CT of the esophagus. II. Carcinoma.

Thoracoabdominal computed tomography (CT) scanning was performed prior to treatment on 30 patients with proven carcinoma of the esophagus. Operative, bronchoscopic, and/or autopsy data were reviewed and showed that CT correctly identified the extent of medistinal spread in 27 patients and intraabdominal metastases in 22 patients. The ability of CT to reliably predict the extent of disease should help the surgeon and radiation oncologist plan optimal therapy.     

M.R.I. spectrum of intrinsic spinal cord lesions.

We report our experience of 42 patients undergoing magnetic resonance imaging (MRI) studies demonstrating intrinsic lesions of the spinal cord, excluding those secondary to spondylosis, trauma or congenital malformations. Histological confirmation of the radiological diagnosis was obtained in 15 (36%). MRI is more sensitive than either myelography or CT. MRI identified a previously non-visualised lesion in 17 of 30 cases. In a further 13 cases, MRI contributed by identifying associated features such as cysts and haemorrhage which have aided in the diagnosis and management of the patients. The last 12 cases, which were patients with multiple sclerosis, had MRI as the only neuroradiological examination. These illustrate a range of appearances. The overlap of imaging appearances of the various pathologies implies that a useful diagnosis and differential can only be offered by considering the MRI appearances of a lesion, with its associated features, with the clinical presentation, and with other imaging modalities where appropriate.     

Complications of fiberoptic Endoscopy. II. Colonoscopy.

Fiberoptic colonoscopy is being used increasingly for endoscopic visualization of the large intestine, particularly in the electrocautery removal of polypoid lesions. Complications may include bleeding, mesosigmoid hematoma, splenic avulsion, and impaction of the instrument, but the most common is perforation of the colon, which occurs in 0.4-1.9% of colonoscopic examinations. Radiological evaluation plays a critical role. Free intraperitoneal rupture may be clinically overlooked in an aged or infirm patient. Extraperitoneal perforation often results in delayed signs and symptoms. The demonstration of extraluminal gas documents perforation. Recent roentgen-anatomical studies of the characteristic distribution of extraperitoneal gas may permit precise localization of the site of colonic perforation on plain films.     

Prof. Dr. iur. Dr. iur. h.c. Adolf Laufs zum 70. Geburtstag

Ohne Zusammenfassung