Intestinal duplication is an uncommon congenital abnormality, with potential life-threatening complications, usually manifesting in childhood. Due to its non-specific clinical presentation as well as its resemblance t...Intestinal duplication is an uncommon congenital abnormality, with potential life-threatening complications, usually manifesting in childhood. Due to its non-specific clinical presentation as well as its resemblance to other abdominal processes at imaging, the differential diagnosis may be very difficult. This case report describes a young female adult accessed twice to our Emergency Department with recurrent pain in the right iliac fossa and a clinical picture of abdominal pain and bowel obstruction, who was finally diagnosed with complicated duplication cyst, then resected. The diagnostic tools performed show the simple duplication cyst at the beginning, in the ileocecal region, with the characteristic “gut signature” at Ultrasound and its subsequent inflammatory changing at Computed Tomography, which led to the right diagnostic hypothesis, confirmed by histopathology. An early diagnosis of this condition is needed to undertake the correct surgical approach.展开更多
We report a case of a 92-year-old man complaining of epigastric pain, which an US first and a CT scan later revealed to be related to a large gallstone causing cholecystitis. After the patient had refused surgical tre...We report a case of a 92-year-old man complaining of epigastric pain, which an US first and a CT scan later revealed to be related to a large gallstone causing cholecystitis. After the patient had refused surgical treatment for this condition, he was again referred to our Emergency Department presenting with a clinical picture of gastric obstruction. A new CT scan showed the classic Rigler’s triad, characterized by pneumobilia, gastric distension and gallstone in the duodenal lumen, which was pathognomonic for a rare form of gallstone ileus named Bouveret’s syndrome. The cause of this event was found out to be the chronic inflammation of gallbladder wall and its consequent erosion, which led to formation of gallbladder-duodenum fistula and the movement of the gallstone from the gallbladder to the duodenum where it impacted. This is a high morbidity and mortality condition, which affects mostly elderly people and needs early diagnosis and surgical treatment.展开更多
Contrast medium induced nephropathy is the third most common cause of renal failure for inpatients and represents the 10% of all acute kidney injury occurring during hospital-stay. It is associated with prolonged hosp...Contrast medium induced nephropathy is the third most common cause of renal failure for inpatients and represents the 10% of all acute kidney injury occurring during hospital-stay. It is associated with prolonged hospitalization, cost increase and, above all, an unfavourable short- and long-term prognosis. Here, the authors discuss about the contrast medium induced nephropathy prevention strategies, from the identification of patients at risk and drugs potentially nephrotoxic, to the hydration with possible administration of drugs that appeared to be, in some contexts, nephron-protective, and finally we analyze the radiological procedure aimed at the correct choice of type and administration modality of the contrast medium according to current literature.展开更多
This is a report of a case of cystic hygroma of the neck in a female child. Cystic hygroma is a rare congenital malformation of the lymphatic system, most frequently detected in the head and neck region. Ultrasound is...This is a report of a case of cystic hygroma of the neck in a female child. Cystic hygroma is a rare congenital malformation of the lymphatic system, most frequently detected in the head and neck region. Ultrasound is considered as being the first level study to investigate a suspected mass suggestive of cystic hygroma. The Authors describe the main diagnostic ultrasound features for this type of lymphatic lesion.展开更多
Pancreatic vipoma is an extremely rare tumor accounting for less than 2% of endocrine pancreatic neoplasms with a reported incidence of 0.1-0.6 per million. While cross-sectional imaging findings are usually not speci...Pancreatic vipoma is an extremely rare tumor accounting for less than 2% of endocrine pancreatic neoplasms with a reported incidence of 0.1-0.6 per million. While cross-sectional imaging findings are usually not specific, exact localization of the tumor by means of either computed tomography(CT) or magnetic resonance(MR) is pivotal for surgical planning. However, cross-sectional imaging findings are usually not specific and further characterization of the tumor may only be achieved bysomatostatin-receptor scintigraphy(SRS). We report the case of a 70 years old female with a two years history of watery diarrhoea who was found to have a solid, inhomogeneously enhancing lesion at the level of the pancreatic tail at Gadolinium-enhanced MR(Somatom Trio 3T, Siemens, Germany). The tumor had been prospectively overlooked at a contrast-enhanced multi-detector CT(Aquilion 64, Toshiba, Japan) performed after i.v. bolus injection of only 100 cc of iodinated non ionic contrast media because of a chronic renal failure(3.4 mg/mL) but it was subsequently confirmed by SRS. The patient first underwent a successful symptomatic treatment with somatostatin analogues and was then submitted to a distal pancreasectomy with splenectomy to remove a capsulated whitish tumor which turned out to be a well-differentiated vipoma at histological and immuno-histochemical analysis.展开更多
文摘Intestinal duplication is an uncommon congenital abnormality, with potential life-threatening complications, usually manifesting in childhood. Due to its non-specific clinical presentation as well as its resemblance to other abdominal processes at imaging, the differential diagnosis may be very difficult. This case report describes a young female adult accessed twice to our Emergency Department with recurrent pain in the right iliac fossa and a clinical picture of abdominal pain and bowel obstruction, who was finally diagnosed with complicated duplication cyst, then resected. The diagnostic tools performed show the simple duplication cyst at the beginning, in the ileocecal region, with the characteristic “gut signature” at Ultrasound and its subsequent inflammatory changing at Computed Tomography, which led to the right diagnostic hypothesis, confirmed by histopathology. An early diagnosis of this condition is needed to undertake the correct surgical approach.
文摘We report a case of a 92-year-old man complaining of epigastric pain, which an US first and a CT scan later revealed to be related to a large gallstone causing cholecystitis. After the patient had refused surgical treatment for this condition, he was again referred to our Emergency Department presenting with a clinical picture of gastric obstruction. A new CT scan showed the classic Rigler’s triad, characterized by pneumobilia, gastric distension and gallstone in the duodenal lumen, which was pathognomonic for a rare form of gallstone ileus named Bouveret’s syndrome. The cause of this event was found out to be the chronic inflammation of gallbladder wall and its consequent erosion, which led to formation of gallbladder-duodenum fistula and the movement of the gallstone from the gallbladder to the duodenum where it impacted. This is a high morbidity and mortality condition, which affects mostly elderly people and needs early diagnosis and surgical treatment.
文摘Contrast medium induced nephropathy is the third most common cause of renal failure for inpatients and represents the 10% of all acute kidney injury occurring during hospital-stay. It is associated with prolonged hospitalization, cost increase and, above all, an unfavourable short- and long-term prognosis. Here, the authors discuss about the contrast medium induced nephropathy prevention strategies, from the identification of patients at risk and drugs potentially nephrotoxic, to the hydration with possible administration of drugs that appeared to be, in some contexts, nephron-protective, and finally we analyze the radiological procedure aimed at the correct choice of type and administration modality of the contrast medium according to current literature.
文摘This is a report of a case of cystic hygroma of the neck in a female child. Cystic hygroma is a rare congenital malformation of the lymphatic system, most frequently detected in the head and neck region. Ultrasound is considered as being the first level study to investigate a suspected mass suggestive of cystic hygroma. The Authors describe the main diagnostic ultrasound features for this type of lymphatic lesion.
文摘Pancreatic vipoma is an extremely rare tumor accounting for less than 2% of endocrine pancreatic neoplasms with a reported incidence of 0.1-0.6 per million. While cross-sectional imaging findings are usually not specific, exact localization of the tumor by means of either computed tomography(CT) or magnetic resonance(MR) is pivotal for surgical planning. However, cross-sectional imaging findings are usually not specific and further characterization of the tumor may only be achieved bysomatostatin-receptor scintigraphy(SRS). We report the case of a 70 years old female with a two years history of watery diarrhoea who was found to have a solid, inhomogeneously enhancing lesion at the level of the pancreatic tail at Gadolinium-enhanced MR(Somatom Trio 3T, Siemens, Germany). The tumor had been prospectively overlooked at a contrast-enhanced multi-detector CT(Aquilion 64, Toshiba, Japan) performed after i.v. bolus injection of only 100 cc of iodinated non ionic contrast media because of a chronic renal failure(3.4 mg/mL) but it was subsequently confirmed by SRS. The patient first underwent a successful symptomatic treatment with somatostatin analogues and was then submitted to a distal pancreasectomy with splenectomy to remove a capsulated whitish tumor which turned out to be a well-differentiated vipoma at histological and immuno-histochemical analysis.
