The authors present the results of the radiological explorations in 15 cases of benign liver tumors. Ultrasound and/or computed tomography can usually confirm the presence of a hepatic tumor. Arteriography combined with the clinical information suggested the diagnosis. The authors stress the role of the radiological investigations for the follow-up of these tumors.
Obstruction of the left subclavian artery is one of the rarest causes of the cogenital subclavian steal syndrome with a right-sided aorta. Radiological diagnosis can be made from a standard film which shows the aorta on the right, and a barium examination of the esophagus which demonstrates the absence of any compression posteriorly. Angiographic exploration (aortography, pulmonary angiography) is essential for positive confirmation of diagnosis and to exclude other types of congenital subclavian steal with a right-sided aorta. Certain cardiac malformations may be associated, but forms have been described without any other anomalies as in the case reported, which only became apparent when neurological symptoms developed in adult age.
Two patients were treated surgically for an aneurysm of the celiac artery, one of atheromatous and the other of dysplasic origin. Diagnosis was established by mode B ultrasonography, and confirmed by arteriography and operative findings. Emphasis is placed on the possibility of detecting such lesions, when confronted with an atypical epigastric symptomatology, by means of ultrasonography, particularly by the use of an apparatus in real time. This should enable a more rapid and probably more precise approach to the aorta and large abdominal vessels.
The addition of side holes to the Teflon catheter used for translumbar aortography results in improved flow of contrast material and good visualization of the aorta and brachiocephalic vessels. Details of the technique and precautions for safe use are discussed.
A new technique for the investigation of multiple vascular disease is described. This involves double aortic puncture conducted successively during the same operation time. The author emphasizes the precautions to be taken in relation to the original technique described by Amplatz, and the essential procedures that must be observed during the injection of large volumes of contrast medium. This technique enables the complete investigtions of multiple vascular disease to be conducted without the risks involved when using Seldinger's method.
The superior mesenteric artery was found to be displaced posteriorly in 5 patients with intraperitoneal masses. In 3 cases, the mass was a mesenteric tumor, and in the 2 other cases a tumor arising from the retroperitoneal area which had grown into the mesentery. The authors emphasize, therefore, the value of defining the position of the superior mesenteric artery in the sagittal plane for the topographic diagnosis of intraperitoneal masses. This investigation does not, however, eliminate the possibility of a retroperitoneal origin of the tumoral mass.
The authors underline the value of selective superior mesenteric arteriography in the diagnosis of Meckel's diverticulum. In the ten cases reported, seven were found to have a Meckel's diverticulum on operation, while it was absent in the other three. Arteriography was able to diagnose its presence correctly in sex patients, gave a false positive diagnosis in three cases, and was considered to be normal in the last case in which a Meckel's diverticulum was present. Valid radiological signs are extravasation of the contrast medium into the lumen of the digestive tract and the presence of a vitellin artery dividing into a vascular network. The single fact of a hypervascularized zone at the end of the superior mesenteric artery dividing into a vascular network. The single fact of a hypervascularized zone at the end of the superior mesenteric artery without definite artery formation is not as valid and its interpretation is difficult.
The authors modified the long needle-catheter used by Amplatz and Stocks, by adding lateral openings. The modified needle-catheter was used to study the aorta and its branches using the left translumbar approach. The high rate of blood flow (30 to 34 ml/s) gave excellent opacification of the thoracic and abdominal aortas, and the lower limbs.
Pseudo-membranous colitis may develop after treatment with antibiotics, and in particular lincomycin a, d clindamycin. A "thumbprint" appearance of lacunae 2 to 4 mm in diameter, in substraction in relation to the wall of the colon, diffuse involvement of the colon and the regression of these signs when antibiotics are stopped are the typical radiological signs of this disorder.