Percutaneous Cholecystostomy PC

The first clinical description of gallstone disease is attributed to Galen, who in the second century AD differentiated the pain of biliary colic from that of pleurisy. By the seventeenth century, gallstones were noted to be the cause of a spectrum of illness (Schlerk, 1609). The first reported therapeutic approach to cholecystitis used by Joenisius in 1676, was cholecystolithotomy, which he performed through a fistula after gallbladder perforation. In 1743, Petit showed that the presence of...

Technique

Pyloric Stenosis Ultra

When the diagnosis of HPS is suspected but the olive is not felt, an ultrasound that looks for the thickened pyloric musculature has a greater than 90 predictive value.3 A high-resolution (7.5-10 MHz) transducer is utilized. One looks with the ultrasound in the region of the gallbladder. It is helpful if there is a small amount of fluid in the gastric antrum, which fills out this portion and makes the thickened musculature more apparent at sonography. One can also assess whether any of this...

Surveillance of Deep Vein Thrombosis DVT

Rajan Gupta and Jeffrey Carpenter Introduction The clinical evaluation of the peripheral venous system can be difficult. History and physical examination have a limited role in the accurate diagnosis of venous disease. Further diagnostic imaging is frequently required. Invasive techniques such as venography have been proven to be reliable and have become the gold standard against which all other techniques are measured. However, the expense and potential risks of such invasive studies have led...

Info

A longitudinal or sagittal view can show the maximal A-P diameter with the transducer oriented in the plane of the aorta, rather than to the patient or the examining table. This can be useful in a tortuous aorta or aneurysm. Measurements are to the outer aortic wall. When using preset for general abdominal instead of aorta, for example, the depth may be set at 22 cm instead ofl4 cm. This allows visualization of the kidneys, which are deeper than the aorta. The presets optimize...