A comparative study of preoperative evaluation of rectal cancer is presented. Sixty-eight patients with rectal cancer were examined digitally and by computerized tomography and transrectal ultrasound. Preoperative staging was compared with pathologic findings at surgery. Digital examination and transrectal ultrasound were accurate in 82.8 and 76.2 percent, respectively and were superior to CT, which was accurate in 65.5 percent of cases for assessment of rectal wall invasion. All three modes play a role in preoperative assessment, but digital examination and rectal ultrasound appear to be more effective.
In a 7-day-old infant referred because of bile-stained vomiting, jaundice and lack of meconium, radiological examination revealed the 'double-bubble' sign of duodenal atresia as well as dextrocardia. This infant also had a strawberry haemangioma on the right shoulder. Operation disclosed situs inversus and a preduodenal portal vein as well as duodenal atresia. A side-to-side duodeno-jejunostomy was performed successfully without damage to the anomalous vein. The history of polyhydramnion during gestation, the presence of other anomalies, the rapid onset of bile-stained vomiting and the classic 'double-bubble' sign, together appeared to indicate that the duodenal atresia was intrinsic and not due to the external pressure of the anomalous vein on the duodenum.
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