technetium-tc-99m-sulfur-colloid and Rupture

Traumatic rupture of the diaphragm, particularly of the right hemidiaphragm, may be occult and can be difficult to diagnose if laparotomy is not required for concomitant injury. Missed or delayed diagnosis of such injuries can produce life-threatening complications, such as intestinal herniation, ischemia, and necrosis. We present a case of traumatic rupture of the right hemidiaphragm that demonstrates the typically occult nature of this injury. The majority of right-sided injuries are diagnosed during laparotomy performed for other injuries. In those patients not requiring laparotomy, the diagnosis is usually delayed because this injury seldom produces clinical or radiographic findings that are either sensitive or specific. In this case, intraperitoneal injection of technetium sulfur colloid was used to establish the diagnosis of right diaphragm rupture, and an uncomplicated repair was undertaken.

Topics: Accidents, Traffic; Adult; Diaphragm; Humans; Male; Radionuclide Imaging; Radiopharmaceuticals; Rupture; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed

This report describes the use of lymphscintigraphy in a patient with traumatic chylous ascites. Radioactivity "leakage" near the origin of the thoracic duct and accumulation into the peritoneal cavity were delineated.

Topics: Adult; Chylous Ascites; Humans; Male; Radionuclide Imaging; Rupture; Technetium Tc 99m Sulfur Colloid; Thoracic Duct

Topics: Bile; Child, Preschool; Evaluation Studies as Topic; Gallbladder; Humans; Imino Acids; Liver; Male; Radionuclide Imaging; Rupture; Technetium; Technetium Tc 99m Disofenin; Technetium Tc 99m Sulfur Colloid

The first task of radiocolloid spleen imaging, after trauma, is to determine if the organ is functioning. If this cannot be demonstrated, splenic avulsion must be considered. The second task is to document splenic injury (not to suggest splenectomy, but to serve as a baseline for following later healing). Failure to heal may be a risk factor for subsequent splenic rupture. The third task of spleen imaging is to determine if accessory splenic fragments are present and functional. The radiocolloid spleen scan facilitates the successful accomplishment of all of these tasks.

Topics: Adolescent; Adult; Aged; Child, Preschool; Female; Humans; Iatrogenic Disease; Male; Middle Aged; Postoperative Complications; Radionuclide Imaging; Rupture; Spleen; Splenectomy; Splenic Rupture; Technetium Tc 99m Sulfur Colloid; Tomography, X-Ray Computed

Topics: Accidents, Traffic; Female; Hernia, Diaphragmatic, Traumatic; Humans; Liver; Middle Aged; Radiography, Thoracic; Radionuclide Imaging; Rupture; Spleen; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid

Five cases of right-sided rupture of the diaphragm are reviewed. Orthopedic injury, head injury, and shock were the most common associated findings. Apparent elevation of the right hemidiaphragm was seen initially in all cases, but two were misdiagnosed. An algorithm that includes modified peritoneal lavage, CT scan with contrast, and intraperitoneal Tc sulfur colloid is suggested for patients with suspected right diaphragmatic trauma.

Topics: Adolescent; Adult; Child; Diaphragm; Female; Humans; Male; Middle Aged; Peritoneum; Radionuclide Imaging; Rupture; Sulfur; Technetium; Technetium Tc 99m Sulfur Colloid; Therapeutic Irrigation; Tomography, X-Ray Computed; Ultrasonography; Wounds, Nonpenetrating

Topics: Adult; Female; Humans; Injections, Intra-Articular; Knee Joint; Male; Radionuclide Imaging; Rupture; Sulfur; Synovial Cyst; Synovial Membrane; Technetium; Technetium Tc 99m Sulfur Colloid