OB/GYN
Diagnosis of a sigmoid volvulus in pregnancy: ultrasonography and magnetic resonance imaging findings by Stefano Palmucci et al. |
Published: 2014 Feb Issue: 8(2) :: Pages: 54-62
| Abstract: Sigmoid volvulus complicating pregnancy is a rare, non-obstetric cause of abdominal pain that requires prompt surgical intervention (decompression) to avoid intestinal ischemia and perforation. We report the case of a 31-week pregnant woman with abdominal pain and subsequent development of constipation. Preoperative diagnosis was achieved using magnetic resonance imaging and ultrasonography: the large bowel distension and a typical whirl sign - near a sigmoid colon transition point - suggested the diagnosis of sigmoid volvulus. The decision to refer the patient for emergency laparotomy was adopted without any ionizing radiation exposure, and the pre-operative diagnosis was confirmed after surgery. Imaging features of sigmoid volvulus and differential diagnosis from other non-obstetric abdominal emergencies in pregnancy are discussed in our report, with special emphasis on the diagnostic capabilities of ultrasonography and magnetic resonance imaging.
Available image modalities: (click on modality to browse for other articles) Ultrasound, Magnetic Resonance Imaging, Macroscopic pathology, Table
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Gastrointestinal Radiology
Pylephlebitis of a variant mesenteric vein complicating sigmoid diverticulitis by Anna L. Falkowski et al. |
Published: 2014 Feb Issue: 8(2) :: Pages: 37-45
| Abstract: Pylephlebitis - suppurative thrombophlebitis of the portal and/or mesenteric veins - is a rare complication of abdominal infections, especially diverticulitis. It can lead to severe complications such as hepatic abscess, sepsis, peritonitis, bowel ischemia, etc., which increase the mortality rate. Here we present a case of suppurative thrombophlebitis of the inferior mesenteric vein, as a complication of sigmoid diverticulitis. The epidemiology, clinical and radiological features as well as treatment strategies are discussed. We also review the anatomy of the mesenteric vein given its anatomic variation in the present case and how this anatomic knowledge might influence the operative approach should surgery be necessary.
Available image modalities: (click on modality to browse for other articles) Computed Tomography, Graph, Microscopic pathology, Table
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General Radiology
Vascular type Ehlers-Danlos Syndrome with fatal spontaneous rupture of a right common iliac artery dissection: case report and review of literature by Aly Abayazeed et al. |
Published: 2014 Feb Issue: 8(2) :: Pages: 63-69
| Abstract: Vascular Ehlers-Danlos Syndrome (previously Ehlers-Danlos IV) is a rare autosomal dominant collagen vascular disorder caused by a 2q31 COL3A1 gene mutation encoding pro-alpha1 chain of type III collagen (in contrast to classic Ehlers-Danlos, caused by a COL5A1 mutation). The vascular type accounts for less than 4% of all Ehlers-Danlos cases and usually has a poor prognosis due to life threatening vascular ruptures and difficult, frequently unsuccessful surgical and vascular interventions. In 70% of cases, vascular rupture or dissection, gastrointestinal perforation, or organ rupture is a presenting sign. We present a case of genetically proven vascular Ehlers-Danlos with fatal recurrent retroperitoneal hemorrhages secondary to a ruptured right common iliac artery dissection in a 30-year-old male. This case highlights the need to suspect collagen vascular disorders when a young adult presents with unexplained retroperitoneal hemorrhage, even without family history of such diseases.
Available image modalities: (click on modality to browse for other articles) Computed Tomography, Microscopic pathology, Table
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Neuroradiology
Imaging of Adult Ocular and Orbital Pathology - a Pictorial Review by Reuben Grech et al. |
Published: 2014 Feb Issue: 8(2) :: Pages: 1-29
| Abstract: Orbital pathology often presents a diagnostic challenge to the reporting radiologist. The aetiology is protean, and clinical input is therefore often necessary to narrow the differential diagnosis. With this manuscript, we provide a pictorial review of adult ocular and orbital pathology.
Available image modalities: (click on modality to browse for other articles) Magnetic Resonance Imaging, Computed Tomography, Table
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Genitourinary Radiology
Testicular Adrenal Rest Tumors in a Patient with Congenital Adrenal Hyperplasia by Jeffrey Dee Olpinš*, Benjamin Witt˛ et al. |
Published: 2014 Feb Issue: 8(2) :: Pages: 46-53
| Abstract: Congenital adrenal hyperplasia refers to a group of autosomal recessive disorders caused by a deficiency of an enzyme involved in the synthesis of glucocorticoids. The enzyme deficiency generally leads to a deficiency of cortisol and/or aldosterone production within the adrenal cortex. The lack of glucocorticoids generally leads to elevated levels of plasma corticotropin (ACTH), which often results in adrenal hyperplasia. Testicular adrenal rest tumors may develop in males with congenital adrenal hyperplasia due to overstimulation of aberrant adrenal cells within the testes. Recognition of this disease entity is essential when evaluating young males with testicular masses.
Available image modalities: (click on modality to browse for other articles) Ultrasound, Computed Tomography, Magnetic Resonance Imaging, Microscopic pathology, Table
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Thoracic Radiology
Catheter-directed clot fragmentation using the CleanerTM device in a patient presenting with massive pulmonary embolism by Barjaktarevic I et al. |
Published: 2014 Feb Issue: 8(2) :: Pages: 30-36
| Abstract: Massive pulmonary embolism not amenable to systemic thrombolysis is a therapeutic challenge. Catheter directed clot fragmentation and thrombolysis have been efficacious in this setting. We describe successfully treating a massive pulmonary embolism with catheter-directed thrombolysis and clot fragmentation using local tPA, aspiration, and the CleanerTM device in a patient with an absolute contraindication to systemic thrombolysis.
Available image modalities: (click on modality to browse for other articles) Computed Tomography, Angiography, Interventional, Table
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