By Prof. Dr. W. Wenz (auth.)
The fantastic but easy proposal of introducing a catheter percutaneously into an artery, with no first dissecting it unfastened, utilizing a versatile advisor twine, has ended in a really innovative leap forward in belly x-ray diag nosis (SELDINGER, 1953). meanwhile, tools and strategies for injecting distinction media into numerous vessels became principally standardized; innumerable courses have seemed which care for each available element of angiographic approach and interpretation. This quantity is designed to give our event with belly angiography. We intentionally shunned any systematic dialogue of the genitourinary tract, which has been safely handled within the literature, additionally with admire to angiographic findings. Our curiosity within the retroperitoneal area relies usually on its importance in differential analysis. In ten years of angiographic job, our division had made profitable use of an easy process which looks compatible additionally for smaller hospitals. we want to indicate its diagnostic strength and, while, to stipulate its barriers. Our adventure embraces 2804 stomach angiograms, which we've categorised in response to scientific and morphologic anatomical standards. Their diagnostic interpretation has been in comparison with the surgical or histopathological effects. this can aid others to prevent mistakes of the sort which we found in our personal paintings. Angiographic prognosis calls for not just familiarity with common radiographic anatomy, but additionally particular wisdom of angiographic patho morphology. now we have attempted to spot these beneficial properties which typify the person findings and to derive therefrom legitimate generalizations simply by uncomplicated sketches.
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Extra resources for Abdominal Angiography
And one patient was not operated on. In 1967. BAUM et al. mentioned 21 angiographed patients with unexplained gastrointestinal bleeding; by 1969. according to a report of NUSBAUM et al.. the number had already increased to 100 examinations for acute and chronic gastrointestinal bleeding. Included in these cases were hemorrhages in the gastroesophageal passage. gastroduodenal ulcers. erosions. tumors. bleeding from colon diverticuli. postoperative stress ulcers. and arteriovenous malformations. With the aid of a small focal spot tube the authors were able to differentiate vessels down to a diameter of 50-90 microns.
The viscosity of the contrast medium is of secondary importance in the diagnosis of occult intestinal bleeding. The following diagram shows the relation between the detection of bleeding by serial angiography and the dose of contrast medium as well as the injection pressure in experimental gastrointestinal bleeding of varying intensity in animals. At a bleeding rate of 3 ml/min, I ml/kg of Urografin is sufficient; at a bleeding rate of 3 ml/min or less, 2 ml/kg of Urografin is required. Injection pressure (kp/cm') 10 0 • o •• • • • • • • • • 0 0 ~ ..
We therefore reviewed our patient records with respect to stenoses and occlusions of visceral arteries. Localization and distribution of obliterating visceral vascular diseases with clinical symptoms in 769 consecutive aortographies (Radiology Department, Surgical Clinic, University of Heidelberg, 1961-1969). , 1971). Most of the patients presented with arterial obstructions in the lower extremities. Occlusions Celiac artery Common hepatic artery Gastroduodenal artery Splenic artery Superior mesenteric artery Middle colic artery Ileal and jejunal arteries Inferior mesenteric artery Proximal stenosis Peripheral stenosis Total 5 5 2 9 4 3 6 7 I 6 7 2 19 I 8 3 2 2 13 25 21 9 55 2 I Among the 769 patients so evaluated, there were 167 with stenoses and occlusions of visceral arteries, of whom only the 55 (7%) listed in the table reported abdominal complaints.
Abdominal Angiography by Prof. Dr. W. Wenz (auth.)