RESUMO
Numerous imaging procedures contributed to the diagnosis of unilateral fused kidney with an associated lower-pole mass in a 68-year old man with back and right lower quadrant pain. 99mTc-DMSA renal scintigraphy provided the best global picture of the renal anomaly and a lower-pole contour defect suggesting a mass.
Assuntos
Hematoma/diagnóstico por imagem , Doenças Renais Císticas/diagnóstico por imagem , Nefropatias/diagnóstico por imagem , Tecnécio , Idoso , Angiografia , Feminino , Humanos , Rim/patologia , Masculino , Cintilografia , Tomografia Computadorizada por Raios X , Ultrassonografia , UrografiaRESUMO
Combined scintigraphy of the lung and liver provides a sensitive, simple and non-invasive method of evaluating the subphrenic space. Since the surgical approach is different in subphrenic, subhepatic and intrahepatic abscesses, accurate localisation and recognition of single or multiple abscesses provides the basis for an operative approach which may avoid unnecessary violation and contamination of the peritoneal cavity. The importance of correlation of the scintiscans with companion roentgenograms of the abdomen and chest, and accurate localisation of the diaphragm using serial scanning, is emphasised. Negative good-quality scans reliably rule out subphrenic abscess.
Assuntos
Fígado , Pulmão , Cintilografia , Abscesso Subfrênico/diagnóstico , Idoso , Diafragma , Feminino , Humanos , Derrame Pleural/complicações , Radiografia , Abscesso Subfrênico/complicações , Abscesso Subfrênico/diagnóstico por imagemRESUMO
Over a 3-year-period, standard treatment with hydrostatic pressure from a contrast enema failed to reduce ileocolic intussusception in 31 of 62 children. With the child anesthetized in the operating room, a second contrast enema was given before laparotomy. Of the 31 intussusceptions, 21 (68%) were reduced without complication, thereby avoiding the discomfort, longer hospitalization, complications, and expense of surgery. Nine of the remaining 10 intussusceptions were difficult to reduce manually during surgery or required resection. The overall nonoperative reduction rate for the 3-year period was 84%; for the last 2 years it was 90%. Success with the second enema may be related to the effects of general anesthesia. In addition, partial reduction with the first enema may improve blood flow from the intussusceptum so that it becomes smaller and easier to reduce with the second enema. Because it can easily be added to standard management protocols without increased risk, routine use of this second enema with anesthesia is recommended.