By Prof. Dr. W. Wenz (auth.)
The exceptional but easy inspiration of introducing a catheter percutaneously into an artery, with out first dissecting it loose, utilizing a versatile consultant twine, has ended in a really innovative step forward in stomach x-ray diag nosis (SELDINGER, 1953). meanwhile, tools and strategies for injecting distinction media into numerous vessels became mostly standardized; innumerable guides have seemed which care for each available element of angiographic strategy and interpretation. This quantity is designed to provide our adventure with belly angiography. We intentionally kept away from any systematic dialogue of the genitourinary tract, which has been correctly handled within the literature, additionally with admire to angiographic findings. Our curiosity within the retroperitoneal area relies quite often on its importance in differential prognosis. In ten years of angiographic job, our division had made profitable use of an easy strategy which seems to be compatible additionally for smaller hospitals. we want to indicate its diagnostic capability and, even as, to stipulate its barriers. Our event embraces 2804 stomach angiograms, which we've got categorised in response to scientific and morphologic anatomical standards. Their diagnostic interpretation has been in comparison with the surgical or histopathological effects. this can support others to prevent mistakes of the kind which we came across in our personal paintings. Angiographic prognosis calls for not just familiarity with basic radiographic anatomy, but additionally particular wisdom of angiographic patho morphology. we have now attempted to spot these positive factors which typify the person findings and to derive therefrom legitimate generalizations by using easy sketches.
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Extra info for Abdominal Angiography
Intestinal necrosis is a virtually inevitable outcome, dominating the overall clinical picture: Acute mesenteric occlusion (according to BURY, 1969) Initial stage (1-2 hours) Acute abdominal vascular pain; retching; hyperhidrosis; tachycardia; prostration; hyperperistalsis, bloody diarrhea; leukocytosis; discrepancy between poor general condition and scarcity of objective findings Latent stage (2-12 hours) Atypical complaints; poor general condition; absence of intestinal sounds; tachycardia Irreversible stage of intestinal necrosis (past 12 hours) Localized or diffuse peritonitis; ileus; toxic circulatory insufficiency Most of our patients with mesenteric occlusion were studied in the latent stage.
Nevertheless, we believe that while the results of treatment of acute mesenteric obstruction remain so dismal, every effort to arrive at a firm diagnosis as quickly as possible is justified. 1 Angiographic Indications and Techniques It is essentially up to the internist or the surgeon to establish the indication for visceral angiography. The radiologist can help by watching for two signs which have often proved helpful to us, namely, severe tachycardia inconsistent with the acute abdominal picture and incipient abdominal x-ray changes pointing to peri- tonitis.
Four patients died before a thorough diagnostic workup could be done, and no autopsy was performed; in another three, even laparotomy failed to determine the cause. Conventional methods of x-ray examination, including aortic flush angiograms, upper G. I. , 1959; PREVOT and LASSRICH, 1959; WENZ, 1967 and 1969). , 1963; SPENCER, 1964; BRICK and PALMER, 1964), and pathologists, too, are at times hard put to find it. No doubt it is due to endoscopy that erosive gastritis is today more frequently being recognized as the cause of bleeding (see tabulation below).
Abdominal Angiography by Prof. Dr. W. Wenz (auth.)