Pancreatic adenocarcinoma: are there pathognomonic changes in the fat surrounding the superior mesenteric artery?

Article Abstract:

Computed tomography (CT), a computerized scanning X-ray technique, is used to diagnose adenocarcinoma (a type of cancer) of the pancreatic ducts. CT use has significantly reduced the need for invasive techniques for diagnosis and differentiation of this type of cancer from other pancreatic cancer and disease. Unfortunately, the use of CT scanning has not improved the prognosis of this disease. Certain CT findings are considered indicative of pancreatic adenocarcinoma. These include images showing the presence of a mass, dilation of the pancreatic ducts, and involvement of adjacent vessels. Changes or obliteration of fat tissue surrounding the vessels have also been considered by many to be indicative of pancreatic adenocarcinoma. Recent studies have challenged this view. Research by Mitchell et al and Luetmer et al showed that CT findings of obliteration of fat tissue surrounding pancreatic vessels can occur in a number of pancreatic diseases. This controversy has been clarified in a study by Schulte et al reported in the September 1991 issue of Radiology. Patients with various pancreatic diseases underwent CT examination. The fat tissue surrounding the superior mesenteric artery (SMA) was specifically examined. Fat tissue changes were common and nonspecific, characterizing a variety of pancreatic disorders. These results support the conclusion that CT findings of fat obliteration of tissue surrounding the SMA do not necessarily lead to a diagnosis of pancreatic adenocarcinoma. (Consumer Summary produced by Reliance Medical Information, Inc.)

Complications and side effects, Pancreatic cancer, editorial

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Pelvic abscesses: CT-guided transrectal drainage

Article Abstract:

Pelvic abscesses sometimes develop as a complication following abdominal or pelvic surgery. There are two major techniques for draining the abscesses, percutaneous abscess drainage and surgical drainage. Percutaneous drainage involves passing a needle through the skin into the abscessed area and placing a catheter into the abscess for drainage. This procedure is less expensive and less invasive than surgery and therefore preferable, but often it is difficult to place the catheter in a position allowing for proper drainage. This study examined using computed tomography (CT), a scanning X-ray technique, to help guide proper catheter placement. Ten patients with pelvic abscesses underwent transrectal drainage (through the rectum), with the needle and catheter being placed in the abscessed area by means of CT guidance. In all 10 patients, catheters were successfully placed and drainage was accomplished with no complications. The period of time for complete drainage was from 2 to 20 days and no abscesses recurred in any of the patients. These results indicate that CT-guided transrectal percutaneous drainage is safe and effective for the treatment of pelvic abscesses. (Consumer Summary produced by Reliance Medical Information, Inc.)

Methods, Pelvis, Drainage, Surgical, Abscess, Drainage (Surgical)

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