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2. Sonographycally guided hydrostatic reduction of childhood intussusceptionDubravka Vidmar, Alenka Višnar-Perovič, 2004, izvirni znanstveni članek Povzetek: Background. Intussusception is the most common cause of bowel obstruction in children under two years of age. The proximal part of the bowel and its mesentery (the intussusceptum) enter within that part immediately beneath it (the intussuscipiens). Being pulled by peristalsis the mesenterial vessels getcompressed which result in ishaemia of the bowel wall. Most intussusceptions are ileocolic. The diagnosis can be confirmed by a contrast enema or ultrasound. Sonography demonstrates a so-called target-within-a-target patfern (in cross-section) with thickened edematous bowel wall with or without vascularisation and prestenotic dilatation with increased peristalsis. Therapeutic reduction can be attempted by a contrast enema (following diagnostic procedure) or by air, both under fluoroscopic monitoring, or by normal saline under sonographic guidance. Patients and methods. We detected sonographically intussusception in three girls of 15, 16 and 18 months having typical clinical signs. We continued with hydrostatic reduction under the sonographic guidance. The reduction was attempted with a saline enema on body-temperature, introduced by the equipment for contrast enema. The bottle o f normal saline was hung up 1 m over the examination desk.We needed few liters of saline to replace lost liquids due to the incomplete occlusion of rectum. Meanwhile we monitored the moving of the intussusceptum back into the proximal direction. Criteria for a succesful reduction were the disappearance of the intussusceptum and the passage of fluid through the ileocecal valve. Results. Success was proven in all three girls. No complications occured and the pain relieved immediately after the procedure. There were no signs of intussusception on sonography after 2 and 12hours. We saw a slightly edematous wall of ileocecal valve and terminal ileum. Due to their exellent clinical conditions they were discharged from hospital after a second sonography. (Abstract truncated at 2000 characters).
Objavljeno v DiRROS: 13.02.2024; Ogledov: 144; Prenosov: 32
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3. Hydrocolonic sonography in the detection of large bowel diseaseDubravka Vidmar, 2000, izvirni znanstveni članek Povzetek: Background. The presence of fluid in the bowel lumen improves the sonographic visualisation of the gastrointestinal tract, thus permitting earlier and more accurate detection of pathological changes. Hydrocolonic sonographic (HS) is amethod of examination the colon after it has been cleaned and filled with water. Patients and methods. We have evaluated the method in a group of 56 patients by comparing its results with the findings of colonoscopy, double-contrast barium enema or surgery. Results. HS had an overall accuracy of 86%, a sensitivity of 81%, a specificity of 92%, a positive predictive value of 91% and a negative predictive value of 82%. Conclusions. The technique is not suitable for examination the rectum, but apart from that it is comparable in usefulness to double-contrast barium enema. The main limitation of HS is that it requires a lot of experience and skill on the partof the sonologist, which affects its acceptability for diagnostic evaluation of the colon.
Objavljeno v DiRROS: 24.01.2024; Ogledov: 185; Prenosov: 35
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4. Ultrasound-guided aspiration biopsy of subclinical regional metastases of head and neck carcinomaAlenka Višnar-Perovič, Aleksandar Aničin, Živa Zupančič, Bojana Černelč, Alojz Šmid, Dubravka Vidmar, Milan Gorenc, 2000, izvirni znanstveni članek Povzetek: Background. Studies concerned with the estimation of ultrasound (US) combined with ultrasound-guided aspiration biopsy (USGAB) in the detection of subclinical regional metastases from the planocellular carcinoma of head and neck are promising, but in few cases. Recently, the authors have pointed out the role of lymph node size parameters in order to decide about the use of USGAB. The aim of this study was to test the reliability of US-USGAB for the detection of subclinical regional metastases in patients with planocellular head and neck carcinomas, including the evaluation of lymph node size parameters. Patients and methods. 121 neck sides with no palpable metastases were examined by US in 77 patients with planocellular carcinomas of head and neck. Depending on the results obtained, USGAB was performed on 64 neck sides.After surgery, the results of US-USGAB were compared with histological findings of the dissected lymph nodes. Results. The study showed 77% overall sensitivity of US and USGAB, and 100% specificity, while the versal / longiyudinal diameter was the best predictor of metastatic lymph node involvement. Conclusion. The results of this study established that USGAB is an appropriate method for detection the subclinical regional metastases on neck, and should be included into routine diagnostic work up in the evaluationof the extent of head and necks carcinomas.
Objavljeno v DiRROS: 24.01.2024; Ogledov: 159; Prenosov: 39
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5. Ultrasound diagnosis of gallstone ileus - a case reportDubravka Vidmar, Stanislav Repše, 1999, strokovni članek Povzetek: Background. The diagnostic method of choice for ileus was a plain abdominal film. However, in the recent years, x-ray has been increasingly replaced by ultrasonography which, in experienced hands, can reveal ileus at an earlier stage and also identify the cause and site of obstruction. Case report. We reported about a male patient who was admitted to the Department of Gastroenterologic Surgery with severe abdominal pain and vomiting. A plain abdominal film showed an obstructive ileus and pneumobilia. Ultrasound examination of the abdomen confirmed the presence of ileus of the small intestine and demonstrated a gallstone impacted in the distal ileum. It also disclosed a distorted gallbladder adhering to the duodenum. The patient was treated surgically and had an uneventful postoperative course. Conclusions. Ultrasonography, in addition to diagnosing the ileus caused by an ectopic gallstone, is also able to identify the aetiology and site of obstruction.
Objavljeno v DiRROS: 22.01.2024; Ogledov: 184; Prenosov: 36
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