0000000000132258
AUTHOR
Brunier A
Akute emphysematöse Cholezystitis als Ursache eines Pneumoperitoneums
A 48-year-old man developed progressively more severe epigastric pain, pain on pressure in the right upper abdomen and fever up to 38.6 degrees C so that acute cholecystitis was suspected. Ultrasound did not demonstrate a gall-bladder but a sickle shaped, dense echo with a distal adjoining echo-free zone. Computed tomography revealed air in the gall-bladder lumen as well as intramural and pericholecystic air pockets, findings pathognomonic for emphysematous cholecystitis. In addition pneumoperitoneum was diagnosed. Subsequent cholecystectomy intraoperatively revealed a gangrenous, nonperforating gall-bladder in which E. coli was demonstrated. During the first postoperative week, there were …
Zur Frage der Darmkontrastierung in der abdominellen Computertomographie
In 56 patients undergoing abdominal CT the gastrointestinal tract was defined by negative contrast instead of the conventional positive contrast from an iodine containing contrast medium. The contrast material was a 2 1/2% mannitol solution and was used for filling the rectum. Filling of the gastrointestinal tract was of similar quality to that obtained with positive contrast media. The number of artifacts due to high contrast boundaries was slightly greater with the negative contrast than it would have been with positive contrast. Differentiation of the gastrointestinal tract from other abdominal organs was equally good for both methods. The negative contrast method was poor in diagnosing …
Darmkontrastierung bei der abdominellen Computertomographie: Wasser oder Kontrastmittel?
The suitability of water as an oral or rectal contrast medium for abdominal CT was studied in 56 patients and compared with an iodine-containing water-soluble contrast medium (ioxital amino acid). In some cases it was impossible to differentiate gastrointestinal structures from extraluminal fluid collections (cystic tumours, ascites, abscesses) and there was poor filling of distal small bowel and colon. The routine use of water can, therefore, not be recommended. In some cases, however, water can result in improved image quality by reducing artifacts and improving the demonstration of the mucosa.