No abstract

Retrospective analysis of 1,020 conventional antegrade small-bowel examinations revealed that the variable which correlated most highly with abnormal radiographic findings was the clinical complex of history, physical examination, and laboratory data which prompted suspicion of small-bowel disease. Thirty indications of possible small-bowel disease were divided into groups carrying (a) a high suspicion and (b) a low suspicion of disease. Pertinent abnormalities were revealed by 14.2% of examinations in the high-suspicion group, compared with 4.9% in the low-suspicion group. The individual indications covered a spectrum of 0-34% abnormality. Overall, 9.7% of examinations (99/1,020) revealed abnormalities, but only 6.6% (67/1,020) were pertinent to the clinical problems. The authors conclude that the efficacy of the small-bowel series is directly dependent upon the reason(s) for which it is performed.

No abstract

Surgery remains the treatment of choice for massive and recurrent hemoptysis. In some instances, however, immediate surgical intervention is contraindicated. In these situations, bronchial artery embolization (BAE) has proved to be a successful definitive treatment for non-surgical candidates and a palliative therapy in patients requiring hemodynamic stabilization prior to surgery. The most serious complication of BAE is spinal cord ischemia. This relates directly to the potential anastomotic connections between the bronchial circulation and the anterior spinal artery. Somatosensory evoked potentials (SSEPs) have been used in the past to monitor spinal cord ischemia during procedures that threaten the vascularity of the spinal cord. The authors report two cases in which SSEPs were employed to monitor spinal cord ischemia during bronchial artery embolization.

An anomalous pulmonary vein draining into the subdiaphragmatic inferior vena cava was initially demonstrated on computed tomographic (CT) scans. The diagnosis of scimitar syndrome was confirmed with digital subtraction angiography. In retrospect, the anomalous vein and dextroposition of the heart were shown on chest radiographs.