Intrathoracic splenosis results from the implantation of splenic tissue in the thoracic cavity following simultaneous rupture of the spleen and diaphragm. These implants may form mass lesions that lead to an extensive, costly, and invasive series of investigations, usually resulting in unnecessary surgery. The key to diagnosis is a high index of suspicion provoked by the history of a traumatic event, possibly in the distant past. This report emphasizes that because of its ability to demonstrate the functional nature of tissue, a definitive diagnosis can be made using heat-damaged Tc-99m RBCs without the need for surgical intervention.
Roentgenographic and clinical findings in a spectrum of malformations of the trachea and oesophagus are discussed. Five previously unreported patients representing four rare anomalies of tracheal agenesis, laryngotracheo-oesophageal cleft, oesophageal atresia with a tracheo-oesophageal (T-E) fistula to the proximal oesophageal pouch, and T-E fistula without oesophageal atresia (H-type fistula) are presented. These anomalies can be characterised by a failure in separation of the oesophagus and trachea and by atresia of either organ. All of the patients were diagnosed roentgenographically. Since the incidence of associated abnormalities is high in babies with these anomalies, a generalised embryological defect must be a basic assumption in any theory to explain the development of T-E anomalies.
In newborns with respiratory distress being treated with continuous lung distending pressures, the development of pneumoperitoneum could be a manifestation of an air-block phenomenon but it can also be due to a real perforation of the bowel. When this clinical situation arises upright films or cross-table lateral films will be helpful to demonstrate air fluid levels and some consideration should be given to inserting aqueous contrast material into the stomach and take sequential films in order to demonstrate the presence or absence of a perforation. Six illustrative cases are reported.
ADVANTAGES OF PRONE POSITIONING IN GASTROINTESTINAL AND GENITOURINARY ROENTGENOLOGIC STUDIES IN INFANTS AND CHILDRENWALTER E. BERDON, M.D., DAVID H. BAKER, M.D. and JOHN LEONIDAS, M.D.Audio Available | Share
