Excavated mass and doubletracking in the sigmoid colon due to colocolic fistula complicating diverticulitis.

We report on a patient admitted for work up of prostatic carcinoma in which CT study showed an excavated mass involving the sigmoid colon and the bladder dome. Barium enema showed a double track pattern associated with diverticular disease. By surgery the mass was separated from the urinary bladder and the sigmoid resected. On pathological exam diverticulitis was evident as well as an organised colocolic fistula in the thickened fibrotic subserosal fat.The usefulness of opacifying the colon is highlighted.

Evaluation of a nitroxyl fatty acid as liver contrast agent for magnetic resonance imaging.

In this study, we report the synthesis and the evaluation as MRI contrast agent of a new compound (nitroxyl fatty acid, NFA), where a pyrrolidinoxyl radical (3-carboxy-proxyl, PCA) is linked to a fatty acid moiety. Fatty acids were selected as vector because they present a high affinity for the liver, their efficient cellular uptake being the result of a specific interaction with a transmembrane transporter (liver plasma membrane-fatty acid binding protein). The uptake of 3H-oleic acid is inhibited after the injection of 1 mmol/kg of NFA, suggesting that NFA recognizes the same transmembrane transporter as the natural fatty acids. The higher relaxivity R1 of NFA in albumin solutions, compared with PCA, was explained by the immobilization of the nitroxyl radical in the protein. MR imaging was performed using T1-weighted images on mice in order to compare the contrast effect obtained after the injection of 1 mmol/kg of radical. The % signal enhancement in the liver 5 min after intravenous injection was 49 +/- 4 and 14 +/- 5 for NFA and PCA, respectively. NFA allowed a better delimitation of some necrotic tumors (Novikoff hepatocarcinoma) due to its preferential uptake by the nontumorous tissue.

[Radiological aspects of peri-diverticular disease of the colon. An anatomo-pathological correlation (author's transl]. / Aspects radiologiques de la péridiverticulite colique. Corréltaion avec l'anatomie pathologique.

Sixty consecutive cases operated for diverticular disease of the colon within the last 10 years are reviewed. A comparative study is made of the anatomopathological examination of the specimens and their radiological aspect trying to establish the precise radiological picture of acute, chronic and fibrotic peri-diverticular disease. Plain films of the abdomen, intravenous uro- and cystography are very useful in acute cases. A baryum enema just prior to surgery (33 cases) heralds by the rigid aspect of the involved bowelsegment the acute case; spasms, thick disorderly folds and localized extravasation characterize the acute peridiverticulitis. Fibrotic peri-diverticular disease shows disorderly, fine but "ragged" folds associated with extrinsic fistulae. In many cases the inflammation is not purely acute nor chronic or fibrotic. The distinguishing histological types are simultaneously present and render the radiological picture complex.

[Double-contrast radiologic examination of the colon and rectum]. / L'examen radiologique en double contraste du côlon et du rectum.

Double contrast (DC) barium enema is used at many centers as a routine technique for examination of the colon. However, simple contrast enema remains an efficient alternative easy to perform. DC may be performed in a direct manner in a single operation. The contraindications are few (severe colitis, risk of perforation). DC has proved advantageous for detection of polyps and study of inflammatory diseases of the colon. In granulomatous colitis in particular, it contributes to better analysis and differential diagnosis of the lesions, and surveillance of their evolution.

[Plain film findings and contrast enema in colon ischemia (author's transl)]. / Abdomen sans préparation et lavement opaque dans l'ischémie du côlon.

We describe our observations on abdominal roentgenograms without preparation in two cases of segmental colon infarct and eighteen cases of ischemic colitis. In both infarct cases a colic ileus was noted. In one patient the infarcted loop appeared as gas contrasted. In the ischemic cases there were, in addition to the bowel ileus: a colectasis in two patients, a collapsed segment in thirteen and a gas-filled segment in three. When associated to a significant clinical situation the two latter images have some diagnostic value. In the majority of patients, the contrast enema made possible a diagnosis of ischemic colitis; in three it shaved the sigmoid narrowing responsible for the ischemia.