Enteral alimentation is a crucial component of care for the malnourished patient who cannot eat. Until recently, long-term alimentation was delivered through nasogastric tubes or gastrostomy tubes ...placed at surgery. In the past few years, percutaneous endoscopic gastrostomy (PEG) has almost completely supplanted these traditional methods. PEG is a safer and better-tolerated procedure. The advantages of PEG over nasogastric tubes include greater social acceptance and improved cosmetic appearance, increased ease of feedings, and decreased nasal alar deformities and gastroesophageal reflux. Complications are less common with PEG than with open gastrostomy but still occur in as many as 15% of cases 1-3. Percutaneous gastrostomies performed using fluoroscopic guidance have complications in approximately 10% of cases 4. Despite a rapid increase in the use of percutaneous gastrostomies and their placement by radiologists 4, few published reports have described imaging findings after the placement of such tubes. This pictorial essay illustrates a spectrum of normal and abnormal imaging findings observed with the use of PEG tubes, including tube migration and misplacement, infection, tumor seeding along the PEG tube track, and a variety of gastric wall defects and pseudomasses.
Perineuritis unassociated with other significant pathological changes is a rare finding. A patient is described with mild, non-insulin dependent diabetes mellitus who presented with the clinical ...picture of mononeuritis multiplex, and in whom perineuritis but no occlusive vascular disease was found on sural nerve biopsy. Treatment with prednisone and plasma exchange resulted in some improvement. We conclude that the focal perineuritis, rather than the diabetes, was responsible for the clinical picture mimicking mononeuritis multiplex. In conjunction with previous reports, this suggests that perineuritis may be a treatable neuropathy.
The authors studied quality of life (QOL) and religiousness in 49 patients with ALS over five consecutive visits spanning approximately 1 year. QOL was not significantly correlated with religiousness ...at entry. Over time, a significant relationship developed between QOL and total, public, and private religiousness.
Acute small bowel ischemia is an important clinical entity with significant morbidity and mortality. Since the clinical presentation is often nonspecific, abdominal computed tomography (CT) is ...frequently obtained for the evaluation of patients with equivocal or unsuspected intestinal ischemia. In this article, the direct and ancillary CT findings of acute small bowel ischemia are reviewed. Although the individual CT manifestations are rarely specific, awareness of the spectrum of CT findings of small intestinal ischemia can help to suggest the diagnosis and direct appropriate management.PUBLICATION ABSTRACT
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