Carcinoma of the pancreas and chronic pancreatitis may be extremely difficult to differentiate by... more Carcinoma of the pancreas and chronic pancreatitis may be extremely difficult to differentiate by standard diagnostic methods preoperatively as well as at the operating table. Operative pancreatic biopsy may have a high morbidity, rare mortality, and can be misleading. Percutaneous aspiration biopsy may be of great potential benefit. It provides additional histological material not usually available, and an accurate diagnosis of malignancy can be made. In select patients a needless laparotomy may be avoided. It appears to be a safe procedure that should be considered in the evaluation of the patient with suspected pancreatic malignancy in which a mass lesion is demonstrated by ultrasonography, computerized tomography, angiography, or retrograde pancreatography. Both preoperative and intraoperative diagnosis of pancreatic carcinoma is difficult (1-4). Despite recent advances in angiography, retrograde pancreatography, ultrasonography, and computerized axial tomography, differentiation between chronic pancreatitis and pancreatic carcinoma remains uncertain in 15-20% of patients (5). Scattered reports indicate a high diagnostic accuracy of 75-80% with percutaneous pancreatic aspiration biopsy (4, 6-8). To evaluate the safety and effectiveness of this technique at our institution, we studied consecutive patients with suspected pancreatic neoplasms. MATERIALS AND METHODS The present report is based on 8 men and 5 women, aged 26-81 (median 61) with suspected pancreatic malignancy. The pancreatic cancer was localized for aspiration biopsy by the combination of ultrasonography and angi
The authors describe 4 patients who had functioning distal splenorenal shunts despite obstruction... more The authors describe 4 patients who had functioning distal splenorenal shunts despite obstruction of the left renal vein at its insertion into the inferior vena cava. The angiographic technique and findings of left renal vein evaluation in 40 shunted patients are reviewed. There were two important findings. First, no correlation existed between the degree of portal hypertension and the degree of filling of collateral tributaries of renal veins. Second, obstruction of the left renal vein does not impair a splenorenal shunt if good collateral pathways are present.
Carcinoma of the pancreas and chronic pancreatitis may be extremely difficult to differentiate by... more Carcinoma of the pancreas and chronic pancreatitis may be extremely difficult to differentiate by standard diagnostic methods preoperatively as well as at the operating table. Operative pancreatic biopsy may have a high morbidity, rare mortality, and can be misleading. Percutaneous aspiration biopsy may be of great potential benefit. It provides additional histological material not usually available, and an accurate diagnosis of malignancy can be made. In select patients a needless laparotomy may be avoided. It appears to be a safe procedure that should be considered in the evaluation of the patient with suspected pancreatic malignancy in which a mass lesion is demonstrated by ultrasonography, computerized tomography, angiography, or retrograde pancreatography. Both preoperative and intraoperative diagnosis of pancreatic carcinoma is difficult (1-4). Despite recent advances in angiography, retrograde pancreatography, ultrasonography, and computerized axial tomography, differentiation between chronic pancreatitis and pancreatic carcinoma remains uncertain in 15-20% of patients (5). Scattered reports indicate a high diagnostic accuracy of 75-80% with percutaneous pancreatic aspiration biopsy (4, 6-8). To evaluate the safety and effectiveness of this technique at our institution, we studied consecutive patients with suspected pancreatic neoplasms. MATERIALS AND METHODS The present report is based on 8 men and 5 women, aged 26-81 (median 61) with suspected pancreatic malignancy. The pancreatic cancer was localized for aspiration biopsy by the combination of ultrasonography and angi
Carcinoma of the pancreas and chronic pancreatitis may be extremely difficult to differentiate by... more Carcinoma of the pancreas and chronic pancreatitis may be extremely difficult to differentiate by standard diagnostic methods preoperatively as well as at the operating table. Operative pancreatic biopsy may have a high morbidity, rare mortality, and can be misleading. Percutaneous aspiration biopsy may be of great potential benefit. It provides additional histological material not usually available, and an accurate diagnosis of malignancy can be made. In select patients a needless laparotomy may be avoided. It appears to be a safe procedure that should be considered in the evaluation of the patient with suspected pancreatic malignancy in which a mass lesion is demonstrated by ultrasonography, computerized tomography, angiography, or retrograde pancreatography. Both preoperative and intraoperative diagnosis of pancreatic carcinoma is difficult (1-4). Despite recent advances in angiography, retrograde pancreatography, ultrasonography, and computerized axial tomography, differentiation between chronic pancreatitis and pancreatic carcinoma remains uncertain in 15-20% of patients (5). Scattered reports indicate a high diagnostic accuracy of 75-80% with percutaneous pancreatic aspiration biopsy (4, 6-8). To evaluate the safety and effectiveness of this technique at our institution, we studied consecutive patients with suspected pancreatic neoplasms. MATERIALS AND METHODS The present report is based on 8 men and 5 women, aged 26-81 (median 61) with suspected pancreatic malignancy. The pancreatic cancer was localized for aspiration biopsy by the combination of ultrasonography and angi
The authors describe 4 patients who had functioning distal splenorenal shunts despite obstruction... more The authors describe 4 patients who had functioning distal splenorenal shunts despite obstruction of the left renal vein at its insertion into the inferior vena cava. The angiographic technique and findings of left renal vein evaluation in 40 shunted patients are reviewed. There were two important findings. First, no correlation existed between the degree of portal hypertension and the degree of filling of collateral tributaries of renal veins. Second, obstruction of the left renal vein does not impair a splenorenal shunt if good collateral pathways are present.
Carcinoma of the pancreas and chronic pancreatitis may be extremely difficult to differentiate by... more Carcinoma of the pancreas and chronic pancreatitis may be extremely difficult to differentiate by standard diagnostic methods preoperatively as well as at the operating table. Operative pancreatic biopsy may have a high morbidity, rare mortality, and can be misleading. Percutaneous aspiration biopsy may be of great potential benefit. It provides additional histological material not usually available, and an accurate diagnosis of malignancy can be made. In select patients a needless laparotomy may be avoided. It appears to be a safe procedure that should be considered in the evaluation of the patient with suspected pancreatic malignancy in which a mass lesion is demonstrated by ultrasonography, computerized tomography, angiography, or retrograde pancreatography. Both preoperative and intraoperative diagnosis of pancreatic carcinoma is difficult (1-4). Despite recent advances in angiography, retrograde pancreatography, ultrasonography, and computerized axial tomography, differentiation between chronic pancreatitis and pancreatic carcinoma remains uncertain in 15-20% of patients (5). Scattered reports indicate a high diagnostic accuracy of 75-80% with percutaneous pancreatic aspiration biopsy (4, 6-8). To evaluate the safety and effectiveness of this technique at our institution, we studied consecutive patients with suspected pancreatic neoplasms. MATERIALS AND METHODS The present report is based on 8 men and 5 women, aged 26-81 (median 61) with suspected pancreatic malignancy. The pancreatic cancer was localized for aspiration biopsy by the combination of ultrasonography and angi
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