AJR. American journal of roentgenology
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AJR Am J Roentgenol · Sep 2007
Indeterminate CT angiography in blunt thoracic trauma: is CT angiography enough?
The primary objective of our study was to determine whether catheter angiography is needed to exclude aortic and intrathoracic great vessel injury when CT angiography (CTA) findings are indeterminate (mediastinal hematoma without direct evidence of aortic or intrathoracic great vessel injury). The secondary objective was to devise a classification scheme for mediastinal hematomas. ⋯ When CTA is indeterminate in blunt thoracic trauma, conventional angiography is unlikely to show an aortic or intrathoracic great vessel injury and may be unnecessary. A grading system for mediastinal hematomas could help triage patients to conventional angiography when further imaging is desired.
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The purpose of our investigation was to assess the stomachs of a world-class speed-eating champion and of a control subject during a speed-eating test in our gastrointestinal fluoroscopy suite to determine how competitive speed eaters are able to eat so much so fast. ⋯ Our observations suggest that successful speed eaters expand the stomach to form an enormous flaccid sac capable of accommodating huge amounts of food. We speculate that professional speed eaters eventually may develop morbid obesity, profound gastroparesis, intractable nausea and vomiting, and even the need for a gastrectomy. Despite its growing popularity, competitive speed eating is a potentially self-destructive form of behavior.
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The objective of this report is to describe a previously unreported technique of selective cervical nerve block, performed from January 1, 2004, to May 19, 2006, in 560 injections, that was designed to allow continual monitoring of injectate passage and verification of needle tip position. We also illustrate faulty needle placement in a cadaveric neck. ⋯ Using a short connecting tube, contrast material mixed with the final injectate, and fluoroscopy when performing a selective cervical nerve block allows continual monitoring of injectate including where washout of the original testing contrast material actually flows. A true lateral view shows a more dangerous anterior needle tip placement. In addition, performing a test with anesthetic and contrast material, waiting 1.5 minutes before administering the final injectate, and using a water-soluble steroid may provide further safety with selective cervical nerve block.