scholarly journals Acute Colonic Pseudo-Obstruction with Feeding Intolerance in Critically Ill Patients: A Study according to Gut Wall Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-11 ◽  
Author(s):  
Chenyan Zhao ◽  
Tingbin Xie ◽  
Jun Li ◽  
Minhua Cheng ◽  
Jialiang Shi ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Nonsurgical Treatment ◽  
Pharmacologic Therapy ◽  
Wall Thickening ◽  
Supportive Treatment ◽  
Feeding Intolerance ◽  
Stage 4 ◽  
Abdominal Radiographs ◽  
Colonoscopic Decompression ◽  
Feeding Tolerance

Objective. To compare the differences between acute colonic pseudo-obstruction (ACPO) with and without acute gut wall thickening.Methods. ACPO patients with feeding tolerance were divided into ACPO with no obvious gut wall thickening (ACPO-NT) group and ACPO with obvious acute gut wall thickening (ACPO-T) group according to computed tomography and abdominal radiographs. Patients’ condition, responses to supportive measures, pharmacologic therapy, endoscopic decompression, and surgeries and outcomes were compared.Results. Patients in ACPO-T group had a significantly higher APACHE II (11.82 versus 8.25,p=0.008) and SOFA scores (6.47 versus 3.54,p<0.001) and a significantly higher 28-day mortality (17.78% versus 4.16%,p=0.032) and longer intensive care unit stage (4 versus 16 d,p<0.001). Patients in ACPO-NT group were more likely to be responsive to supportive treatment (62.50% versus 24.44%,p<0.001), neostigmine (77.78% versus 17.64%,p<0.001), and colonoscopic decompression (75% versus 42.86%,p=0.318) than those in ACPO-T group. Of the patients who underwent ileostomy, 81.25% gained benefits.Conclusions. ACPO patients with gut wall thickening are more severe and are less likely to be responsive to nonsurgical treatment. Ileostomy may be a good option for ACPO patients with gut wall thickening who are irresponsive to nonsurgical treatment.

scholarly journals Role of MSCT in the diagnosis of perforated gall bladder (a retrospective study)

2020 ◽  
Vol 51 (1) ◽  
Author(s):  
Mohamed M. Harraz ◽  
Ahmed H. Abouissa
Keyword(s):  
Computed Tomography ◽  
Retrospective Study ◽  
Gall Bladder ◽  
Acute Cholecystitis ◽  
Acute Diverticulitis ◽  
Wall Thickening ◽  
Free Fluid ◽  
Iodinated Contrast ◽  
Contrast Enhanced

Abstract Background Although gall bladder perforation (GBP) is not common, it is considered a life-threating condition, and the possibility of occurrence in cases of acute cholecystitis must be considered. The aim of this study was to assess the role of multi-slice computed tomography (MSCT) in the assessment of GBP. Results It is a retrospective study including 19 patients that had GBP out of 147, there were 11 females (57.8%) and 8 males (42.1%), aged 42 to 79 year (mean age 60) presented with acute abdomen or acute cholecystitis. All patients were examined with abdominal ultrasonography and contrast-enhanced abdominal MSCT after written informed consent was obtained from the patients. This study was between January and December 2018. Patients with contraindications to contrast-enhanced computed tomography (CT) (pregnancy, acute kidney failure, or allergy to iodinated contrast agents) who underwent US only were excluded. Patients with other diagnoses, such as acute diverticulitis of the right-sided colon or acute appendicitis, were excluded. The radiological findings were evaluated such as GB distention; stones; wall thickening, enhancement, and defect; pericholecystic free fluid or collection; enhancement of liver parenchyma; and air in the wall or lumen. All CT findings are compared with the surgical results. Our results revealed that the most important and diagnostic MSCT finding in GBP is a mural defect. Nineteen patients were proved surgically to have GBP. Conclusion GBP is a rare but very serious condition and should be diagnosed and treated as soon as possible to decrease morbidity and mortality. The most accurate diagnostic tool is the CT, MSCT findings most specific and sensitive for the detection of GBP and its complications.

scholarly journals Present and future utility of computed tomography scanning in the assessment and management of COPD

2016 ◽  
Vol 48 (1) ◽  
pp. 216-228 ◽  
Author(s):  
Kristoffer Ostridge ◽  
Tom M.A. Wilkinson
Keyword(s):  
Computed Tomography ◽  
Clinical Applications ◽  
Wall Thickening ◽  
Chronic Obstructive ◽  
Clinical Tool ◽  
Obstructive Pulmonary Disease ◽  
Lung Structure ◽  
Computed Tomography Scanning ◽  
Underlying Mechanisms ◽  
Future Utility

Computed tomography (CT) is the modality of choice for imaging the thorax and lung structure. In chronic obstructive pulmonary disease (COPD), it used to recognise the key morphological features of emphysema, bronchial wall thickening and gas trapping. Despite this, its place in the investigation and management of COPD is yet to be determined, and it is not routinely recommended. However, lung CT already has important clinical applications where it can be used to diagnose concomitant pathology and determine which patients with severe emphysema are appropriate for lung volume reduction procedures. Furthermore, novel quantitative analysis techniques permit objective measurements of pulmonary and extrapulmonary manifestations of the disease. These techniques can give important insights into COPD, and help explore the heterogeneity and underlying mechanisms of the condition. In time, it is hoped that these techniques can be used in clinical trials to help develop disease-specific therapy and, ultimately, as a clinical tool in identifying patients who would benefit most from new and existing treatments. This review discusses the current clinical applications for CT imaging in COPD and quantification techniques, and its potential future role in stratifying disease for optimal outcome.

scholarly journals Computed tomography findings in patients with H1N1 influenza A infection

2013 ◽  
Vol 46 (5) ◽  
pp. 299-306 ◽  
Author(s):  
Viviane Brandão Amorim ◽  
Rosana Souza Rodrigues ◽  
Miriam Menna Barreto ◽  
Gláucia Zanetti ◽  
Edson Marchiori
Keyword(s):  
Computed Tomography ◽  
Influenza A ◽  
H1n1 Virus ◽  
Severe Disease ◽  
H1n1 Influenza ◽  
Wall Thickening ◽  
High Resolution Computed Tomography ◽  
Air Trapping ◽  
Bronchial Wall

The present study aimed to review high resolution computed tomography findings in patients with H1N1 influenza A infection. The most common tomographic findings include ground-glass opacities, areas of consolidation or a combination of both patterns. Some patients may also present bronchial wall thickening, airspace nodules, crazy-paving pattern, perilobular opacity, air trapping and findings related to organizing pneumonia. These abnormalities are frequently bilateral, with subpleural distribution. Despite their nonspecificity, it is important to recognize the main tomographic findings in patients affected by H1N1 virus in order to include this possibility in the differential diagnosis, characterize complications and contribute in the follow-up, particularly in cases of severe disease.

Clinical significance of incidentally detected bladder wall thickening on computed tomography

2016 ◽  
Vol 49 (2) ◽  
pp. 191-196
Author(s):  
Wan Song ◽  
Hwang Gyun Jeon ◽  
Byong Chang Jeong ◽  
Seong Il Seo ◽  
Seong Soo Jeon ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Clinical Significance ◽  
Bladder Wall ◽  
Wall Thickening

S1549: Association Between Serum Albumin Levels and Computed Tomography (CT) Findings of Colon Wall Thickening (CWT)

2010 ◽  
Vol 71 (5) ◽  
pp. AB191-AB192
Author(s):  
Hiral Shah ◽  
Bikram S. Bal ◽  
Raman Battish ◽  
Michael D. Crowell ◽  
Rohini R. Vanga ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Serum Albumin ◽  
Wall Thickening ◽  
Colon Wall ◽  
Ct Findings

Unusual Causes of Colonic Wall Thickening on Computed Tomography

2003 ◽  
Vol 58 (3) ◽  
pp. 191-200 ◽  
Author(s):  
D.R Turner ◽  
G Markose ◽  
M.J Arends ◽  
C.S Ng ◽  
A.H Freeman
Keyword(s):  
Computed Tomography ◽  
Wall Thickening ◽  
Colonic Wall

scholarly journals A scoring system based on computed tomography for the correct diagnosis of xanthogranulomatous cholecystitis

2020 ◽  
Vol 9 (4) ◽  
pp. 205846012091823 ◽  
Author(s):  
Ryota Ito ◽  
Takashi Kobayashi ◽  
Gou Ogasawara ◽  
Yoshiharu Kono ◽  
Kazuhiko Mori ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Confidence Interval ◽  
Gallbladder Cancer ◽  
Scoring System ◽  
Correct Diagnosis ◽  
Chronic Cholecystitis ◽  
Wall Thickening ◽  
Xanthogranulomatous Cholecystitis ◽  
Ct Findings ◽  
Pericholecystic Abscess

Background Xanthogranulomatous cholecystitis (XGC) is an uncommon variant of chronic cholecystitis. The differential diagnoses of XGC include gallbladder cancer (GBC), adenomyomatosis, and actinomycosis of the gallbladder. Purpose To assess the usefulness of computed tomography (CT) findings in the diagnosis of XGC and differentiation from GBC. Material and Methods We retrospectively assessed the pathological and radiological records of 13 patients with pathologically proven XGC and 33 patients with GBC. Results Significant differences were observed for the following five CT findings: diffuse wall thickening (XGC = 85%, GBC = 15%, P < 0.01); absence of polypoid lesions (XGC = 100%, GBC = 48%, P < 0.01); intramural nodules or bands (XGC = 54%, GBC = 9%, P < 0.01); pericholecystic infiltration (XGC = 69%, GBC = 9%, P < 0.01); and pericholecystic abscess (XGC = 23%, GBC = 0%, P = 0.018). We defined the scoring system based on how many of the five CT findings were observed. Our scoring system, which included these findings, revealed that patients with three or more findings had sensitivity of 77% (95% confidence interval [CI] = 57–87) and specificity of 94% (95% CI = 86–98). Conclusion Our scoring system can assist in the differentiation of XGC from GBC.

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