Radiology
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In some patients acute pulmonary emboli may fail to resolve normally, resulting in chronic pulmonary embolism. This may lead to pulmonary hypertension, respiratory insufficiency, cor pulmonale, and death. ⋯ In chronic pulmonary embolism, pulmonary arteries distal to obstructed areas may remain patent and be supplied by hypertrophied bronchial arteries. Since back-bleeding of arterial blood from the bronchial circulation at surgery may predict the success of embolectomy, preoperative bronchial arteriography may be useful for predicting potential surgical success.
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Nine dogs underwent a surgically created partial obstruction of the large bowel and were then given oral barium sulfate. The residual lumen of the obstructed portion varied from 4 to 10 mm in diameter. Clinical obstruction did not develop, and all dogs passed the barium sulfate in 1 to 16 days. This limited study plus certain clinical observations would suggest that barium sulfate proximal to a partial large-bowel obstruction may not be as dangerous as commonly thought.