Radiology
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A solitary giant lipoma of the omentum and gastrocolic ligament in an 8-year-old boy is reported. The patient had a large abdominal mass and signs of partial intestinal obstruction. Radiographs showed the characteristic radiolucency of a fatty mass, excluding a mesenteric cyst.
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Punctures guided by ultrasound were performed in 59 patients with the aid of a modern dynamic sector scanner and a needle-guide unit fitted on the transducer head. The passage of the needle through the tissues could be observed on the monitor during puncture of both cysts and solid tissues. Consequently, the direction or position of the needle can be corrected if necessary.
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The high resolution modification of an EMI 5005 scanner was utilized with an edge enhancement technique to study inflammatory lesions of the temporal bone. Bone erosions caused by cholesteatomas can be accurately delineated because of the circumscribed nature of expansion. ⋯ Computed tomography is limited in demonstrating the stapes superstructure and horizontal portion of the facial canal due to the inability to obtain good coronal scans. The remaining ossicles can be demonstrated with equal clarity with pluridirectional tomography.
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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.