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Radionuclide voiding cystography is generally advocated for the reevaluation of proved vesicoureteral reflux. The purpose of this study was to assess the efficacy of tailored low-dose fluoroscopic voiding cystourethrography for this purpose.Forty-five girls (2 years 9 months to 19 years 7 months old; mean, 7.4 years) who had proved reflux were examined with tailored low-dose voiding cystourethrography. The technique used a low-dose fluoroscopic system and a computer-based video frame grabber that produced frame-averaged digital video fluoroscopic hard copies. A tailored voiding cystourethrographic protocol was designed to minimize ovarian radiation dose. Digital images were compared with standard 105-mm spot films in a similar group of 25 children.The tailored low-dose fluoroscopic technique produced diagnostically adequate images in all patients that were comparable in quality to standard spot films. The ovarian dose was 1.7-5.2 mrad (0.017-0.052 mGy) with a mean of 2.9 mrad (0.029 mGy). This compared favorably with the lowest reported doses with the radionuclide technique.Tailored low-dose fluoroscopic voiding cystourethrography is an attractive and practical alternative to the radionuclide technique in girls with proved vesicoureteral reflux.

Dilatation of unobstructed extrahepatic bile ducts was observed in patients with conditions associated with intestinal hypomotility. For further investigation of this association, a prospective study was undertaken in which the common hepatic duct was measured in 15 patients before and 1 day after laparotomy, when all patients had postoperative paralytic ileus. A statistically significant (p less than 0.01) increase in the mean diameter of the hepatic duct was observed postoperatively. When compared with the preoperative measurement, the mean diameter of the duct almost doubled, from 3.3 to 5.9 mm. This phenomenon may be due to persistent contraction of the sphincter of Oddi that occurs when intestinal hypomotility eliminates the stimuli for cholecystokinin release.