Selective Splanchnic Arteriography in the Diagnosis of Pancreatic Tumors

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IN the diagnosis of pancreatic tumors, a major obstacle is the relative inaccessability of the pancreas for direct study. Although tumors of the brain and kidneys are often recognized by means of arteriographic methods, tumors of the pancreas have not been commonly diagnosed from a study of the pancreatic and peripancreatic arteries. Visualization of these vessels in the past has been dependent upon opacification of the abdominal aorta, and the nonselective distribution of the contrast material to aortic branches concerned with the pancreas. Consequently, the dilution of the contrast material by aortic blood, and the opacification of arteries not concerned with the pancreas have resulted in arteriograms with insufficient detail for diagnosis. However, these disadvantages were overcome by Ödman,1 who used the technic of selective celiac arteriography. Moreover, he successfully demonstrated arterial displacement and distortion produced by pancreatic masses in two patients. In order to evaluate further the potentiality of selective angiography in the diagnosing of pancreatic tumors, we studied by selective celiac and superior mesenteric arteriography a series of 25 patients who had abdominal pain of obscure cause.

Method of Study

In each case the same procedure was used. After percutaneous introduction of a catheter into the femoral artery, by the Seldinger2 technic, selective arteriography was performed. Under fluoroscopic observation, a radiopaque catheter was manipulated into the celiac artery and the superior mesenteric artery, and from 10 to 20 ml. of contrast material (Hypaque sodium, 50%*) was injected manually. Serial radiography in the anteroposterior and oblique or lateral projections . . .



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