Echography for nasogastric tube placement verification.

To report the interest of abdominal ultrasonography for confirming the appropriate location of nasogastric tube (NGT) in the stomach using a new dynamic test, and to illustrate the aspect of this test at ultrasonography. Clinical observation of a patient, images of abdominal ultrasonography and video of the stomach visualized by ultrasonography. We describe the video of a critically ill patient in whom, immediately after NGT insertion, aspiration of gastric liquid and instillation within the NGT was associated with ultrasonographic evidence of turbulences in the stomach. In addition to the direct visualization of the NGT in the stomach, ultrasonographic visualization of turbulences after aspiration and instillation of gastric liquid may allow to assess the appropriate positioning of the NGT.

An analysis of sestamibi-positive versus -negative patients with primary hyperparathyroidism.

We performed this study to evaluate two patient groups with primary hyperparathyroidism depending on whether their abnormal gland(s) could be preoperatively imaged with sestamibi. Patients with primary hyperparathyroidism evaluated by preoperative sestamibi examination from January 1999 to June 2000 were divided into two groups depending on the ability of sestamibi to localize their disease. Records were reviewed to determine pre- and postoperative biochemical data, weight of the excised glands, and total operating room time. When the sestamibi imaging was positive a minimally invasive parathyroidectomy was performed; however, when sestamibi scanning was negative patients underwent a formal bilateral neck exploration. All 40 patients in the sestamibi-positive group and 17 of 18 patients in the sestamibi-negative group were cured of their primary hyperparathyroidism as a result of surgery. Sestamibi scanning with a minimally invasive parathyroidectomy shortens operating room time and is most effective when adenomas are large. The results of this study suggest that strategies to preoperatively increase the activity of adenomas may improve the sensitivity of sestamibi scan localization of parathyroid adenomas.