Showing papers by "Todd H. Baron published in 1997"

Pancreatic fluid collections prior to intervention: evaluation with MR imaging compared with CT and US.

Abstract: PURPOSE: To evaluate the ability of magnetic resonance (MR) imaging to depict solid debris within pancreatic collections prior to intervention and to help assess drainability, as well as to compare MR findings with those obtained at computed tomography (CT) and ultrasound (US). MATERIALS AND METHODS: Nineteen collections in 18 patients were evaluated with MR imaging, CT, and US prior to drainage. Prospective, blinded interpretations of imaging studies by three independent readers (each interpreted all the images obtained with only one modality) evaluated collection characteristics (debris, consistency, septation, wall thickness, and irregularity) and predicted drainability. Findings were compared with clinical diagnosis and clinical outcome of drainage. RESULTS: MR imaging and CT depicted all collections; US failed to depict two collections. In nine patients with subacute necrotic collections, solid debris was seen in eight (89%) at MR imaging, in two (22%) at CT, and in eight (89%) at US. In seven patien...

Treatment of colonic obstruction with expandable metal stents: radiologic features.

Abstract: The purpose of this prospective study was to evaluate the efficacy of expandable metal stents for colonic decompression in patients presenting with acute malignant obstruction and to describe the associated radiographic findings.Using both fluoroscopic and endoscopic guidance, we placed expandable metal stents within the colons of 13 patients presenting with acute malignant obstruction. Stents were placed in four patients to permit a standard bowel cleansing before surgical resection with primary anastomosis. In the other nine patients, stents were placed for palliation of nonresectable tumors, obviating colostomy. Outcomes and complications were analyzed. The radiologic aspects of procedural planning, stent placement, assessment after placement, and detection of complications were evaluated.Of the four surgical candidates who were successfully resected with primary anastomosis, two received incomplete bowel cleansing because of stent migration with recurrent obstruction. Eight of the nine patients who ha...

Solitary breast metastasis to the ampulla and distal common bile duct.

Abstract: The indications for pancreaticoduodenectomy have continued to expand over the past 10 to 15 years. This is in large part due to improved diagnostic studies, endoscopic retrograde cholangiopancreaticogram and computed tomography, and decreases in hospital perioperative morbidity and mortality. One third of breast cancer patients will develop metastatic disease usually to the liver, lung, or bone (World J Surg 1994;18:98-111). However, the presentation of painless jaundice due to a single metastatic lesion to the distal common bile duct from ductal adenocarcinoma of the breast is extremely rare. In this case report and review of the literature, we discuss the indications and emerging evidence that pancreaticoduodenectomies can now be performed for localized metastatic disease.