iothalamate-meglumine and Postoperative-Complications

Hyperosmotic water-soluble contrast materials have been fo und to be helpful diagnostic tools in postoperative small-bowel obstruction (POSBO); however, their therapeutic value remains controversial.. A prospective, randomized clinical study was conducted to examine the use of meglumine ioxitalamate as a supplement to the standard conservative treatment of POSBO. Patients with POSBO (n = 50) suitable for a conservative approach were randomized to receive standard conservative treatment with (n = 25) or without (n = 25) the addition of 100 mL of meglumine ioxitalamate via the nasogastric tube (patients with diffuse carcinomatosis and early POSBO were excluded). Both groups were compared for resolution of obstruction, need for surgical relief of obstruction, and complications.. Seven (14%) patients required surgery: 3 in the contrast material group and 4 in the control group (P = not significant [NA]. Resolution of symptoms was achieved in nonsurgical patients within an average of 25.7 hours in the contrast material group and 28.7 hours in the control group (P = NS). There was no mortality in this study. In 2 (4%) patients (1 in each group), strangulated bowel was found during surgery, but only the 1 (2%) patient in the contrast material group required bowel resection. No difference was found in the length of hospital stay or rate of complications. There were no complications that could be attributed to the use of the contrast material itself.. Although water-soluble contrast material is a safe and useful diagnostic tool, it offers no advantage as a supplement to the usual conservative treatment of POSBO.

Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; Contrast Media; Humans; Intestinal Obstruction; Iothalamate Meglumine; Middle Aged; Postoperative Complications; Prospective Studies; Suction; Treatment Failure

In contrast to esophageal perforations, the more radiopaque barium-suspensions are not as important as iodinated aqueous contrast agents for the detection of pharyngeal perforations. This study was performed to find out whether the highly different viscosities (of iodinated and barium-containing contrast agents with comparable radiopacities) are a reason for this.. Viscosity, subjective difference in contrast, and CT-density of an iodinated aqueous (Telebrix) and a 50 wt/vol% barium-containing contrast agent (Micropaque) were determined. Moreover, to exclude postoperative perforation, 104 patients were prospectively examined by pharyngography using both contrast media. Pharyngographies of patients with perforation were later compared by two independent readers. All patients with perforation were followed up clinically to exclude complications due to barium administration.. In-vitro comparison showed comparable radiopacity but the 50 wt/vol% barium-suspension was much more viscous than the iodinated contrast agent. During pharyngography, totally, 14 perforations were clearly delineated with the iodinated aqueous contrast agent. However, two of them were not detected with the barium-suspension. All the other perforations presented equally.. Given a sufficient radiopacity, a low viscosity appears to be essential for a contrast agent to detect especially pharyngeal perforations. Thus, we recommend the sole use of an iodinated contrast agent (at suspicion of aspiration as isoosmolar variant) for this purpose.

Topics: Adult; Aged; Aged, 80 and over; Barium Sulfate; Contrast Media; Female; Follow-Up Studies; Humans; Iothalamate Meglumine; Iothalamic Acid; Male; Middle Aged; Phantoms, Imaging; Pharyngeal Diseases; Pharyngectomy; Pharynx; Postoperative Complications; Prospective Studies; Time Factors; Tomography, X-Ray Computed; Viscosity

Topics: Adult; Aged; Cicatrix; Contrast Media; Diagnosis, Differential; Diatrizoate Meglumine; Evaluation Studies as Topic; Female; Humans; Infusions, Intravenous; Intervertebral Disc Displacement; Iothalamate Meglumine; Lumbar Vertebrae; Male; Middle Aged; Postoperative Care; Postoperative Complications; Predictive Value of Tests; Radiographic Image Enhancement; Recurrence; Reoperation; Retrospective Studies; Sensitivity and Specificity; Single-Blind Method; Tomography, X-Ray Computed

The purpose of this study was to explore the role of sonography for women with urethral symptoms and a suspected urethral diverticulum.. Nineteen women with urethral symptoms underwent voiding cystourethrography (VCUG) and transvaginal, transperineal, and urethral sonography (using a catheter-based transducer). VCUGs and sonograms were evaluated for diverticula, defined on sonography by direct visualization of the neck connecting the periurethral sac with the urethral lumen. The diverticular neck, size, location, and shape were noted. Lesions revealed by sonography as not connected to the urethra were also noted.. Of 19 women, 14 had urethral diverticula and one had two diverticula, for a total of 15 diverticula. On sonography the diverticula ranged in diameter from 2 mm to 5 cm. Both sonography and VCUG showed 13 of the 15 diverticula. In addition, sonography revealed two infected periurethral cysts, a periurethral leiomyoma, a diffuse urethritis, and scarring or deformity of one patient's urethra from a prior diverticulectomy. On sonography, eight of the 13 diverticula wrapped around more than 50% of the urethral circumference. The neck was precisely seen (by definition) in 13 of 15 diverticula on sonography and in two of 13 diverticula on VCUG.. Sonography is useful in this group of women with urethral symptoms and suspected urethral diverticula. It provides information on the extent and location of the diverticular neck, both of which are important in surgical excision. Also, sonography provides information on lesions not connected to the urethra. Sonography may prove useful in a broader group of women with urethral symptomatology.

Topics: Adult; Catheterization; Cicatrix; Contrast Media; Cysts; Diverticulum; Female; Humans; Iothalamate Meglumine; Leiomyoma; Middle Aged; Postoperative Complications; Radiography; Transducers; Ultrasonography, Doppler, Color; Urethra; Urethral Diseases; Urethral Neoplasms; Urethritis; Urinary Bladder

Demonstration of an air-fluid level in the body wall on a computed tomography examination usually suggests the presence of an abscess or a postoperative fluid collection. However, the small amount of air that frequently is injected during intravenous contrast administration may result in a similar computed tomography appearance.

Topics: Abscess; Adenocarcinoma; Adult; Axillary Vein; Breast Neoplasms; Diagnosis, Differential; Humans; Iothalamate Meglumine; Lymphatic Metastasis; Male; Mastectomy, Modified Radical; Postoperative Complications; Tomography, X-Ray Computed

An unusual case of iodide-induced thyrotoxicosis is documented in this article. The patient was a 64-year-old euthyroid man with acromegaly. He also had multiple follicular and papillary thyroid carcinomas with a metastatic lesion in the lumbar vertebrae. After a total thyroidectomy, he became slightly hypothyroid, and the lumbar lesion began to incorporate 131I by scintigraphy. When an iodine-containing contrast medium happened to be injected, a transient increase of serum thyroid hormone level was observed. After complete thyroid ablation with 83 mCi of 131I, the oral administration of 100 mg of potassium iodide for 7 days induced a prominent increase of serum thyroid hormone level. These findings indicated that the metastatic thyroid carcinoma could produce excess thyroid hormone insofar as a sufficient amount of iodide was given. Although this is the first report of such a case, iodide-induced thyrotoxicosis may not be rare in patients with thyroid carcinomas because the Wolff-Chaikoff effect is thought to be lost, and the organic iodinating activity and lysosomal protease activity are well-preserved.

Topics: Acromegaly; Adenocarcinoma; Contrast Media; Iodine Radioisotopes; Iothalamate Meglumine; Neoplasms, Multiple Primary; Postoperative Complications; Radionuclide Imaging; Spinal Neoplasms; Thyroid Hormones; Thyroid Neoplasms; Thyrotoxicosis

A prospective study of contrast-enhanced computed tomography (CT) scanning was undertaken for 17 levels previously operated upon in the lumbosacral spine in 14 patients. All levels with prior operations were scanned before and after the administration of intravenous contrast medium. A standardized technique for contrast enhancement using high doses of intravenous contrast medium was employed and a specialized technique for measuring enhancement with corrections for scan artifacts was used. Results indicated that measurable contrast enhancement occurred in 16 of 17 postoperative scars up to 12 years after surgery. Enhanced scans provided more accurate delineation of the size and margins of postoperative scarring than precontrast scans. No instances of enhancement of normal disk or recurrent herniated disk were observed. In six instances recurrent herniated disks were predicted on the basis of contrast-enhanced CT scans and subsequently confirmed at reoperation. Contrast-enhanced CT scans meticulously performed appear to permit differentiation between scarring and disk herniation in patients with recurring symptoms after operations for lumbosacral disk disease.

Topics: Humans; Intervertebral Disc Displacement; Iothalamate Meglumine; Lumbar Vertebrae; Lumbosacral Region; Postoperative Complications; Prospective Studies; Recurrence; Time Factors; Tomography, X-Ray Computed

Twenty-two patients had combined radiographic and radiocolloid arthrography. The two procedures were in agreement in 86% of the patients as to whether the femoral component was loose or not. Fourteen patients has surgical revision of the prosthesis and in 3 (23%) radiographic arthrography was falsely negative. No false negative results were obtained with radiocolloid arthrography thus far. The radionuclide method cannot be used to assess the acetabular component.

Topics: Colloids; False Negative Reactions; Hip Joint; Hip Prosthesis; Humans; Iothalamate Meglumine; Postoperative Complications; Radiography; Radionuclide Imaging; Technetium; Technetium Compounds; Tin; Tin Compounds

The authors conducted a retrospective analysis of the CT findings in 29 consecutive patients being studied to detect complications of aortofemoral bypass surgery. Presenting symptoms included fever in 22 (76%), gastrointestinal bleeding in 2 (7%), a pulsating mass in 3 (10%), jaundice in 1 (3%), and back pain in 1 (3%). The complications observed most frequently were groin infection in 7 (24%), abdominal perigraft abscess in 11 (38%), pseudoaneurysm in 6 (21%), aortoenteric fistula in 3 (10%), and lymphocystic hematoma in 3 (10%). There were no false negatives, and the overall accuracy and sensitivity of CT in detecting complications was 100%. The authors recommend that CT be performed prior to angiography or surgery whenever an abscess, pseudoaneurysm, or aorto-enteric fistula is suspected.

Topics: Abscess; Aorta, Abdominal; Aortic Aneurysm; Blood Vessel Prosthesis; Femoral Artery; Fever; Gastrointestinal Hemorrhage; Humans; Iothalamate Meglumine; Postoperative Complications; Retrospective Studies; Surgical Wound Infection; Tomography, X-Ray Computed

After preceding lumbar intervertebral disk operations, 88 Dimer-X myelographies were carried out. The examinations were performed with the patients in a lying position; if required, function pictures were taken in a sitting or standing position. Only in three cases the X-ray findings were unconspicuous. The findings included 12 prolapses at other levels, 6 prolapses, 5 massive scars, one pronounced osteophytosis, two cases of serious reticulitis, two meningoceles and one neurinoma outside the field of operation. The dorsal or lateral narrowing of the contrast band typical of prolapses found in the first dimer-X myelogram were only produced by scars in the renewed operation. The authors warn against pantopaque myelography for lumbar intervertebral disk diagnosis because of proven arachnoidal adhesions. The necessity of surgical procedures avoiding as far as possible tissue damage leaving scars and adhesions is stressed.

Topics: Adult; Contrast Media; Female; Humans; Intervertebral Disc Displacement; Iothalamate Meglumine; Male; Middle Aged; Myelography; Postoperative Complications; Posture

Either arachnoriditis or dural/arachnoidal tears may cause symptoms in the postoperative spinal patient. Surgery and myelography as causes of arachnoiditis are discussed. Intradural arachnoid cyst formation and intramedullary cavitation may present as unusual sequelae of arachnoiditis. Extra-dural cysts and cerebrospinal fluid fistulas resulting from dural/arachnoidal tears are unusual postoperative complications presenting striking myelographic features. Their mechanisms of formation, clinical significance, and radiographic features are discussed.

Topics: Animals; Arachnoid; Arachnoiditis; Central Nervous System Diseases; Cerebrospinal Fluid; Contrast Media; Cysts; Dura Mater; Fistula; Iothalamate Meglumine; Mesylates; Metrizamide; Myelography; Postoperative Care; Postoperative Complications; Solubility; Spinal Cord Diseases; Steroids; Water