonic evaluation of the obstructed duplex kidney. 总被引:1,自引:0,他引:1
V J Mascatello E H Smith G F Carrera M Berger R L Teele 《AJR. American journal of roentgenology》1977,129(1):113-120
The problem of a duplex collecting system associated with an obstructed ectopic ureter or ureterocele is common in pediatric urology. Four such patients were studied by gray scale ultrasound which was useful in demonstrating the dilated upper pole collecting system as well as an ectopic ureter and a ureterocele. Although the diagnosis of a nonfunctioning upper pole unit in a duplex kidney is usually suggested by the urogram, ultrasound provides a noninvasive means of confirmation which is independant of function. Further, ultrasound-guided puncture with antegrade pyelography demonstrates the course of the ectopic ureter, thus providing a more complete preoperative evaluation. 相似文献
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CT scans of 40 patients without pathology in the floor of the mouth or the submandibular glands were reviewed. Intraglandular ducts were visualized in 27 and extraglandular ducts in 3 patients. The CT appearances of dilated submandibular ducts are described in 4 patients with proven causes of obstruction. Widening of the narrow gutter between the mylohyoid and hyoglossus muscles in one scan level is a prominent feature. An intra- or extraglandular duct diameter of 3 mm or more indicates possible obstruction, and the CT images should be scrutinized to reveal the cause. 相似文献
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A Piepsz H R Ham J H Roland J L Froideville J Kinthaert M Hall M Verboven F Collier 《Clinical nuclear medicine》1986,11(6):389-391
Although several authors have claimed that the function of an obstructed kidney could be overestimated on Tc-99m DMSA imaging, the clinical importance of such an overestimation has not been well documented. Partial obstruction of one ureter was created in a rat, and a relative Tc-99m DMSA uptake was obtained 4 hours after intravenous injection. By puncture of the isolated obstructed kidney, it was shown that the function of that kidney was overestimated by at least 17%. 相似文献
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Kennedy PT Goodacre BW Wittich GR VanSonnenberg E 《Cardiovascular and interventional radiology》2002,25(4):337-339
We report a case of an obstructed pelvic kidney
which was decompressed using a transosseous access route. The patient
presented with obstructive uropathy and fever, necessitating
decompression. Initial access was gained to the kidney by traversing
the ilium, allowing subsequent retrograde placement of a double-J
ureteric catheter. 相似文献
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Skeletal muscle strength is known to decline with age. Although lower extremity (LE) muscle strength is critical to maintaining dynamic stability, few studies have investigated lower extremity muscle challenge during activities of daily living. The purpose of this study was to investigate the effects of age and obstructed gait on relative lower extremity muscular challenge, with respect to available joint strength. Fifteen healthy young and fifteen healthy older adults were asked to walk over level ground and step over obstacles. Pre-amplified surface electrodes were used to measure bilateral muscular activation of the gluteus medius (GM), vastus lateralis (VL), and gastrocnemius (GA). Muscle activation signals were normalized to peak magnitudes collected during maximal manual muscle testing (MMT). Normalized magnitudes were analyzed during the double-support phase for gluteus medius and vastus lateralis and during the single-support phase for gastrocnemius. A two-factor ANOVA was used to test for age group effect, with repeated measure of obstacle height. In general, older adults demonstrated greater relative activation levels compared to young adults. Gluteus medius activity was significantly greater in the elderly as compared to young during periods of double-support (weight transfer). Increased obstacle height resulted in greater relative activation in all muscles, confirming the increased challenge to the musculo-skeletal system. While healthy elderly adults were able to successfully negotiate obstacles of different heights during walking, their muscular strength capacity was significantly lower than young adults, resulting in relatively higher muscular demands. The resulting potential for muscular fatigue during locomotion may place individuals at higher risk for trips and/or falls. 相似文献
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The ureteral diversions performed in the treatment of mainly malignant lesions of the pelvis with ureteral or bladder involvement may be complicated by strictures and cause hydronephrosis, pyelonephritis and lithiasis. Personal experience and technique are described as applied in the percutaneous antegrade drainage of different urinary diversions (cutaneous ureterostomy, ileal conduit, colon conduit, ureterosigmoidostomy, ureterocolostomy) in 46 patients. The good results obtained (70% success rate), the absence of major complications, the low cost and the little patient discomfort confirm the leading role of percutaneous treatment versus surgery in obstructed urinary diversions. 相似文献
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Five percutaneous nephropyelostomies were performed on 4 patients with obstructed renal allografts. In all instances the procedure significantly influenced further management of these patients. It allowed pressure measurement within the obstructed collecting system, assessment of renal function after prolonged drainage, and anatomical delineation of the site of the obstruction using antegrade pyelography. Percutaneous pyelonephrostomy and drainage is a useful means to determine whether obstruction or rejection is the major contributor to renal failure following renal transplantation. 相似文献
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