1.
[Ultrasound for abdominal lymphadenopathy].
Dietrich, CF, Hocke, M, Jenssen, C
Deutsche medizinische Wochenschrift (1946). 2013;(19):1001-18
Abstract
This CME-review is about the clinical importance of the abdominal lymph node diagnostic with special attention to various ultrasound techniques. This includes innovative techniques like contrast enhanced ultrasound and elastography. The clinical importance of ultrasound in relation to cross sectional imaging will be the target of the article as well as anatomic- topographic aspects. The article deals as well with endosonographic techniques because of the upmost importance of the technique for diagnosing mediastinal and abdominal lymphnode swellings. In conclusion of the article different clinical scenarios and clinical algorithms are presented to help the reader to diagnose abdominal lymphadenopathy correctly in an efficient way.
2.
Successful management of perforated duodenal diverticulitis with intra-abdominal drainage and feeding jejunostomy: a case report and literature review.
Chen, CF, Wu, DC, Chen, CW, Hsieh, JS, Chen, CY, Wang, JY
The Kaohsiung journal of medical sciences. 2008;(8):425-9
Abstract
We report the clinical experience of one patient with perforated duodenal diverticulitis who was successfully treated by intra-abdominal drainage and feeding jejunostomy. A 53-year-old male patient visited our hospital due to acute onset of abdominal pain and distension. Physical examination revealed tenderness over the epigastric area and right-lower quadrant of the abdomen without obvious rebound tenderness or muscle guarding. Duodenal diverticulitis with a retroperitoneal abscess was identified by abdominal computed tomography scan. Surgical intervention was performed after the failure of conservative treatment. The operative findings were compatible with perforated duodenal diverticulitis, and intra-abdominal drainage of retroperitoneal abscess with simultaneous feeding jejunostomy was undertaken. The patient was doing well at the 4-month postoperative follow-up visit. We suggest the use of a conservative operative method, as opposed to conventional diverticulectomy and duodenorrhaphy, as an alternative approach for the management of this disorder, especially when conservative treatment has failed.
3.
Helical tomotherapy as a new treatment technique for whole abdominal irradiation.
Rochet, N, Sterzing, F, Jensen, A, Dinkel, J, Herfarth, K, Schubert, K, Eichbaum, M, Schneeweiss, A, Sohn, C, Debus, J, et al
Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al]. 2008;(3):145-9
Abstract
PURPOSE To describe a new intensity-modulated radiotherapy (IMRT) technique using helical tomotherapy for whole abdominal irradiation (WAI) in patients with advanced ovarian cancer. MATERIAL AND METHODS A patient with radically operated ovarian cancer FIGO stage IIIc was treated in a prospective clinical trial with WAI to a total dose of 30 Gy in 1.5-Gy fractions as an additional therapy after adjuvant platinum-based chemotherapy. The planning target volume (PTV) included the entire peritoneal cavity. PTV was adapted according to breathing motion as detected in a four-dimensional respiratory-triggered computed tomography (4D-CT). Inverse treatment planning was done with the Hi-Art tomotherapy planning station. Organs at risk (OARs) were kidneys, liver, bone marrow, spinal cord, thoracic and lumbosacral vertebral bodies, and pelvic bones. Daily control of positioning accuracy was performed with megavoltage computed tomography (MV-CT). RESULTS Helical tomotherapy enabled a very homogeneous dose distribution with excellent sparing of OARs and coverage of the PTV (V90 of 93.1%, V95 of 86.9%, V105 of 1.9%, and V110 of 0.01%). Mean liver dose was 21.57 Gy and mean kidney doses were 9.75 Gy and 9.14 Gy, respectively. Treatment could be performed in 18.1 min daily and no severe side effects occurred. CONCLUSION Helical tomotherapy is feasible and fast for WAI. Tomotherapy enabled excellent coverage of the PTV and effective sparing of liver, kidneys and bone marrow.