Afferent loop syndrome(ALS) is caused by obstruction of the afferent loop after subtotal gastrectomy with Billroth II gastrojejunostomy. Prompt diagnosis of ALS is important as perforation of the loop occurs. The aim of this study is to ascertain the value of sonography and CT to diagnose ALS. We describe the radiologic findings in ten patients with ALS. The causes of ALS, established at surgery, included cancer recurrence (n=4), internal hernia(n=4), marginal ulcer (n=1), and development of cancer at the anastomosis site(n=1). Abdominal X-ray and sonography were performed in all cases, upper GI series in five cases and computed tomography in two cases. The dilated afferent loop was detected in only two cases out of ten patients in retrospective review of abdominal X-ray. ALS with recurrence of cancer was diagnosed in three cases by upper GI series. Of the cases that had sonography, the afferent loop was seen in the upper abdomen crossing transversely over the midline in all ten patients. The causes of ALS were predicted on the basis of the sonograms in three of the five cancer patients. In two cases of computed tomography, the dilated afferent loop and recurrent cancer at the remnant stomach were seen. Our experience suggests that the diagnosis of afferent loop syndrome can be made on the basis of the typical anatomic location and shape of the dilated bowel loop in both sonography and computed tomography.
Abdomen ; Afferent Loop Syndrome* ; Diagnosis ; Gastrectomy ; Gastric Bypass ; Gastric Stump ; Gastroenterostomy ; Humans ; Peptic Ulcer ; Recurrence ; Retrospective Studies

The most common causes of conjugated hyperbilirubinemia after the first or second week of life are neonatal hepatitis and biliary atresia. Since these entities represent variable expressions of same pathologic process and have similar clinical, biochemical, and histologic features, differential diagnosis is extremely difficult. We prospectively studied 28 jaundiced infants by sonography and hepatobiliary scintigraphy. Final diagnoses included 12 biliary atresia and 16 neonatal hepatitis. Visualization of a normal-sized common bile duct or gallbladder was compatible with the diagnosis of neonatal hepatitis. Non-visualized or atrophic gallbladder no sonography coupled with non-visualization of bowel activity on scintigraphy was highly suggestive of biliary atresia. We believe that sonography plays valuable role in the initial evaluation of the infants with persistent neonatal jaundice. The combined use of sonography and hepatobiliary scintigraphy provides the most valuable in formation in suspected biliary atresia for prompt surgical treatment.
Biliary Atresia ; Common Bile Duct ; Diagnosis* ; Diagnosis, Differential ; Gallbladder ; Hepatitis ; Humans ; Hyperbilirubinemia ; Infant ; Infant, Newborn ; Jaundice, Neonatal* ; Prospective Studies ; Radionuclide Imaging*

PURPOSE: In vitro sonography of lymph nodes was performed to ascertain the differential point between benignancy and malignancy. MATERIALS AND METHODS: Ninty-one lymph nodes were obtained at gastric cancer surgery and pathologically proved as benignancy in 68 and malignancy in 23 cases. Sohographic and pathologic correlation of resected ninty one lymph nodes was done in terms of size, the ratio of longest diameter versus shortest diameter, central hyperechogenicity, and peripheral cortical echo. RESULTS: Sonographic findings of benign lymph node were small size, oval shape(85%), narrow central high echogenicity(44%), and symmetric cortical thickening(41%). Sonographic findings of malignant lymph node were large size, round contour(39%), loss of central high echogenicity(82%), and diffuse increase of cortical thickness(82%). CONCLUSION: The most reliable sonographic criterion for differentiation of benignancy from malignancy was size of a lymphnode.
Lymph Nodes* ; Stomach Neoplasms ; Ultrasonography

To assess the pathological basis of the sonographic changes of the gallbladder wall in cholecystitis, thesonographic appearances of the gallbladder wall were analysed in 17 patients with acute cholecystitis and 27patients with chronic cholecystitis, and correlated with pathological specimens removed at surgery. In acutecholecystitis, a thin sonolucent layer within the echogenic gallbladder wall corresponds to subserosal edema,hemorrhage and inflammatory cell infiltration: in chronic cholecystitis it corresponds to subserosal edema,hemorrhage and inflammatory cell infiltration: in chronic cholelcystitis it corresponds to subserosal edema,hemorrhage and inflammatory cell infiltration, in chronic cholelcystitis it corresponds to muscular hypertrophy.Indistinctness and/or a low echogenicity rind along the inner margin reflects mucosal sloughing or obliteration ofthe mucosal folds. Uniformly decreased echogenicity of the wall is caused by severe inflammatory cell infiltrationwith sloughing of the mucosa or obliteration of the mucosal folds. These sonographic singns are considered to bevaluable sings of cholecystitis.
Cholecystitis ; Cholecystitis, Acute ; Gallbladder ; Humans ; Mucous Membrane ; Ultrasonography

Bile duct necrosis and liver abscess are rare complications after transcatheter hepatic arterial embolization (THAE) of hepatocellular carcinoma. Authors report bile duct necrosis and liver abscess occurred in 2 cases as a complication of THAE of hepatocellular carcinoma. In these two patients, lipiodol emulsion mixed with adriamycin and mitomycin was used more than three times as chemoembolic materials.
Bile Ducts* ; Bile* ; Carcinoma, Hepatocellular ; Doxorubicin ; Ethiodized Oil ; Humans ; Liver Abscess ; Mitomycin ; Necrosis

PURPOSE: To determine the significance of anomalous position of the gallbladder. MATERIALS AND METHODS: Sixteen patients with anomalous position of the gallbladder were evaluated for analysis. The diagnosis was confirmed by ultrasonography(15 patients) and oral cholecystography(1patient). Among those, six patients underwent CT scan and a patient had 99mTc-DISIDA scan. The images were analysed with respect to the location of the GB and configuration and associated abnormality of the liver and hepatobiliary systems. Medical records of each patient were also reviewed. RESULTS: Among 16 patients having an anomalous position of the gallbladder, nine had retrodisplaced gallbladder, four had left-sided gallbaldder, two had suprahepatic gallbladder, and one had floating gallbladder. Except for one patient, fifteen had abnormality in the liver such as focal atrophic or hypoplastic change and liver cirrhosis. Intrahepatic stones were demonstrated in 6 patients. CONCLUSION: Our results showed that anomalous position of the gallbladder was commonly associated with atrophy or hypoplasia of the liver rather than congenital in origin. The possiblity of an anomalous location of gallbladder should be kept in mind when GB is not in its normal location.
Atrophy ; Diagnosis ; Gallbladder* ; Humans ; Liver ; Liver Cirrhosis ; Medical Records ; Technetium Tc 99m Disofenin ; Tomography, X-Ray Computed

No abstract available.
Evoked Potentials* ; Intercostal Nerves* ; Neural Conduction*

No abstract available.
Infant, Newborn ; Meconium Aspiration Syndrome* ; Meconium* ; Mortality ; Suction*

PURPOSE: To evaluate criteria for differentiating benign versus malignant solitary pulmonary nodules (SPNs) by analyzing their morphology and perinodular parenchymal changes on CT/HRCT. MATERIALS AND METHODS: We retrospectively reviewed the CT/HRCT in 99 patients with SPN. Sixty two cases were proved by surgery, PCNA, clinical follow up and etc. Thirty seven cases were diagnosed by typical benign calcification. We defined SPN as a discrete, single lesion in the lung with margins that are sharp enough to permit measurement of diameter. We excluded lesions more than 4cm in diameter and lesions with cavity from our study protocol. The study included 41 malignant nodules and 58 benign nodules. RESULTS: Mean diameter of malignant nodule was 2.9cm, benign nodule was 2.2cm. Peripheral location of nodule was 28 in malignant nodules, 50 in benign nodules. Typical benign calcification was observed in 37 tuberculoma and three hamartoma. Lobulated margin was noted in 32 malignant nodules and 14 benign nodules. Spiculated margin was observed in 17 malignant nodules and 20 benign nodules. Low attenuation within the nodule was observed in 14 malignant nodules and 12 benign nodules. Pleural tail was observed in 14 malignant nodules and 31 benign nodules. Air bronchogram was noted in 18 malignant nodules and 4 benign nodules. Juxta nodular tuberculosis was observed in 6 malignant nodules and 29 benign nodules. CONCLUSION: Malignant nodules were larger than benign nodules and more commonly demonstrated a Iobulated contour and air bronchogram (p<0.05). Benign nodules more commonly demonstrated low density in the nodule and associated with juxta nodular tuberculosis and peripheral location (p<0.05). Spiculated margin and pleural tail were not helpful to differentiate benign from malignant nodule.
Follow-Up Studies ; Hamartoma ; Humans ; Lung ; Proliferating Cell Nuclear Antigen ; Retrospective Studies ; Solitary Pulmonary Nodule* ; Tuberculoma ; Tuberculosis

PURPOSE: To evaluate criteria for differentiating benign versus malignant solitary pulmonary nodules (SPNs) by analyzing their morphology and perinodular parenchymal changes on CT/HRCT. MATERIALS AND METHODS: We retrospectively reviewed the CT/HRCT in 99 patients with SPN. Sixty two cases were proved by surgery, PCNA, clinical follow up and etc. Thirty seven cases were diagnosed by typical benign calcification. We defined SPN as a discrete, single lesion in the lung with margins that are sharp enough to permit measurement of diameter. We excluded lesions more than 4cm in diameter and lesions with cavity from our study protocol. The study included 41 malignant nodules and 58 benign nodules. RESULTS: Mean diameter of malignant nodule was 2.9cm, benign nodule was 2.2cm. Peripheral location of nodule was 28 in malignant nodules, 50 in benign nodules. Typical benign calcification was observed in 37 tuberculoma and three hamartoma. Lobulated margin was noted in 32 malignant nodules and 14 benign nodules. Spiculated margin was observed in 17 malignant nodules and 20 benign nodules. Low attenuation within the nodule was observed in 14 malignant nodules and 12 benign nodules. Pleural tail was observed in 14 malignant nodules and 31 benign nodules. Air bronchogram was noted in 18 malignant nodules and 4 benign nodules. Juxta nodular tuberculosis was observed in 6 malignant nodules and 29 benign nodules. CONCLUSION: Malignant nodules were larger than benign nodules and more commonly demonstrated a Iobulated contour and air bronchogram (p<0.05). Benign nodules more commonly demonstrated low density in the nodule and associated with juxta nodular tuberculosis and peripheral location (p<0.05). Spiculated margin and pleural tail were not helpful to differentiate benign from malignant nodule.
Follow-Up Studies ; Hamartoma ; Humans ; Lung ; Proliferating Cell Nuclear Antigen ; Retrospective Studies ; Solitary Pulmonary Nodule* ; Tuberculoma ; Tuberculosis