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Section: Gastrointestinal Radiology

 




Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Accidental Concentrated Hydrogen Peroxide Ingestion Associated with Portal Venous Gas by Eslam W Youssef et al.

Published: 2018 Aug
Issue: 12(8) :: Pages: 12-16


Free full text article: Accidental Concentrated Hydrogen Peroxide Ingestion Associated with Portal Venous Gas

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Abstract: A case of a 52-year old male patient who presented to the emergency department with severe nausea and vomiting following accidental ingestion of H2O2. A computed tomography (CT) abdomen performed at our institution demonstrated extensive portal venous gas throughout the liver with few gas droplets seen in the extrahepatic portal vein portion. Pneumatosis was also noted in the wall of the gastric antrum. Upper GI Endoscopy was done revealing diffuse hemorrhagic gastritis and mild duodenal bulb erosion. The patient was treated with hyperbaric oxygen. On the second day of admission, the patient was able to eat without difficulty or pain. Accidental ingestion of high concentration H2O2 solution has been shown to cause extensive injury to surrounding tissues. The injury occurs via three main mechanisms: corrosive damage, oxygen gas formation, and lipid peroxidation. We report a case of accidental ingestion of a highly concentrated (35%) solution of H2O2 causing portal venous gas.


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Computed Tomography, Clinical image, Table





Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Temporal Evolution of Intramural Esophageal Dissection with 3D Reconstruction and Cinematic Virtual Fly-Through by Ying Mei Wong et al.

Published: 2018 Feb
Issue: 12(2) :: Pages: 11-17


Free full text article: Temporal Evolution of Intramural Esophageal Dissection with 3D Reconstruction and Cinematic Virtual Fly-Through

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Abstract: Intramural esophageal dissection is an uncommon condition, involving the separation of the esophageal mucosa from the muscular layers. To our knowledge, the temporal evolution of intramural esophageal dissection on computed tomography has not been previously demonstrated. We present a case of a 51-year-old male who first presented to the emergency department with fever, odynophagia, and dysphagia. He was treated for acute tonsillitis and discharged, but presented again after 10 days with worsening symptoms. A series of radiographs and computed tomography studies, with 3D reconstruction and cinematic virtual fly-through, in these 2 admissions depicts the temporal evolution of intramural hematoma to subsequent intramural esophageal dissection. Recognizing its appearance on imaging is invaluable in distinguishing it from other important differential diagnoses. A complete description of the case, relevant radiologic imaging, and review of the relevant literature are provided.


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Conventional Radiography, Computed Tomography, Clinical image, Table





Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Internal Hernia in Pregnant Woman after Roux-en-Y Gastric Bypass Surgery by Bogna Warsza et al.

Published: 2018 Jan
Issue: 12(1) :: Pages: 9-16


Free full text article: Internal Hernia in Pregnant Woman after Roux-en-Y Gastric Bypass Surgery

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Abstract: Laparoscopic Roux-en-Y gastric bypass has become the most common obesity surgery procedure worldwide over the last two decades. Many patients undergoing the procedure are women of reproductive age. This carries a risk for developing gastric bypass-related complications during pregnancy. One of the potentially serious risks is an internal hernia. We present a patient in the third trimester of pregnancy with an internal hernia following a laparoscopic Roux-en-Y gastric bypass for morbid obesity. We discuss the importance of computed tomography (CT) in the diagnosis of an internal hernia and review key CT findings including compression of the superior mesenteric vein, which proved to be crucial in diagnosing the internal hernia in this patient.


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Conventional Radiography, Computed Tomography, Table





Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Complicated Gastric Duplication Cyst in an Adult Patient: Uncommon presentation of an uncommon disease by Mohamad Abdalkader et al.

Published: 2017 Aug
Issue: 11(8) :: Pages: 16-23


Free full text article: Complicated Gastric Duplication Cyst in an Adult Patient: Uncommon presentation of an uncommon disease

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Abstract: Gastric duplication cyst is a very rare congenital anomaly accounting up to 4% of all gastrointestinal tract duplications. It is a quite rare anomaly in adults, the majority of the cases are diagnosed in the neonatal period. Gastric duplication cysts are usually asymptomatic or they do present with non-specific symptoms. They are usually discovered incidentally during endoscopy or laparotomy or very rarely after getting complicated. We describe herein, along with literature review, a case of an adult patient who presented with abdominal pain and bloody vomiting and turned out to have a gastric duplication cyst complicated by internal bleeding.


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Ultrasound, Computed Tomography, Magnetic Resonance Imaging, Fluoroscopy, Microscopic pathology, Table





Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Adenocarcinoma of the Appendix Presenting as a Palpable Right Thigh Mass by Marci Handler et al.

Published: 2017 Apr
Issue: 11(4) :: Pages: 20-29


Free full text article: Adenocarcinoma of the Appendix Presenting as a Palpable Right Thigh Mass

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Abstract: Intra-abdominal and intra-pelvic pathologies initially presenting in extra-abdominal/pelvic locations is unusual. This spread predominantly occurs with infectious processes to sites including the buttock, thigh, and calf. The routes of extension into adjacent anatomically weak compartments include the pelvic outlet, greater sciatic foramen, obturator foramen, inguinal or femoral canal, weak bones, or along nerves and blood vessels. Malignant neoplasms of the appendix, while extremely rare and accounting for only 0.4% of all gastrointestinal cancers, is one of the intra-abdominal pathologies that can spread via these routes. Adenocarcinoma of the appendix accounts for 10-20% of primary appendiceal tumors. They usually present as acute appendicitis or as a right lower quadrant abdominal mass when associated with a mucocele. We report the unique case of mucinous appendiceal adenocarcinoma in a 57-year-old male who initially presented with a right thigh mass secondary to extension of the neoplasm from the right lower quadrant through the femoral canal. A similar presentation of a mucinous appendiceal cystadenoma has been previously reported, however, to our knowledge, this is the first case of a malignant appendiceal tumor extending into the thigh. We review the literature and discuss imaging findings and treatment of this tumor.


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Ultrasound, Magnetic Resonance Imaging, Computed Tomography, Microscopic pathology, Table





Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Amyand`s Hernia: A Case Report by Haris N. Shekhani et al.

Published: 2016 Dec
Issue: 10(12) :: Pages: 7-11


Free full text article: Amyand`s Hernia: A Case Report

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Abstract: Amyand`s hernia is a rare and atypical hernia characterized by the herniation of the appendix into the inguinal sac. This hernia may be present without symptoms until inflammation of the appendix may lead to incarceration, strangulation, necrosis, perforation or rupture. Early symptoms include tenderness and inguinal swelling which may be misdiagnosed as a strangulated hernia. This condition can be difficult to diagnose clinically. Ultrasound and Computed Tomography may aid in diagnosis. This article presents a rare case of Amyand`s hernia followed by a discussion of the epidemiology, diagnosis, imaging details and treatment options for this condition.


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Computed Tomography, Table

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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Case of Spigelian hernia with incarcerated appendix by Michael Bevilacqua et al.

Published: 2016 Nov
Issue: 10(11) :: Pages: 23-28


Free full text article: Case of Spigelian hernia with incarcerated appendix

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Abstract: Spigelian hernias are uncommon lateral ventral wall hernias with a significant rate of incarceration; these hernias often produce nonspecific clinical signs and symptoms as well as elusive imaging findings. Although there are reported cases of incarcerated appendices within Spigelian hernias, this case specifically illustrates the diagnostic difficulty these hernias present to both surgeons and radiologists. Additionally, we discuss important anatomy, demographics and risk factors, clinical symptoms, imaging pitfalls and recommendations for repair based on a review of literature.


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Computed Tomography, Macroscopic pathology, Table

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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Adult pancreatoblastoma - Case report and review of literature by Filipa Vilaverde et al.

Published: 2016 Aug
Issue: 10(8) :: Pages: 28-38


Free full text article: Adult pancreatoblastoma -  Case report and review of literature

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Abstract: Most cases of pancreatoblastoma, a rare malignant epithelial tumor of the pancreas, are seen in the pediatric population. The rarity of pancreatoblastoma, the similar radiologic findings to those seen in other pancreatic lesions, and its histopathologic heterogeneity, make its preoperative diagnosis in adults a real challenge. We report ultrasound, computed tomography and magnetic resonance imaging correlative findings of a histologically proven pancreatoblastoma in a 37-year-old woman. Pancreatoblastoma should be considered in the differential diagnosis of a pancreatic mass presenting uncommon imaging features.


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Ultrasound, Computed Tomography, Magnetic Resonance Imaging, Microscopic pathology, Table





Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Fishbone Perforated Appendicitis by Joey Chan Yiing Beh et al.

Published: 2016 Jul
Issue: 10(7) :: Pages: 14-22


Free full text article: Fishbone Perforated Appendicitis

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Abstract: Ingested foreign bodies tend to pass through the gastrointestinal tract without incidence, and vast majority of cases do not need intervention. Rarely, these foreign bodies drop into the appendix and not likely to re-enter the normal digestive tract. We describe a case of a 72-year-old male patient who presented with right iliac fossa pain of 3-day duration. Clinical examination suggested classic acute appendicitis. Blood test results revealed leukocytosis. Computed tomography of the abdomen and pelvis showed evidence of acute appendicitis and a linear hyperdensity (foreign body) perforating the appendix. The patient was managed successfully with prompt laparoscopic appendectomy and removal of the foreign body which was confirmed to be a fish bone measuring about 10mm. While imaging diagnosis of fishbone in the appendix has been published, reports are few. To the best of the author`s knowledge, fishbone induced perforated appendicitis has been described only in 2 cases (including this case) in the literature.


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Computed Tomography, Macroscopic pathology, Table





Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Incisional Hernia Following Ventriculoperitoneal Shunt Positioning by Matteo Bonatti et al.

Published: 2016 Jun
Issue: 10(6) :: Pages: 9-15


Free full text article: Incisional Hernia Following Ventriculoperitoneal Shunt Positioning

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Abstract: Incisional hernia represents a rare complication after ventriculoperitoneal shunt positioning due to failure of the fascial suture in the site of abdominal entrance of ventriculoperitoneal catheter. Clinical presentation can be extremely variable, according to patient’s performance status, herniated material constitution (i.e. mesenteric fat, bowel loops or both) and complication occurrence (e.g. strangulation or intestinal obstruction). Early diagnosis is fundamental in order to surgically repair the defect and prevent further complications. We present the case of a paucisymptomatic incisional hernia following ventriculoperitoneal shunt positioning. Diagnosis was made by means of ultrasound and confirmed by means of computed tomography. The patient was successfully managed by means of surgical repositioning of herniated loop and re-suture.


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Ultrasound, Conventional Radiography, Computed Tomography, Table





Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Case Report: Gallbladder Varices in a Patient with Portal Vein Thrombosis Secondary to Hepatocellular Carcinoma by Jeffrey Gnerre et al.

Published: 2016 May
Issue: 10(5) :: Pages: 22-28


Free full text article: Case Report: Gallbladder Varices in a Patient with Portal Vein Thrombosis Secondary to Hepatocellular Carcinoma

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Abstract: Gallbladder varices are a rare form of collateralization that develop in patients with portal hypertension. We present here a case of gallbladder varices accurately diagnosed by contrast enhanced CT imaging of the abdomen and confirmed by Color Doppler Sonography. A 76-year-old patient with hepatocellular carcinoma developed portal vein thrombosis due to tumor extension during the course of treatment and was incidentally discovered to have gallbladder varices. While most commonly asymptomatic, gallbladder varices are associated with increased risk of massive bleeding, either spontaneously or during cholecystectomy. As a result, the existence of such varices should be well documented if the patient is to undergo any abdominal surgical procedures. In addition, because of a particular association with portal vein thrombosis, patients with portal hypertension that are found to possess gallbladder varices should be evaluated for portal vein thrombosis.


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Magnetic Resonance Imaging, Computed Tomography, Ultrasound, Table





Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Gastric infarction following gastric bypass surgery by Patrick H Do et al.

Published: 2016 Apr
Issue: 10(4) :: Pages: 16-22


Free full text article: Gastric infarction following gastric bypass surgery

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Abstract: Gastric infarction is an extremely rare occurrence owing to the stomach`s extensive vascular supply. We report an unusual case of gastric infarction following gastric bypass surgery. We describe the imaging findings and discuss possible causes of this condition.


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Conventional Radiography, Computed Tomography, Table





Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Incidentally Discovered Middle Mesenteric Artery In A Renal Donor by Ahmed Kamel Abdel-Aal et al.

Published: 2015 Dec
Issue: 9(12) :: Pages: 15-20


Free full text article: Incidentally Discovered Middle Mesenteric Artery  In A Renal Donor

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Abstract: The middle mesenteric artery is a very rare anomalous artery originating from the ventral surface of the abdominal aorta in-between the superior mesenteric artery and inferior mesenteric artery. We identified a middle mesenteric artery during abdominal computed tomographic angiography in a renal donor patient as a part of his work up. The middle mesenteric artery branched out into ileal and ileocolic arteries, supplying the terminal ileal loops as well as the cecum. The anomalous artery had no effect on patient`s eligibility as a renal donor candidate.


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Computed Tomography, Table





Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Wandering spleen, gastric and pancreatic volvulus and right-sided descending and sigmoid colon by Enrique Flores-Ríos et al.

Published: 2015 Oct
Issue: 9(10) :: Pages: 18-25


Free full text article: Wandering spleen, gastric and pancreatic volvulus and right-sided descending and sigmoid colon

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Abstract: Wandering spleen is a rare condition, characterized by a mobile spleen that is attached only by an elongated vascular pedicle, allowing it to migrate to any part of the abdomen or pelvis. Mesenteroaxial gastric volvulus usually occurs in children and may be associated with wandering spleen. Both entities result from abnormal laxity or absence of the peritoneal attachments due to abnormal fusion of the peritoneal mesenteries. Pancreatic volvulus is a very rare anomaly, with only a few isolated case reports described in association with wandering spleen. Anomalous right sided descending and sigmoid colon is a very rare entity and its association with wandering spleen has not been previously reported. We report a case of wandering spleen associated with mesenteroaxial gastric volvulus, pancreatic volvulus and rightward shift of the splenic flexure of the colon and right sided descending and sigmoid colon in a young female.


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Conventional Radiography, Computed Tomography, Macroscopic pathology, Table





Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Incarceration of umbilical hernia: a rare complication of large volume paracentesis by Iman Khodarahmi et al.

Published: 2015 Sep
Issue: 9(9) :: Pages: 20-25


Free full text article: Incarceration of umbilical hernia: a rare complication of large volume paracentesis

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Abstract: We present two cases of umbilical hernia incarceration following large volume paracentesis (LVP) in patients with cirrhotic ascites. Both patients became symptomatic within 48 hours after the LVP. Although being rare, given the significantly higher mortality rate of cirrhotic patients undergoing emergent herniorrhaphy, this complication of LVP is potentially serious. Therefore, it is recommended that patients be examined closely for the presence of umbilical hernias before removal of ascitic fluid and an attempt should be made for external reduction of easily reducible hernias, if a hernia is present.


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Computed Tomography, Conventional Radiography, Table





Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Heterotaxy Polysplenia Syndrome In An Adult With Unique Vascular Anomalies: Case Report With Review Of Literature by Chittapuram Srinivasan Rameshbabu et al.

Published: 2015 Jul
Issue: 9(7) :: Pages: 22-37


Free full text article: Heterotaxy Polysplenia Syndrome In An Adult With Unique Vascular Anomalies:  Case Report With Review Of Literature

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Abstract: The pattern of anatomical organization of the thoraco-abdominal visceral and vascular structures which is not the expected normal arrangement, is called as situs ambiguous or heterotaxy syndrome. Patients with heterotaxy syndrome exhibit a wide spectrum of anatomical variations involving thoraco-abdominal structures. We present here an incidental finding of heterotaxy syndrome associated with unique vascular anomalies in a 35 year old male patient evaluated initially for nephrolithiasis by ultrasonography, and intravenous pyelography. Further evaluation by multidetector row computed tomography showed bilateral bilobed lungs with hyparterial bronchi, cardiac apex to the left, five branches from left-sided aortic arch with retroesophageal right subclavian artery, interrupted inferior vena cava with azygos continuation, left renal vein continuing as hemiazygos vein and replaced common hepatic artery arising from the superior mesenteric artery. Other vascular anomalies include right internal iliac vein joining the left common iliac vein and precaval course of the single main right renal artery. Anomalies involving abdominal organs include right-sided stomach, midline liver, multiple splenules (polysplenia) in right upper quadrant of abdomen, short truncated pancreas, intestinal malrotation, inversion of superior mesenteric vessels and a preduodenal portal vein. To the best of our knowledge this is the first report of association of left renal vein continuing as hemiazygos vein, precaval right renal artery and anomalous branching pattern of aortic arch with heterotaxy syndrome.


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Ultrasound, Computed Tomography, Table





Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Combined Undifferentiated and Neuroendocrine Carcinomas of the Gallbladder Appearing as Two Separate Lesions: A Case Report with Radiological-Pathological Correlation by So Won Lee et al.

Published: 2015 May
Issue: 9(5) :: Pages: 14-21


Free full text article: Combined Undifferentiated and Neuroendocrine Carcinomas of the Gallbladder Appearing as Two Separate Lesions: A Case Report with Radiological-Pathological Correlation

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Abstract: We report herein a rare case of incidentally detected combined undifferentiated and neuroendocrine carcinomas of the gallbladder. An incidental gallbladder malignancy was revealed on abdominal ultrasound and multi-detector computed tomography in a 54-year-old man. A short distance from the main polypoid hypoechoic mass at the fundus of the gallbladder, focal wall thickening was noted with prominently increased power Doppler flow. Extended cholecystectomy was performed, and histology confirmed the main polypoid mass as undifferentiated carcinoma and the separate nodule as neuroendocrine carcinoma. To our knowledge, this is the first report presenting two separate lesions of combined gallbladder carcinomas by radiological features.


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Ultrasound, Computed Tomography, Macroscopic pathology, Microscopic pathology, Table

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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Incarcerated Grynfeltt-Lesshaft Hernia by Max Scheffler et al.

Published: 2015 Apr
Issue: 9(4) :: Pages: 9-13


Free full text article: Incarcerated Grynfeltt-Lesshaft Hernia

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Abstract: Superior lumbar triangle hernia, also known as Grynfeltt-Lesshaft hernia, denotes a subtype of abdominal wall hernia, and more specifically of lumbar hernia, occurring between the 12th rib, the internal oblique muscle, and the quadratus lumborum muscle. We report the case of a 92-year-old female patient in which this form of hernia occurred, complicated by incarceration and acute bowel obstruction. The discussion contains a short résumé of the different kinds of abdominal wall hernias.


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Conventional Radiography, Computed Tomography, Table

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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Transduodenal migration of a retained surgical swab causing small bowel obstruction - imaging findings in the acute setting and prior to onset of symptoms by Marc Williams

Published: 2015 Jan
Issue: 9(1) :: Pages: 43-48


Free full text article: Transduodenal migration of a retained surgical swab causing small bowel obstruction - imaging findings in the acute setting and prior to onset of symptoms

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Abstract: Transmural migration of a retained surgical sponge causing small bowel obstruction is a rare occurrence. We report a case which demonstrates both the associated foreign body reaction seen on computed tomography months in advance of the onset of symptoms and confirms the subsequent fistulous decompression into the duodenum on both computed tomography and barium meal studies. To the best of the author`s knowledge, a retained surgical swab causing small bowel obstruction has not been previously described with imaging both pre and post transluminal decompression.


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Conventional Radiography, Computed Tomography, Fluoroscopy, Table

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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Ischemic Colitis Due to a Mesenteric Arteriovenous Malformation in a Patient with a Connective Tissue Disorder by Peter D. Poullos et al.

Published: 2014 Dec
Issue: 8(12) :: Pages: 9-21


Free full text article: Ischemic Colitis Due to a  Mesenteric Arteriovenous Malformation in a Patient with a Connective Tissue Disorder

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Abstract: Ischemic colitis is a rare, life-threatening, consequence of mesenteric arteriovenous malformations. Ischemia ensues from a steal phenomenon through shunting, and may be compounded by the resulting portal hypertension. Computed tomographic angiography is the most common first-line test because it is quick, non-invasive, and allows for accurate anatomic characterization. Also, high-resolution three-dimensional images can be created for treatment planning. Magnetic resonance angiography is similarly sensitive for vascular mapping. Conventional angiography remains the gold standard for diagnosis and also allows for therapeutic endovascular embolization. Our patient underwent testing using all three of these modalities. We present the first reported case of this entity in a patient with a vascular connective tissue disorder.


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Computed Tomography, Clinical image, Microscopic pathology, Magnetic Resonance Imaging, Angiography, Interventional, Table





Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Dynamic MRI in the Diagnosis and Post Surgical Evaluation of Wandering Spleen by James K. Clark et al.

Published: 2014 Oct
Issue: 8(10) :: Pages: 15-22


Free full text article: Dynamic MRI in the Diagnosis and  Post Surgical Evaluation of Wandering Spleen

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Abstract: Wandering spleen is a rare but potentially clinically significant entity, and may be a cause for a patient presenting with acute abdomen. Because wandering spleen may present with non-specific symptoms and presentation, it can be a difficult diagnosis to make clinically. This paper describes a case report of the use of dynamic Magnetic Resonance Imaging (MRI) in a young woman to confirm the diagnosis of wandering spleen pre-operatively. The patient underwent a splenopexy and a post-operative MRI confirmed the successful surgical fixation of the patient`s spleen.


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Computed Tomography, Magnetic Resonance Imaging, Table

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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Posterior Rectus Sheath Hernia Causing Intermittent Small Bowel Obstruction by Scott Lenobel et al.

Published: 2014 Sep
Issue: 8(9) :: Pages: 25-29


Free full text article: Posterior Rectus Sheath Hernia  Causing Intermittent Small Bowel Obstruction

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Abstract: A posterior rectus sheath hernia is an abdominal wall hernia that is rarely encountered. Owing to its rarity, it can be easily overlooked in the setting of a patient presenting with abdominal pain. We report a case of a posterior rectus sheath hernia that caused intermittent small bowel obstruction. The unusual aspects of this case are that the defect was large, measuring 6 cm in the transverse diameter, and that it contained small bowel within a large portion of the rectus sheath. Because the defect was large and affected nearly the entire posterior rectus sheath, it was difficult to discern on computed tomography until a small bowel obstruction developed. In this case, a limited awareness of this clinical entity contributed to the delay in diagnosis.


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Conventional Radiography, Computed Tomography, Table

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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Angiosarcoma of the Liver: Imaging of a rare salient entity by Shalini Thapar et al.

Published: 2014 Aug
Issue: 8(8) :: Pages: 24-32


Free full text article: Angiosarcoma of the Liver:  Imaging of a rare salient entity

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Abstract: Hepatic angiosarcomas are rare mesenchymal tumors with few case series and reports describing their imaging findings in the last two decades. The computed tomography and magnetic resonance imaging findings are variable and may appear like hemangioma at one end of the spectrum and hepatoma at the other end. The use of hepatocyte specific contrast on magnetic resonance imaging may also be insufficient in making a reliable imaging diagnosis. These tumors can easily mimic hypervascular liver cancer, atypical hemangioma or metastases. This case report highlights the imaging features of this entity and also underlines that, this tumor should always be considered as a differential diagnosis for hypervascular tumors in cirrhotic patients. The current imaging paradigms for its diagnosis are also discussed.


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Computed Tomography, Magnetic Resonance Imaging, Microscopic pathology, Table

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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Case report: Portal and systemic venous gas in a patient with perforated duodenal ulcer: CT findings by Maged Nassef Abdalla Fam et al.

Published: 2014 Jul
Issue: 8(7) :: Pages: 20-27


Free full text article: Case report: Portal and systemic venous gas in a patient with perforated duodenal ulcer: CT findings

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Abstract: Gas within the portal circulation has been known to be associated with a number of conditions most commonly mesenteric ischemia and necrosis. Systemic venous gas is described with few conditions and is mostly iatrogenic in nature. We describe a case of combined portal and systemic venous gas detected by computed tomography in a patient with perforated duodenal ulcer.


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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Tale of a wandering spleen: 1800 degree torsion with infarcted spleen and secondary involvement of liver by Safia F. A. Maksoud et al.

Published: 2014 Jun
Issue: 8(6) :: Pages: 18-26


Free full text article: Tale of a wandering spleen: 1800 degree torsion with infarcted spleen and secondary involvement of liver

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Abstract: Wandering spleen is a rare clinical entity characterized by splenic hypermobility resulting from laxity or maldevelopment of the suspensory splenic ligaments. The spleen can "wander" or migrate into various positions within the abdomen or pelvis due to this ligamentous laxity. It is usually detected between 20 and 40 years of age, and is more common in women. The clinical presentation of a wandering spleen is variable, it could present as an asymptomatic, incidentally detected, abdominal or pelvic mass, or as an acute abdomen secondary to splenic torsion. Diagnosis in an emergent setting can be challenging as it is a rare cause of acute abdomen and does not produce any symptoms until splenic torsion has occurred. We present and discuss a case of ectopic, torsed spleen resulting in complete infarction of the spleen and severe hepatic vascular compromise, diagnosed by ultrasound, confirmed by computed tomography and effectively managed by splenectomy.


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Renal Cell Carcinoma presenting as small bowel obstruction secondary to a metastatic ileal intussusception by Rahul G Hegde et al.

Published: 2014 Apr
Issue: 8(4) :: Pages: 25-31


Free full text article: Renal Cell Carcinoma presenting as small bowel obstruction secondary to a metastatic ileal intussusception

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Abstract: We report a rare clinical presentation of renal cell carcinoma in the form of small bowel obstruction which was secondary to a metastatic ileal intussusception. Intussusception in the elderly is most commonly due to an underlying neoplasm, however metastases from a renal cell carcinoma is very uncommon. We present clinical details, radiological and pathological findings of the case followed by a discussion of the diagnosis and management of intussusception in the adult population.


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Inflammatory Pseudotumor of the Liver: A Rare Case of Recurrence Following Surgical Resection by Silvia D. Chang et al.

Published: 2014 Mar
Issue: 8(3) :: Pages: 23-30


Free full text article: Inflammatory Pseudotumor of the Liver: A Rare Case of Recurrence Following Surgical Resection

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Abstract: Inflammatory pseudotumor (IPT) of the liver is a rare, benign lesion that may be mistaken for malignancy. IPTs are difficult to diagnose due to non-specific clinical, laboratory and imaging features. We report the case of a 38-year old Asian male who presented with fatigue, weight loss and hepatomegaly. He was found to have a large hepatic IPT and underwent surgical resection; approximately two and a half years later, he developed acute cholangitis secondary to IPT recurrence. We present the imaging features of hepatic IPT using ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI). We also review the literature on the diagnosis and management of this disease. The unique features of this case include the IPT`s recurrence following surgical resection, large size and multiple modalities presented.


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Pylephlebitis of a variant mesenteric vein complicating sigmoid diverticulitis by Anna L. Falkowski et al.

Published: 2014 Feb
Issue: 8(2) :: Pages: 37-45


Free full text article: Pylephlebitis of a variant mesenteric vein  complicating sigmoid diverticulitis

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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.


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Adult abdominal Burkitt lymphoma with isolated peritoneal involvement by Catarina Oliveira et al.

Published: 2014 Jan
Issue: 8(1) :: Pages: 27-33


Free full text article: Adult abdominal Burkitt lymphoma  with isolated peritoneal involvement

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Abstract: Burkitt lymphoma is a fast-growing high grade B-cell neoplasm that rarely affects adults. Three clinical variants are described in the World Health Organization classification: endemic, sporadic, and immunodeficiency-associated. The non-endemic form typically presents as an abdominal mass in children. Symptoms usually occur due to mass effect or direct intestinal involvement. We describe a very unusual presentation of a sporadic Burkitt lymphoma case in a 61-year-old male with diffuse peritoneal and omental involvement, without lymphadenopathies, mimicking peritoneal carcinomatosis.


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Gallbladder torsion resulting in gangrenous cholecystitis within a parastomal hernia: Findings on unenhanced CT by Jessica K. Rosenblum et al.

Published: 2013 Dec
Issue: 7(12) :: Pages: 21-25


Free full text article: Gallbladder torsion resulting in gangrenous cholecystitis within a parastomal hernia:  Findings on unenhanced CT

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Abstract: Gallbladder torsion is a rare cause of acute gangrenous cholecystitis; its occurrence within an abdominal hernia has not been previously reported. We present such a case occurring within a parastomal hernia and imaged with unenhanced CT.


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Traumatic Portacaval Shunt: A Case Report and Literature Review by Susanna C Spence et al.

Published: 2013 Nov
Issue: 7(11) :: Pages: 1-6


Free full text article: Traumatic Portacaval Shunt:  A Case Report and Literature Review

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Abstract: Computed tomography (CT) evaluation of the acute polytrauma patient has become well established as a mainstay of ER triage in hemodynamically stable patients. The radiologist plays a pivotal role in directing management by identifying and appropriately categorizing the severity of a patient`s injuries. High-grade liver injuries have undergone an increasing trend of nonoperative management over the last several decades, with concurrent decrease in mortality. However, we present a case of a patient with a grade V liver laceration, in whom a rare portacaval shunt was also present. In the setting of this rare injury, the radiologist will likely be the first person to recognize and categorize a severe complication, which may indicate the need for a fundamental change in patient management.


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Isolated duodenal duplication cyst presenting as a complex solid and cystic mass in the upper abdomen by Salina D. Tsai et al.

Published: 2013 Nov
Issue: 7(11) :: Pages: 32-37


Free full text article: Isolated duodenal duplication cyst presenting as a complex solid and cystic mass in the upper abdomen

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Abstract: Duodenal duplication cysts are a rare subtype of gastrointestinal duplications cysts. Approximately 5% of gastrointestinal duplication cysts occur in the duodenum. An 18-year-old woman presented with epigastric pain and a subjective abdominal bulge. A computed tomography scan was subsequently performed and showed a solid and cystic mass with wall calcifications in the lesser sac of the upper abdomen. A duodenal duplication cyst was found unexpectedly on histopathologic analysis. This was also an unusual case as there was no evidence of malignancy. Four years after surgery, the patient remains asymptomatic. We present a brief literature review on duodenal duplication cysts and discuss its differential diagnosis.


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Sclerosing Encapsulating Peritonitis (Cocoon Bowel) Presenting after Laparotomy for Splenic Abscess by Jason Caldwell

Published: 2013 Oct
Issue: 7(10) :: Pages: 17-23


Free full text article: Sclerosing Encapsulating Peritonitis (Cocoon Bowel) Presenting after Laparotomy for Splenic Abscess

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Abstract: Sclerosing encapsulating peritonitis, previously referred to as cocoon bowel, is a rare cause of intestinal obstruction that often results in obstruction due to the development of a fibrous enhancing membrane that encases multiple small bowel loops. We present a case of a patient who presented to our institution with abdominal distension and guarding. Computed tomography was obtained which revealed findings concerning for sclerosing encapsulating peritonitis. Sonographic imaging was also obtained and provides correlative imaging.


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Imaging findings post colorectal endoscopic mucosal resection by James A Stephenson et al.

Published: 2013 Sep
Issue: 7(9) :: Pages: 27-32


Free full text article: Imaging findings  post colorectal endoscopic mucosal resection

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Abstract: Endoscopic mucosal resection is commonly the treatment regime of choice for large sessile colonic polyps. We describe the computed tomography findings of a 51 year old female who presented with transient severe abdominal pain without systemic upset post endoscopic mucosal polyp resection, which resolved with conservative management. This is the second case in the literature that demonstrates `normal` appearances post endoscopic mucosal resection. The clinical team and radiologist need to be aware of these findings when making management decisions in patients who present with acute pain post endoscopic mucosal resection.


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Fistulation as a complication of intra-abdominal soft-tissue sarcomas; a case series by Bo Wang et al.

Published: 2013 Jun
Issue: 7(6) :: Pages: 15-21


Free full text article: Fistulation as a complication of intra-abdominal soft-tissue sarcomas; a case series

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Abstract: Soft-tissue sarcomas are rare, accounting for only one percent of all cancers. They can occur in retroperitoneal and intraperitoneal sites, including gastrointestinal stromal tumours (GIST), and have the potential to cause complications secondary to interaction with other abdominal viscera. Fistulation, or an abnormal communication between two epithelium-lined surfaces that do not usually connect, is a rare example of such a complication. We present a series of cases of fistulation due to the presence of an intra-abdominal soft-tissue sarcoma and contrast three different approaches to management. We discuss the radiological features and other modalities of imaging which may be useful in diagnosing this rare complication.


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The French and their hernias: Prospective radiological differentiation of de Garengeot from other groin hernias by Nicholas Brown et al.

Published: 2013 Apr
Issue: 7(4) :: Pages: 16-21


Free full text article: The French and their hernias:  Prospective radiological differentiation of de Garengeot from other groin hernias

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Abstract: A femoral hernia containing an appendix, known as de Garengeot hernia, is an uncommon and potentially confusing presentation. Prompt differentiation of this condition from other groin hernias in an acute setting will influence management and reduce morbidity. Computed Tomography (CT) should be performed in all suspected cases and an awareness of likely CT findings can facilitate rapid pre-operative diagnosis. Despite this, we present only the fourth published case of prospective CT diagnosis of de Garengeot hernia.


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Unicentric Castleman`s Disease of Abdomen by Dharita Shah et al.

Published: 2013 Mar
Issue: 7(3) :: Pages: 26-33


Free full text article: Unicentric Castleman`s Disease of Abdomen

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Abstract: Castleman`s disease (CD) is a rare lymphoproliferative disease of uncertain etiology that affects lymph nodes. CD can be classified as a) unicentric vs. multicentric, based on clinical and radiological findings, b) hyaline vascular ( 80-90% ) vs. plasmacytic ( 10-20% ) vs. mixed cellularity variety based on histopathology. Unicentric disease is more common in the 3rd and 4th decade, whereas the multicentric form is more common in the 5th and 6th decade with no sex predilection. HIV seropositive individuals appear to be at an increased risk for multicentric castleman`s disease (MCD) at a younger age due to the increased incidence of HHV- 8 infection. Diagnosis is usually based on histopathology features as imaging features show considerable overlap, thus posing diagnostic difficulties. Overall prognosis is good, particularly in the unicentric variety of disease. We have presented a case of the unicentric CD in a 40 year old male patient having abdominal pain and hematuria as chief complaints.


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Ischemic Bowel: Uncommon Imaging Findings in a Case of Cocaine Enteropathy by Wesley Angel et al.

Published: 2013 Feb
Issue: 7(2) :: Pages: 38-43


Free full text article: Ischemic Bowel: Uncommon Imaging Findings in a Case of Cocaine Enteropathy

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Abstract: While the clinical findings of cocaine-induced enteropathy from mesenteric ischemia are fairly well understood, there is a paucity of imaging description and detail in the literature that describes these findings. Imaging characteristics of cocaine-induced mesenteric ischemia on CT examination include bowel edema, mucosal enhancement, venous engorgement, mesenteric free fluid, and dilatation of the small bowel lumen. A thorough history, physical examination, and laboratory testing are critical for the diagnosis and prompt surgical intervention may be necessary. We present a case of cocaine-induced mesenteric ischemia in a 49 year old male which resolved within 24 hours of supportive therapy.


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Bile leak after elective laparoscopic cholecystectomy: Role of MR imaging by Francesco Mungai et al.

Published: 2013 Jan
Issue: 7(1) :: Pages: 25-32


Free full text article: Bile leak after elective laparoscopic cholecystectomy: Role of MR imaging

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Abstract: Increasing hepatobiliary laparoscopic surgeries have lead to a rise in injury to the biliary tree and other complications like bile leak. Ultrasonography (US) and computed tomography (CT) cannot reliably distinguish bile from other postoperative fluid collections. Magnetic resonance (MR) imaging with hepatobiliary agents and MR cholangiopancreatography provide anatomic and functional information that allows for prompt diagnosis and excludes any other concomitant complications. We report a case of post-cholecystectomy bile leak in a 42-year-old female who presented with persistent dull abdominal pain after the intervention; we emphasize the role of MR imaging in achieving the correct diagnosis.


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Dermoid cyst of the pancreas: A case report with literature review by Jason Lane* et al.

Published: 2012 Dec
Issue: 6(12) :: Pages: 17-25


Free full text article: Dermoid cyst of the pancreas:  A case report with literature review

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Abstract: Pancreatic dermoid cysts represent a rare entity with 35 cases described in the world literature, including the present one. Pre-operative diagnosis is difficult, with definitive diagnosis usually taking place intra-operatively. We report the case of a 63 year old male with a symptomatic, 6 cm cystic mass in the body of the pancreas. The pre-operative evaluation suggested a cystic neoplasm, but was indeterminate as to whether the lesion was benign or malignant. The diagnosis of dermoid cyst was made intra-operatively with frozen section. Although the diagnosis could not be made pre-operatively this retrospective report highlights the difficulty in evaluating cystic pancreatic lesions by imaging and summarizes the current body of knowledge on this rare entity.


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Presentation of Ileal Burkitt Lymphoma in Children by Joseph R. Grajo et al.

Published: 2012 Aug
Issue: 6(8) :: Pages: 27-38


Free full text article: Presentation of Ileal Burkitt Lymphoma in Children

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Abstract: Burkitt lymphoma is a highly aggressive form of Non-Hodgkin lymphoma that responds favorably if diagnosed accurately and treated early. Recognition of the various radiologic manifestations of Burkitt lymphoma can help guide the clinician to expedite appropriate chemotherapy. We present two cases that illustrate different radiologic presentations of this aggressive gastrointestinal malignancy in children. Case 1 features a 7-year-old boy who presented to our hospital with recurrent ileocecal intussusception. Case 2 describes a 16-year-old male with history of blood-streaked stools. Ileocectomy was performed in both cases and histologic analysis showed the "starry sky pattern" and t(8;14) translocation, classic for Burkitt lymphoma. Both patients remain disease-free following surgical excision and chemotherapy.


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Esophageal Lipoma: A Rare Tumor by Jeremy Feldman et al.

Published: 2012 Jul
Issue: 6(7) :: Pages: 17-22


Free full text article: Esophageal Lipoma: A Rare Tumor

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Abstract: Esophageal lipomas are rare tumors, making up 0.4% of all digestive tract benign neoplasms. Most of these lesions are clinically silent as a result of their small size, however, the majority of lesions over 4 cm have been reported to cause dysphagia, regurgitation and/or epigastralgia. We report a case of a 53 year-old African American female who presented with dysphagia. Computed tomography of the chest and esophagram confirmed esophageal lipoma as the cause of the patient`s symptoms. Accurately diagnosing an esophageal lipoma is crucial in order to rule out potential malignant lesions, relieve patient symptoms and plan the appropriate treatment.


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Colonic Angiolipoma - A rare finding in the gastrointestinal tract. Case Report and review of literature. by Beatriz Molinares et al.

Published: 2012 Jun
Issue: 6(6) :: Pages: 23-28


Free full text article: Colonic Angiolipoma - A rare finding in the gastrointestinal tract. Case Report and review of literature.

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Abstract: Angiolipomas are benign lesions that are frequently found in subcutaneous cellular tissue, but are rarely located in the gastrointestinal tract. Here we discuss a case of colonic angiolipoma that presented as a mass near the hepatic flexure, occupying approximately 90% of the colonic lumen. The diagnosis was made by endoscopy and computed tomography. The mass was resected successfully and diagnosis was confirmed by histological studies and immunohistochemical tests.


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Isolated Gallbladder Injury in a Case of Blunt Abdominal Trauma by Jeffrey Birn et al.

Published: 2012 Apr
Issue: 6(4) :: Pages: 25-30


Free full text article: Isolated Gallbladder Injury in a Case of Blunt Abdominal Trauma

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Abstract: The diagnosis of blunt injury to the gallbladder may constitute a significant challenge to the diagnostician. There is often a delay in presentation with non-specific clinical symptoms. In the absence of reliable clinical symptoms, diagnostic imaging becomes an invaluable tool in the rapid identification of gallbladder injury. We present a case of isolated gallbladder injury following blunt abdominal trauma which was diagnosed by computed tomography and subsequently confirmed by cholecystectomy.


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Rare pancreatic neoplasm: MDCT and MRI features of a typical Solid Pseudopapillary Tumor by Stefano Palmucci et al.

Published: 2012 Jan
Issue: 6(1) :: Pages: 17-24


Free full text article: Rare pancreatic neoplasm: MDCT and MRI features of a typical Solid Pseudopapillary Tumor

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Abstract: Solid pseudopapillary tumor of the pancreas is a rare neoplasm, predominantly observed in young women and with greatest incidence in the second and third decade. It has clinically good behavior, although large at the time of diagnosis. We report the case of a thirty-year-old woman with a giant mass in the pancreas, incidentally discovered during an abdominal ultrasonography. The mass was later investigated by multidetector computed tomography and magnetic resonance imaging. The cystic-solid appearance of the encapsulated lesion suggested to radiologists the possibility of a solid pseudopapillary tumor. Imaging features of this pancreatic neoplasm and differential diagnosis from other cystic pancreatic tumors are discussed in our report, in order to help radiologists and clinicians achieve correct diagnosis and management.


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Critical Pitfall: Varices in Cancer Patients mimicking Lymphadenopathy; Differentiation of varicose veins and enlarged lymph nodes in routine staging by Tilman Schubert et al.

Published: 2011 Sep
Issue: 5(9) :: Pages: 23-29


Free full text article: Critical Pitfall: Varices in Cancer Patients mimicking Lymphadenopathy; Differentiation of varicose veins and enlarged lymph nodes in routine staging

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Abstract: Two patients, each with a history of multiple cancers, were referred to our institution for routine cancer staging. Contrast enhanced multislice-CT showed round and oval shaped inguinal and retroperitoneal masses in one patient and inguinal mass lesions in the other patient. The mass lesions were suspicious of lymphadenopathy related to cancer recurrence. Additional MR-Imaging, however, showed tortuous varicose veins as well as suspicious lymph nodes in one patient and solely venous convolutes in the other patient. Regarding the routine contrast enhanced CT-scan in the portovenous phase, varices showed no significant difference in radiodensity compared to enlarged lymph nodes.


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Pancreatic Arteriovenous Malformation: a case report and literature review by Damon D. Shearer et al.

Published: 2011 Aug
Issue: 5(8) :: Pages: 8-13


Free full text article: Pancreatic Arteriovenous Malformation: a case report and literature review

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Abstract: Most pancreatic arteriovenous malformations (PAVM) present due to gastrointestinal bleeding or abdominal pain, but these patients may be asymptomatic. Increased portal vein flow from these malformations can lead to portal hypertension and gastrointestinal bleeding. Diagnosis is often made by imaging, and early diagnosis has led to successful surgical resection or percutaneous embolization. We report a patient with PAVM, diagnosed by CT and angiography, who has remained asymptomatic for 2 years without treatment.


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Solid Pseudopapillary Tumor of the Pancreas: a rare and probably misdiagnosed neoplasm by Ana Frias Vilaça et al.

Published: 2011 July
Issue: 5(7) :: Pages: 24-34


Free full text article: Solid Pseudopapillary Tumor of the Pancreas: a rare and probably misdiagnosed neoplasm

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Abstract: Solid Pseudopapillary Tumor of the pancreas is a rare nonfunctioning tumor. It is considered a low-grade malignancy that is apparently curable with surgical complete excision in most instances. We present a case of solid pseudopapillary pancreatic tumor that represented a challenge to the radiologists. This case highlights its possible various appearances and the need to the radiologist to be familiar with them.


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Cystic lymphangioma of the lesser curvature of the stomach - case report by Hyuma A. Leland et al.

Published: 2011 May
Issue: 5(5) :: Pages: 31-37


Free full text article: Cystic lymphangioma of the lesser curvature of the stomach - case report

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Abstract: We report a case of a cystic lymphangioma arising from the lesser curvature of the stomach in a 16-year-old female who initially presented with abdominal pain, nausea, and emesis. Contrast enhanced computed tomography and magnetic resonance imaging revealed a large, thin-walled multicystic mass located anteromedial to the stomach, which was predominately supplied by the left gastric artery. Given the imaging appearance and location, a mesenteric cyst, specifically a cystic lymphangioma, was considered. Lymphangioma was the final pathological diagnosis after laparotomy with complete resection of the cystic abdominal mass.


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Umbilical Concretion by David Sheehan et al.

Published: 2011 Apr
Issue: 5(4) :: Pages: 25-31


Free full text article: Umbilical Concretion

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Abstract: Umbilical concretion is a rarely encountered benign entity. Concretions typically form within an umbilical cleft which is unusually deep and consist of keratinaceous and sebaceous material. Lack of attention to umbilical hygiene usually plays a role in their formation. Concretions are generally asymptomatic and may only present clinically when complicated by inflammation or infection. Their appearance on imaging studies may be problematic for the radiologist given their rarity, particularly in the setting of a known or suspected intra-abdominal malignancy.


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Case report of xanthogranulomatous cholecystitis, review of its sonographic and magnetic resonance findings, and distinction from other gallbladder pathology by Nathan D. Cecava et al.

Published: 2011 Apr
Issue: 5(4) :: Pages: 19-24


Free full text article: Case report of xanthogranulomatous cholecystitis, review of its sonographic and magnetic resonance findings, and distinction from other gallbladder pathology

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Abstract: A case of xanthogranulomatous cholecystitis is presented with a brief review of its sonographic and magnetic resonance features. These imaging features are also compared to those seen in gallbladder adenomyomatosis and gallbladder carcinoma. While there are many overlapping imaging findings in these entities, it is important to recognize distinguishing characteristics so a correct surgical approach is chosen. Laparoscopic cholecystectomy attempted with existing xanthogranulomatous cholecystitis has an increased surgical complication rate compared to open cholecystectomy and often necessitates intraoperative conversion to open cholecystectomy.


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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Groove pancreatitis: A Case Report and Review of the Literature by Ana Ferreira et al.

Published: 2010 Nov
Issue: 4(11) :: Pages: 9-17


Free full text article: Groove pancreatitis: A Case Report and Review of the Literature

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Abstract: Groove pancreatitis is a rare form of segmental chronic pancreatitis. It involves the anatomic space between the head of the pancreas, the duodenum and the common bile duct. It was first described in the early 1970s, but it remains largely unfamiliar to most physicians. Radiological diagnosis can be challenging, as it is often difficult to differentiate it from other entities. The differential diagnosis from pancreatic head carcinoma may be difficult and recognition of subtle differences between these two entities is extremely important as the management differs significantly. Groove pancreatitis can be managed by conservative medical treatment, and surgery is reserved only for patients with persistent and severe clinical symptoms. We present a case of a 27 year-old male with groove pancreatitis and discuss the Magnetic Resonance Imaging (MRI) appearance of this entity as well as the differential diagnosis.


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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

CT and MR findings in extramedullary haematopoiesis with biliary system encasement: a case report by Alfredo La Fianza et al.

Published: 2010 Nov
Issue: 4(11) :: Pages: 1-8


Free full text article: CT and MR findings in extramedullary haematopoiesis with biliary system encasement: a case report

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Abstract: Extramedullary haematopoiesis is the production of blood elements outside the bone marrow cavity. In our case computed tomography and magnetic resonance imaging revealed the presence of a rare localization of extramedullary haematopoiesis with encasement of the biliary system in a 59 years-old male Caucasian patient, with chronic myelofibrosis and hepatic failure`s symptomatology. Computed tomography detected the presence of homogeneous hypodense tissue around intra-hepatic bile ducts with minimal contrast enhancement, strongly suggestive for extramedullary haematopoiesis. Magnetic resonance confirmed the presence of a solid tissue surrounding the biliary tree, showing late enhancement after gadolinium administration suggestive for non-active lesion of extramedullary haematopoiesis. Final diagnosis was established by percutaneous biopsy.


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Ultrasound, Computed Tomography, Magnetic Resonance Imaging, Table

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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Acute Mesenteric Ischaemia on Unenhanced Computer-Tomography by Nidhi Gupta et al.

Published: 2010 Sep
Issue: 4(9) :: Pages: 24-30


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Abstract: We present a 39-year old man with mesenteric ischaemia. The initial unenhanced images of the, non-oral contrast CT abdomen clearly demonstrated increased density in a significant length of the small bowel and in the veins of the adjacent mesentery. Mesenteric ischaemia is a difficult diagnosis both clinically and radiologically and we demonstrate the potential benefits of an unenhanced abdominal scan (often left out if a contrast enhanced scan is to be performed) and the omission of oral bowel contrast in emergency scans.


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Microscopic pathology, Computed Tomography, Table

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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Extramedullary duodenal plasmacytoma presenting with gastric outlet obstruction and painless jaundice by Adib R. Karam¹*, Rita J. Semaan², Karen Buch³, Sridhar Shankar4 et al.

Published: 2010 Aug
Issue: 4(8) :: Pages: 22-28


Free full text article: Extramedullary duodenal plasmacytoma presenting with gastric outlet obstruction and painless jaundice

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Abstract: Malignant plasma cells in multiple myeloma are predominantly confined to the medullary space of the skeletal system, therefore the disease course will be dominated by signs and symptoms related to bone marrow infiltration and destructive bone lesions with their consequences as well as abnormal protein production. Visceral extramedullary plasmacytoma involving the gastrointestinal system and particularly the duodenum is a rare manifestation of the disease. We report a case of duodenal extramedullary plasmacytoma presenting with gastric outlet obstruction and painless jaundice, in a patient treated for multiple myeloma. Diagnosis was first suggested on imaging, and proved by endoscopic biopsy. The duodenal mass resolved following chemotherapy.


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Computed Tomography, Magnetic Resonance Imaging, Clinical image, Table

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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Solitary Fibrous Tumor Originating in the Pelvis: A Case Report by Justin Boe et al.

Published: 2010 Jul
Issue: 4(7) :: Pages: 21-28


Free full text article: Solitary Fibrous Tumor Originating in the Pelvis: A Case Report

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Abstract: A 52 year old male presented with changes in bowel movements, and a mass was detected on digital rectal exam. Both CT and MRI revealed a large pelvic and gluteal mass filling the pelvic cavity displacing the adjacent pelvic structures. After surgical removal, pathology revealed solitary fibrous tumor; a rare neoplasm uncommonly discovered in the thorax, and even less commonly in extrapleural locations. We discuss in this article imaging findings and histological features of extrapleural solitary fibrous tumor.


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Computed Tomography, Magnetic Resonance Imaging, Angiography, Interventional, Microscopic pathology, Table

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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Portal Vein Aneurysms: A Case Series with Literature Review by Ryan B. Schwope et al.

Published: 2010 Jun
Issue: 4(6) :: Pages: 28-38


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Abstract: Portal vein aneurysms are a relatively uncommon entity and often an incidental, asymptomatic finding. Recognition of this finding can help to avoid potential confusion with abdominal masses of other etiologies. We would like to present four cases of portal vein aneurysms, and discuss the natural history, imaging findings, and treatment of this condition. One of the cases of portal vein aneurysm presented occurred after liver transplantation, which, to the best of our knowledge, has only been described once in the English-language literature.


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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Blunt abdominal trauma – An important cause of portal venous pseuodoaneurysm by Adam Wallis et al.

Published: 2010 May
Issue: 4(5) :: Pages: 27-31


Free full text article: Blunt abdominal trauma – An important cause of portal venous pseuodoaneurysm

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Abstract: Aneurysms and pseudoaneurysms of the portal venous system are rarely seen following abdominal trauma but clinicians need to be aware of them as possible vascular complications following blunt trauma. This case report of a 10 year old boy following a handlebar injury demonstrates a clear causal relationship between trauma and portal venous pseudoaneurysm. Portal venous aneurysms have a prevalence of less than 0.4% and most are found in patients with underlying hepatocellular disease. Many are asymptomatic in which case surveillance is an accepted management strategy, with Doppler ultrasound proving useful. Complications including thrombosis, distal embolism, compression of the biliary tree and haemorrhage are usually indications for surgical management. Portal venous pseudoaneurysms may be managed conservatively but transcatheter embolisation can be used if there are ongoing complications or haemorrhage.


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Computed Tomography, Ultrasound, Angiography, Interventional

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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Fasciola hepatica infection in a 65-year-old woman by Bernard Pilet et al.

Published: 2010 Apr
Issue: 4(4) :: Pages: 13-19


Free full text article: Fasciola hepatica infection in a 65-year-old woman

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Abstract: Fascioliasis is an infectious disease caused by fasciola or liver fluke. Humans are accidental hosts to these flatworms. The World Health Organisation considers fascioliasis an important human parasitic disease. In Europe, Australia and Northern America, the disease is rare, but should have a high index of suspicion in patients who have lived in or travelled to endemic areas. Although it can be self-limiting, fascioliasis is associated with an increased risk of bile duct cancer. Before a clear-cut diagnosis is made using ELISA-based arrays, radiologic studies can provide the clinician with a number of suggestive features, thereby avoiding the need for liver biopsy or even surgery, which have nowadays become obsolete for the diagnosis of fascioliasis. We provide an overview of the major radiologic hallmarks and we demonstrate the role of iron-oxide enhanced MRI.


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Computed Tomography, Nuclear Medicine, Magnetic Resonance Imaging, Microscopic pathology

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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Gardner syndrome complicated with hydronephrosis. A case report by Paolo Cabassa et al.

Published: 2010 Mar
Issue: 4(3) :: Pages: 19-23


Free full text article: Gardner syndrome complicated with hydronephrosis. A case report

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Abstract: Gardner syndrome is an autosomal dominant disease characterized by the presence of colonic polyposis, osteomas and soft tissue tumors. We present a case of a man who was admitted for a relapse of adenocarcinoma of the rectum. CT-staging showed multiple locations of desmoid tumors and osteomas, with final diagnosis of Gardner syndrome. The follow-up CT, after surgery and chemotherapy, showed a relapse of the lesions with hydronephrosis due to ureteral compression.


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Computed Tomography, Microscopic pathology

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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Esophageal Actinomycosis: A Case Report and Review of Radiographic Findings by Rodney D. Welling et al.

Published: 2009 Dec
Issue: 3(12) :: Pages: 44-48


Free full text article: Esophageal Actinomycosis: A Case Report and Review of Radiographic Findings

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Abstract: Esophageal Actinomycosis is a rare disease with only two previous reports in the Radiology literature. We present a 27 year-old African American male with a past medical history of a renal transplant for renal disease secondary to lupus who presented with odynophagia. The computed tomography and barium swallow findings are presented as well as a differential diagnosis of infectious esophageal diseases.


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Clinical image, Microscopic pathology, Computed Tomography, Fluoroscopy

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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Multifocal extra-adrenal myelolipoma arising in the greater omentum by Adib R. Karam

Published: 2009 Nov
Issue: 3(11) :: Pages: 20-23


Free full text article: Multifocal extra-adrenal myelolipoma arising in the greater omentum

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Abstract: Myelolipomas are rare benign tumors composed of mature fat and hematopoietic elements. They are most often discovered incidentally within the adrenal glands, with extra-adrenal myelolipomas being extremely rare tumors. We report a case of multifocal omental extra-adrenal myelolipoma in a patient who had undergone bilateral adrenalectomy. To our knowledge, this is the first reported case of an intraperitoneal extra-adrenal myelolipoma.


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Computed Tomography, Macroscopic pathology, Microscopic pathology

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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Gastrointestinal amyloidosis presenting as enterocolitis on abdominal CT scan by Inneke Willekens et al.

Published: 2009 Oct
Issue: 3(10) :: Pages: 11-14


Free full text article: Gastrointestinal amyloidosis presenting as enterocolitis on abdominal CT scan

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Abstract: The imaging findings of amyloidosis are nonspecific and diverse due to its association with various chronic diseases such as multiple myeloma. We report a case of gastrointestinal amyloidosis presenting as enterocolitis on a contrast enhanced CT scan of the abdomen.


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Conventional Radiography, Computed Tomography

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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Spontaneous isolated superior mesenteric artery dissection - Report of two cases by Kaliappan Gurusamy Srinivasan et al.

Published: 2009 Sep
Issue: 3(9) :: Pages: 6-13


Free full text article: Spontaneous isolated superior mesenteric artery dissection  - Report of two cases

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Abstract: Two cases of isolated superior mesenteric artery dissection diagnosed by contrast enhanced 64 slice CT are reported. In both, the dissection was seen extending along the entire length of the artery with one of them showing partially thrombosed false lumen. One case was associated with dissection of left renal artery with consequent renal infarcts. Although superior mesenteric artery dissection is a rare phenomenon, it should be considered in the differential diagnosis of abdominal angina.


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Computed Tomography

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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Epiploic Appendagitis in a Female Patient with Situs Ambiguous Abnormality by Christopher Ryen

Published: 2009 Aug
Issue: 3(8) :: Pages: 30-34


Free full text article: Epiploic Appendagitis in a Female Patient with Situs Ambiguous Abnormality

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Abstract: We report the case of a 23 year-old obese female, with previously diagnosed situs inversus below the diaphragm, who presented with severe left upper quadrant abdominal pain. The patient was believed to have a surgical indication, possibly appendicitis or diverticulitis, and had an emergent abdominal Computed Tomography (CT) scan. The CT was interpreted as epiploic appendagitis with no signs of appendicitis. Epiploic appendagitis is a rare cause of acute abdominal pain, which involves the torsion and eventual necrosis of one of the epiploic appendages. This case was complicated by the fact that the patient had situs inversus below the diaphragm, which made it difficult to relate her localized abdominal pain to the correct anatomic area. The diagnosis allowed the patient to avoid invasive surgery and instead opt for conservative medical management. The utilization of radiologic imaging is of utmost importance in diagnosing this condition, which has characteristic findings on CT, US, and MR, all of which is discussed in this article.


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Computed Tomography

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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Importance of CT in Evaluating Internal Hernias after Roux-en-Y Gastric Bypass Surgery by Hasan S. Merali et al.

Published: 2009 Jun
Issue: 3(6) :: Pages: 34-37


Free full text article: Importance of CT in Evaluating Internal Hernias after Roux-en-Y Gastric Bypass Surgery

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Abstract: As the incidence of obesity increases, laparoscopic Roux-en-Y gastric bypass (REYGB) surgery has become a surgical option for many patients. Although the laparoscopic Roux-en Y procedure has been shown to reduce weight and improve diabetes, hyperlipidemia, hypertension and sleep apnea, it is not without significant risks, as more than 10% of patients who undergo this procedure have postoperative GI complications. This is a case of a 51 year old man who presented with diffuse abdominal pain one month status-post Roux-en-Y gastric bypass. CT imaging proved to be crucial in the diagnosis of this pathology with small bowel volvulus and ischemia. We review some key CT findings that can aid clinicians in diagnosing internal hernias since this complication is often misdiagnosed and have a mortality rate of more than 50%.


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Conventional Radiography, Computed Tomography

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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Noncontrast and contrast enhanced computed tomography for diagnosing acute appendicitis: A retrospective study for the usefulness by Maki Kitagawa et al.

Published: 2009 Jun
Issue: 3(6) :: Pages: 26-33


Free full text article: Noncontrast and contrast enhanced computed tomography for diagnosing acute appendicitis: A retrospective study for the usefulness

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Abstract: Abdominal computed tomography (CT) provides great benefits for the differential diagnosis in patients complaining of acute abdominal pain. However, the use of diagnostic X-rays is associated with the cumulative risk of cancer development. In order to determine the relative usefulness of noncontrast and enhanced CT with intravenous contrast material for diagnosing acute appendicitis, the retrospective analysis was performed using 247 patients (46 children and 201 adults) with clinically suspected appendicitis, who were admitted to our hospital from 2002 to 2006 and underwent noncontrast or combined noncontrast and enhanced CT examination. Of 185 patients who were diagnosed to have acute appendicitis with appendiceal thickening (167 cases) or normal-sized appendix (18 cases), 73 cases underwent noncontrast CT alone and these 73 cases could be retrospectively diagnosed to have appendicitis on noncontrast CT. On the other hand, 112 cases of these 185 patients underwent noncontrast CT followed by enhanced CT, and vermiform appendix was detected in 86 cases of them (86/112, 76.8%) on noncontrast CT. These 86 cases could be retrospectively diagnosed to have acute appendicitis on noncontrast CT, whereas enhanced CT was required to detect vermiform appendix and to obtain the final diagnosis of appendicitis in the remaining 26 cases (26/112, 23.2%). Enhanced CT was superior to noncontrast CT in diagnosing appendicitis in all age and any gender groups. We suggest that enhanced, but not noncontrast, CT should be primarily performed for diagnosing acute appendicitis in all patients to minimize the radiation exposure unless intravenous administration of contrast material is contraindicated.


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Computed Tomography, Table

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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

A Jejunal Gastrointestinal Stromal Tumour: an unusual cause of massive acute gastrointestinal haemorrhage with emphasis on pre intervention MDCT by Suchi Gaba et al.

Published: 2009 May
Issue: 3(5) :: Pages: 21-24


Free full text article: A Jejunal Gastrointestinal Stromal Tumour: an unusual cause of massive acute gastrointestinal haemorrhage with emphasis on pre intervention MDCT

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Abstract: Gastrointestinal stromal tumors (GIST) most commonly arise from the stomach followed by the small intestine and are common cause for an occult gastrointestinal (GI) bleeding. We present an unusual case of a jejunal GIST, which presented as an acute gastrointestinal haemorrhage. This case highlights the importance of an intravenous contrast enhanced abdominal CT with neutral oral contrast for the assessment of gastrointestinal bleeding where non-obstructive enhancing tumour, active extravasations and arteriovenous malformations (AVM) could potentially be obscured by the use of positive oral contrast. This case also emphasizes on the use of multiplanar image reconstructions that are extremely useful in determining the exact location and size of the pathology.


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Computed Tomography, Macroscopic pathology, Microscopic pathology

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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Ileocolic invagination as a complication of a cecal adenocarcinoma by Inneke Willekens Johan de Mey et al.

Published: 2008 Nov
Issue: 2(5) :: Pages: 29-32


Free full text article: Ileocolic invagination as a complication of a cecal adenocarcinoma

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Abstract: Ileocolic invagination in the adult may be caused by adenocarcinoma and lead to intestinal obstruction. We report a case of a cecal adenocarcinoma that was complicated by an ileocolic invagination in a 38 year old female, diagnosed on a contrast enhanced CT scan of the abdomen and highlights the importance of contrast enhanced CT for diagnosis of ileocolic invagination.


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Computed Tomography, Ultrasound, Microscopic pathology

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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Primary Burkitt`s Lymphoma Of The Appendix Presenting As Acute Abdomen: A Case Report by Maneesh Khanna et al.

Published: 2008 Nov
Issue: 2(5) :: Pages: 9-14


Free full text article: Primary Burkitt`s Lymphoma Of The Appendix Presenting As Acute Abdomen: A Case Report

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Abstract: Leukemic and lymphomatous involvement of the appendix is rare and even rarer is its presentation as appendicitis. Burkitt`s lymphoma is a high grade B-cell neoplasm. Its non-endemic form typically presents as abdominal mass in children. This rapidly growing tumour may cause symptoms due to mass effect or direct involvement of the bowel. Clinical presentations like acute abdomen can be secondary to intestinal obstruction, intussusception or sometimes perforation. We describe here a case of an adult male with an unusual presentation of appendiceal Burkitt`s lymphoma mimicking acute cholecystitis or appendicitis.


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Ultrasound, Computed Tomography, Microscopic pathology

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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Jejunal diverticulitis: an unusual cause of an intra-abdominal abscess - coronal Computed Tomography reconstruction can aid the diagnosis by Alex Mortimer et al.

Published: 2008 Nov
Issue: 2(5) :: Pages: 15-18


Free full text article: Jejunal diverticulitis: an unusual cause of an intra-abdominal abscess - coronal Computed Tomography reconstruction can aid the diagnosis

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Abstract: Jejunal diverticulitis is a rare condition that can present with an acute abdomen and be referred for imaging. We present the case of an elderly patient who at CT was diagnosed with an intra-abdominal abscess involving both jejunum and transverse colon. However, the underlying eitiology was not initially clear until small bowel barium follow-through. Pertinent points regarding CT findings in jejunal diverticulitis are discussed, and practical recommendations in small bowel diverticulum recognition and diagnosis are made.


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Computed Tomography, Fluoroscopy

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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Focal nodular hyperplasia of the liver with pseudo-angiomatous appearance of the central area: MRI findings and physiopathological insights by Ludivine Glas et al.

Published: 2008 Oct
Issue: 2(4) :: Pages: 8-12


Free full text article: Focal nodular hyperplasia of the liver with pseudo-angiomatous appearance of the central area: MRI findings and physiopathological insights

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Abstract: We report an unusual case of focal nodular hyperplasia (FNH) with angioma-like vascularity in the central scar illustrated on MRI and proven by histopathology. The vascular theory of common causative factors in FNH and haemangioma is discussed.


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Magnetic Resonance Imaging, Microscopic pathology

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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

Visualization of Noncalcified Gallstones on CT Due to Vicarious Excretion of Intravenous Contrast by Andres Krauthamer et al.

Published: 2008 Aug
Issue: 2(2) :: Pages: 5-8


Free full text article: Visualization of Noncalcified Gallstones on CT Due to Vicarious Excretion of Intravenous Contrast

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Abstract: We present a case where low attenuation gallstones are visible on CT only on delayed imaging secondary to gallbladder opacification from vicarious excretion of contrast. We discuss heterotopic accumulation of contrast in the gallbladder and its potential diagnostic utilization in the detection of occult pathology.


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Computed Tomography, Ultrasound

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An unusual presentation of early appendicitis with left sided flank pain by Roland Talanow

Published: 2008 Jul
Issue: 2(1) :: Pages: 8-11


Free full text article: An unusual presentation of early appendicitis with left sided flank pain

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Abstract: The author presents a case with an unusual presentation of early appendicitis. The patient presented initially with left sided flank pain. Workup for nephrolithiasis, including non-contrast CT of the abdomen and pelvis was negative for renal stones or hydronephrosis. After discharge, the patient presented one week later in the ED with right lower quadrant pain. Contrast enhanced CT of the abdomen revealed perforated appendicitis.


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Computed Tomography

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Other Radiology articles from the Gastrointestinal Radiology section Gastrointestinal Radiology

An unusual presentation of early appendicitis with left sided flank pain by Roland Talanow

Published: 2007 Sep
Issue: 1(3) :: Pages: 1-4


Free full text article: An unusual presentation of early appendicitis with left sided flank pain

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Abstract: The author presents a case with an unusual presentation of early appendicitis. The patient presented initially with left sided flank pain. Workup for nephrolithiasis, including non-contrast CT of the abdomen and pelvis was negative for renal stones or hydronephrosis. After discharge, the patient presented one week later in the ED with right lower quadrant pain. Contrast enhanced CT of the abdomen revealed perforated appendicitis.


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Computed Tomography

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